TRUSTEES OF SHOPMENS LOCAL UNION NO. 508 HEALTH & WELFARE FUND has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SHOPMEN'S LOCAL UNION NO. 508 HEALTH & WELFARE PLAN
401k plan membership statisitcs for SHOPMEN'S LOCAL UNION NO. 508 HEALTH & WELFARE PLAN
| Measure | Date | Value |
|---|
| 2023 : SHOPMEN'S LOCAL UNION NO. 508 HEALTH & WELFARE PLAN 2023 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2023-05-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-05-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-05-31 | $0 |
| Total income from all sources (including contributions) | 2023-05-31 | $494,119 |
| Total loss/gain on sale of assets | 2023-05-31 | $0 |
| Total of all expenses incurred | 2023-05-31 | $649,621 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2023-05-31 | $468,935 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2023-05-31 | $466,586 |
| Value of total assets at end of year | 2023-05-31 | $2,165,184 |
| Value of total assets at beginning of year | 2023-05-31 | $2,320,686 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2023-05-31 | $180,686 |
| Total interest from all sources | 2023-05-31 | $27,533 |
| Total dividends received (eg from common stock, registered investment company shares) | 2023-05-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2023-05-31 | No |
| Administrative expenses professional fees incurred | 2023-05-31 | $30,241 |
| Was this plan covered by a fidelity bond | 2023-05-31 | Yes |
| Value of fidelity bond cover | 2023-05-31 | $250,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2023-05-31 | No |
| Contributions received from participants | 2023-05-31 | $481 |
| Assets. Other investments not covered elsewhere at end of year | 2023-05-31 | $8,628 |
| Assets. Other investments not covered elsewhere at beginning of year | 2023-05-31 | $2,249 |
| Administrative expenses (other) incurred | 2023-05-31 | $150,445 |
| Total non interest bearing cash at end of year | 2023-05-31 | $163,832 |
| Total non interest bearing cash at beginning of year | 2023-05-31 | $130,823 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-05-31 | No |
| Value of net income/loss | 2023-05-31 | $-155,502 |
| Value of net assets at end of year (total assets less liabilities) | 2023-05-31 | $2,165,184 |
| Value of net assets at beginning of year (total assets less liabilities) | 2023-05-31 | $2,320,686 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2023-05-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2023-05-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2023-05-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2023-05-31 | $1,932,220 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2023-05-31 | $2,149,267 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2023-05-31 | $2,149,267 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2023-05-31 | $27,533 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2023-05-31 | $468,435 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2023-05-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2023-05-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2023-05-31 | No |
| Contributions received in cash from employer | 2023-05-31 | $466,105 |
| Employer contributions (assets) at end of year | 2023-05-31 | $51,689 |
| Employer contributions (assets) at beginning of year | 2023-05-31 | $38,347 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2023-05-31 | $500 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2023-05-31 | $8,815 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2023-05-31 | $0 |
| Did the plan have assets held for investment | 2023-05-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-05-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2023-05-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2023-05-31 | Unqualified |
| Accountancy firm name | 2023-05-31 | PLANTE & MORAN, PLLC |
| Accountancy firm EIN | 2023-05-31 | 381357951 |
| 2022 : SHOPMEN'S LOCAL UNION NO. 508 HEALTH & WELFARE PLAN 2022 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2022-05-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-05-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-05-31 | $0 |
| Total income from all sources (including contributions) | 2022-05-31 | $506,266 |
| Total loss/gain on sale of assets | 2022-05-31 | $0 |
| Total of all expenses incurred | 2022-05-31 | $592,549 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-05-31 | $430,326 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-05-31 | $523,600 |
| Value of total assets at end of year | 2022-05-31 | $2,320,686 |
| Value of total assets at beginning of year | 2022-05-31 | $2,406,969 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-05-31 | $162,223 |
| Total interest from all sources | 2022-05-31 | $-17,334 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-05-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-05-31 | No |
| Administrative expenses professional fees incurred | 2022-05-31 | $26,988 |
| Was this plan covered by a fidelity bond | 2022-05-31 | Yes |
| Value of fidelity bond cover | 2022-05-31 | $250,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2022-05-31 | No |
| Contributions received from participants | 2022-05-31 | $1,065 |
| Assets. Other investments not covered elsewhere at end of year | 2022-05-31 | $2,249 |
| Assets. Other investments not covered elsewhere at beginning of year | 2022-05-31 | $2,415 |
| Administrative expenses (other) incurred | 2022-05-31 | $135,235 |
| Total non interest bearing cash at end of year | 2022-05-31 | $130,823 |
| Total non interest bearing cash at beginning of year | 2022-05-31 | $261,289 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-05-31 | No |
| Value of net income/loss | 2022-05-31 | $-86,283 |
| Value of net assets at end of year (total assets less liabilities) | 2022-05-31 | $2,320,686 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-05-31 | $2,406,969 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-05-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-05-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-05-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-05-31 | $2,149,267 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-05-31 | $2,092,618 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-05-31 | $2,092,618 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-05-31 | $-17,334 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-05-31 | $429,776 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-05-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2022-05-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-05-31 | No |
| Contributions received in cash from employer | 2022-05-31 | $522,535 |
| Employer contributions (assets) at end of year | 2022-05-31 | $38,347 |
| Employer contributions (assets) at beginning of year | 2022-05-31 | $50,647 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-05-31 | $550 |
| Did the plan have assets held for investment | 2022-05-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-05-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-05-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2022-05-31 | Unqualified |
| Accountancy firm name | 2022-05-31 | PLANTE & MORAN, PLLC |
| Accountancy firm EIN | 2022-05-31 | 381357951 |
| 2021 : SHOPMEN'S LOCAL UNION NO. 508 HEALTH & WELFARE PLAN 2021 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2021-05-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-05-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-05-31 | $0 |
| Total income from all sources (including contributions) | 2021-05-31 | $539,529 |
| Total loss/gain on sale of assets | 2021-05-31 | $0 |
| Total of all expenses incurred | 2021-05-31 | $547,673 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-05-31 | $413,482 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-05-31 | $534,844 |
| Value of total assets at end of year | 2021-05-31 | $2,406,969 |
| Value of total assets at beginning of year | 2021-05-31 | $2,415,113 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-05-31 | $134,191 |
| Total interest from all sources | 2021-05-31 | $3,221 |
| Total dividends received (eg from common stock, registered investment company shares) | 2021-05-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-05-31 | No |
| Administrative expenses professional fees incurred | 2021-05-31 | $22,614 |
| Was this plan covered by a fidelity bond | 2021-05-31 | Yes |
| Value of fidelity bond cover | 2021-05-31 | $250,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2021-05-31 | No |
| Contributions received from participants | 2021-05-31 | $2,146 |
| Assets. Other investments not covered elsewhere at end of year | 2021-05-31 | $2,415 |
| Assets. Other investments not covered elsewhere at beginning of year | 2021-05-31 | $2,099 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2021-05-31 | $0 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2021-05-31 | $0 |
| Other income not declared elsewhere | 2021-05-31 | $1,464 |
| Administrative expenses (other) incurred | 2021-05-31 | $111,577 |
| Total non interest bearing cash at end of year | 2021-05-31 | $261,289 |
| Total non interest bearing cash at beginning of year | 2021-05-31 | $473,819 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-05-31 | No |
| Value of net income/loss | 2021-05-31 | $-8,144 |
| Value of net assets at end of year (total assets less liabilities) | 2021-05-31 | $2,406,969 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-05-31 | $2,415,113 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-05-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-05-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-05-31 | No |
| Investment advisory and management fees | 2021-05-31 | $0 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-05-31 | $2,092,618 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-05-31 | $1,892,650 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-05-31 | $1,892,650 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-05-31 | $3,221 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-05-31 | $413,207 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-05-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2021-05-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-05-31 | No |
| Contributions received in cash from employer | 2021-05-31 | $532,698 |
| Employer contributions (assets) at end of year | 2021-05-31 | $50,647 |
| Employer contributions (assets) at beginning of year | 2021-05-31 | $46,545 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-05-31 | $275 |
| Contract administrator fees | 2021-05-31 | $0 |
| Did the plan have assets held for investment | 2021-05-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-05-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-05-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2021-05-31 | Unqualified |
| Accountancy firm name | 2021-05-31 | PLANTE & MORAN, PLLC |
| Accountancy firm EIN | 2021-05-31 | 381357951 |
| 2020 : SHOPMEN'S LOCAL UNION NO. 508 HEALTH & WELFARE PLAN 2020 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2020-05-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-05-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-05-31 | $1,347 |
| Total income from all sources (including contributions) | 2020-05-31 | $599,771 |
| Total loss/gain on sale of assets | 2020-05-31 | $0 |
| Total of all expenses incurred | 2020-05-31 | $593,121 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-05-31 | $437,249 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-05-31 | $550,407 |
| Value of total assets at end of year | 2020-05-31 | $2,415,113 |
| Value of total assets at beginning of year | 2020-05-31 | $2,409,810 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-05-31 | $155,872 |
| Total interest from all sources | 2020-05-31 | $47,810 |
| Total dividends received (eg from common stock, registered investment company shares) | 2020-05-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-05-31 | No |
| Administrative expenses professional fees incurred | 2020-05-31 | $25,474 |
| Was this plan covered by a fidelity bond | 2020-05-31 | Yes |
| Value of fidelity bond cover | 2020-05-31 | $250,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2020-05-31 | No |
| Contributions received from participants | 2020-05-31 | $1,170 |
| Assets. Other investments not covered elsewhere at end of year | 2020-05-31 | $2,099 |
| Assets. Other investments not covered elsewhere at beginning of year | 2020-05-31 | $4,475 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2020-05-31 | $0 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-05-31 | $1,347 |
| Other income not declared elsewhere | 2020-05-31 | $1,554 |
| Administrative expenses (other) incurred | 2020-05-31 | $130,398 |
| Total non interest bearing cash at end of year | 2020-05-31 | $473,819 |
| Total non interest bearing cash at beginning of year | 2020-05-31 | $244,504 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-05-31 | No |
| Value of net income/loss | 2020-05-31 | $6,650 |
| Value of net assets at end of year (total assets less liabilities) | 2020-05-31 | $2,415,113 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-05-31 | $2,408,463 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-05-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-05-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-05-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-05-31 | $1,892,650 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-05-31 | $2,101,431 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-05-31 | $2,101,431 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-05-31 | $47,810 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-05-31 | $436,624 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-05-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2020-05-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-05-31 | No |
| Contributions received in cash from employer | 2020-05-31 | $549,237 |
| Employer contributions (assets) at end of year | 2020-05-31 | $46,545 |
| Employer contributions (assets) at beginning of year | 2020-05-31 | $59,400 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-05-31 | $625 |
| Did the plan have assets held for investment | 2020-05-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-05-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-05-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2020-05-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2020-05-31 | Unqualified |
| Accountancy firm name | 2020-05-31 | PLANTE & MORAN, PLLC |
| Accountancy firm EIN | 2020-05-31 | 381357951 |
| 2019 : SHOPMEN'S LOCAL UNION NO. 508 HEALTH & WELFARE PLAN 2019 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2019-05-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-05-31 | $1,347 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-05-31 | $6,078 |
| Total income from all sources (including contributions) | 2019-05-31 | $726,524 |
| Total loss/gain on sale of assets | 2019-05-31 | $0 |
| Total of all expenses incurred | 2019-05-31 | $596,429 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-05-31 | $448,681 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-05-31 | $688,255 |
| Value of total assets at end of year | 2019-05-31 | $2,409,810 |
| Value of total assets at beginning of year | 2019-05-31 | $2,284,446 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-05-31 | $147,748 |
| Total interest from all sources | 2019-05-31 | $19,577 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-05-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-05-31 | No |
| Administrative expenses professional fees incurred | 2019-05-31 | $28,192 |
| Was this plan covered by a fidelity bond | 2019-05-31 | Yes |
| Value of fidelity bond cover | 2019-05-31 | $250,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2019-05-31 | No |
| Contributions received from participants | 2019-05-31 | $1,317 |
| Assets. Other investments not covered elsewhere at end of year | 2019-05-31 | $4,475 |
| Assets. Other investments not covered elsewhere at beginning of year | 2019-05-31 | $7,026 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2019-05-31 | $1,347 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2019-05-31 | $6,078 |
| Other income not declared elsewhere | 2019-05-31 | $18,692 |
| Administrative expenses (other) incurred | 2019-05-31 | $119,556 |
| Total non interest bearing cash at end of year | 2019-05-31 | $244,504 |
| Total non interest bearing cash at beginning of year | 2019-05-31 | $106,196 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-05-31 | No |
| Value of net income/loss | 2019-05-31 | $130,095 |
| Value of net assets at end of year (total assets less liabilities) | 2019-05-31 | $2,408,463 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-05-31 | $2,278,368 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-05-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-05-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-05-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-05-31 | $2,101,431 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-05-31 | $2,101,256 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-05-31 | $2,101,256 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-05-31 | $19,577 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-05-31 | $448,581 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-05-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2019-05-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-05-31 | No |
| Contributions received in cash from employer | 2019-05-31 | $686,938 |
| Employer contributions (assets) at end of year | 2019-05-31 | $59,400 |
| Employer contributions (assets) at beginning of year | 2019-05-31 | $69,968 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-05-31 | $100 |
| Did the plan have assets held for investment | 2019-05-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-05-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-05-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-05-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-05-31 | Unqualified |
| Accountancy firm name | 2019-05-31 | PLANTE & MORAN, PLLC |
| Accountancy firm EIN | 2019-05-31 | 381357951 |
| 2018 : SHOPMEN'S LOCAL UNION NO. 508 HEALTH & WELFARE PLAN 2018 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2018-05-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-05-31 | $6,078 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-05-31 | $7,065 |
| Total income from all sources (including contributions) | 2018-05-31 | $742,265 |
| Total loss/gain on sale of assets | 2018-05-31 | $0 |
| Total of all expenses incurred | 2018-05-31 | $582,683 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-05-31 | $430,799 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-05-31 | $736,803 |
| Value of total assets at end of year | 2018-05-31 | $2,284,446 |
| Value of total assets at beginning of year | 2018-05-31 | $2,125,851 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-05-31 | $151,884 |
| Total interest from all sources | 2018-05-31 | $4,251 |
| Total dividends received (eg from common stock, registered investment company shares) | 2018-05-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-05-31 | No |
| Administrative expenses professional fees incurred | 2018-05-31 | $21,925 |
| Was this plan covered by a fidelity bond | 2018-05-31 | Yes |
| Value of fidelity bond cover | 2018-05-31 | $190,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2018-05-31 | No |
| Contributions received from participants | 2018-05-31 | $2,953 |
| Assets. Other investments not covered elsewhere at end of year | 2018-05-31 | $7,026 |
| Assets. Other investments not covered elsewhere at beginning of year | 2018-05-31 | $23,774 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2018-05-31 | $6,078 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2018-05-31 | $7,065 |
| Other income not declared elsewhere | 2018-05-31 | $1,211 |
| Administrative expenses (other) incurred | 2018-05-31 | $129,959 |
| Total non interest bearing cash at end of year | 2018-05-31 | $106,196 |
| Total non interest bearing cash at beginning of year | 2018-05-31 | $408,957 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-05-31 | No |
| Value of net income/loss | 2018-05-31 | $159,582 |
| Value of net assets at end of year (total assets less liabilities) | 2018-05-31 | $2,278,368 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-05-31 | $2,118,786 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-05-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-05-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-05-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-05-31 | $2,101,256 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-05-31 | $1,627,005 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-05-31 | $1,627,005 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-05-31 | $4,251 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-05-31 | $430,799 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-05-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2018-05-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-05-31 | No |
| Contributions received in cash from employer | 2018-05-31 | $733,850 |
| Employer contributions (assets) at end of year | 2018-05-31 | $69,968 |
| Employer contributions (assets) at beginning of year | 2018-05-31 | $66,115 |
| Did the plan have assets held for investment | 2018-05-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-05-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-05-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-05-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-05-31 | Unqualified |
| Accountancy firm name | 2018-05-31 | PLANTE & MORAN, PLLC |
| Accountancy firm EIN | 2018-05-31 | 381357951 |
| 2017 : SHOPMEN'S LOCAL UNION NO. 508 HEALTH & WELFARE PLAN 2017 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2017-05-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-05-31 | $7,065 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-05-31 | $2 |
| Total income from all sources (including contributions) | 2017-05-31 | $948,056 |
| Total loss/gain on sale of assets | 2017-05-31 | $0 |
| Total of all expenses incurred | 2017-05-31 | $728,562 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-05-31 | $554,491 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-05-31 | $942,211 |
| Value of total assets at end of year | 2017-05-31 | $2,125,851 |
| Value of total assets at beginning of year | 2017-05-31 | $1,899,294 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-05-31 | $174,071 |
| Total interest from all sources | 2017-05-31 | $5,805 |
| Total dividends received (eg from common stock, registered investment company shares) | 2017-05-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-05-31 | No |
| Administrative expenses professional fees incurred | 2017-05-31 | $24,062 |
| Was this plan covered by a fidelity bond | 2017-05-31 | Yes |
| Value of fidelity bond cover | 2017-05-31 | $190,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2017-05-31 | No |
| Contributions received from participants | 2017-05-31 | $2,515 |
| Assets. Other investments not covered elsewhere at end of year | 2017-05-31 | $23,774 |
| Assets. Other investments not covered elsewhere at beginning of year | 2017-05-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-05-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-05-31 | $70,280 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2017-05-31 | $7,065 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2017-05-31 | $2 |
| Other income not declared elsewhere | 2017-05-31 | $40 |
| Administrative expenses (other) incurred | 2017-05-31 | $150,009 |
| Total non interest bearing cash at end of year | 2017-05-31 | $408,957 |
| Total non interest bearing cash at beginning of year | 2017-05-31 | $182,106 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-05-31 | No |
| Value of net income/loss | 2017-05-31 | $219,494 |
| Value of net assets at end of year (total assets less liabilities) | 2017-05-31 | $2,118,786 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-05-31 | $1,899,292 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-05-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-05-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-05-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-05-31 | $1,627,005 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-05-31 | $1,529,773 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-05-31 | $1,529,773 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-05-31 | $5,805 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-05-31 | $554,491 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-05-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2017-05-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-05-31 | No |
| Contributions received in cash from employer | 2017-05-31 | $939,696 |
| Employer contributions (assets) at end of year | 2017-05-31 | $66,115 |
| Employer contributions (assets) at beginning of year | 2017-05-31 | $117,135 |
| Did the plan have assets held for investment | 2017-05-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-05-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-05-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-05-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-05-31 | Unqualified |
| Accountancy firm name | 2017-05-31 | PLANTE & MORAN, PLLC |
| Accountancy firm EIN | 2017-05-31 | 381357951 |
| 2016 : SHOPMEN'S LOCAL UNION NO. 508 HEALTH & WELFARE PLAN 2016 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2016-05-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-05-31 | $2 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-05-31 | $7,673 |
| Total income from all sources (including contributions) | 2016-05-31 | $1,105,565 |
| Total loss/gain on sale of assets | 2016-05-31 | $0 |
| Total of all expenses incurred | 2016-05-31 | $784,497 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-05-31 | $655,517 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-05-31 | $1,099,221 |
| Value of total assets at end of year | 2016-05-31 | $1,899,294 |
| Value of total assets at beginning of year | 2016-05-31 | $1,585,897 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-05-31 | $128,980 |
| Total interest from all sources | 2016-05-31 | $5,431 |
| Total dividends received (eg from common stock, registered investment company shares) | 2016-05-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-05-31 | No |
| Administrative expenses professional fees incurred | 2016-05-31 | $23,837 |
| Was this plan covered by a fidelity bond | 2016-05-31 | Yes |
| Value of fidelity bond cover | 2016-05-31 | $190,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2016-05-31 | No |
| Contributions received from participants | 2016-05-31 | $3,020 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-05-31 | $70,280 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-05-31 | $52,391 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2016-05-31 | $2 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2016-05-31 | $7,673 |
| Other income not declared elsewhere | 2016-05-31 | $913 |
| Administrative expenses (other) incurred | 2016-05-31 | $105,143 |
| Total non interest bearing cash at end of year | 2016-05-31 | $182,106 |
| Total non interest bearing cash at beginning of year | 2016-05-31 | $211,862 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-05-31 | No |
| Value of net income/loss | 2016-05-31 | $321,068 |
| Value of net assets at end of year (total assets less liabilities) | 2016-05-31 | $1,899,292 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-05-31 | $1,578,224 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-05-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-05-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-05-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-05-31 | $1,529,773 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-05-31 | $1,192,346 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-05-31 | $1,192,346 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-05-31 | $5,431 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-05-31 | $655,517 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-05-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2016-05-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-05-31 | No |
| Contributions received in cash from employer | 2016-05-31 | $1,096,201 |
| Employer contributions (assets) at end of year | 2016-05-31 | $117,135 |
| Employer contributions (assets) at beginning of year | 2016-05-31 | $129,298 |
| Did the plan have assets held for investment | 2016-05-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-05-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-05-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-05-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-05-31 | Unqualified |
| Accountancy firm name | 2016-05-31 | PLANTE & MORAN, PLLC |
| Accountancy firm EIN | 2016-05-31 | 381357951 |
| 2015 : SHOPMEN'S LOCAL UNION NO. 508 HEALTH & WELFARE PLAN 2015 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2015-05-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-05-31 | $7,673 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-05-31 | $7,167 |
| Total income from all sources (including contributions) | 2015-05-31 | $1,109,637 |
| Total loss/gain on sale of assets | 2015-05-31 | $0 |
| Total of all expenses incurred | 2015-05-31 | $736,359 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-05-31 | $603,699 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-05-31 | $1,103,522 |
| Value of total assets at end of year | 2015-05-31 | $1,585,897 |
| Value of total assets at beginning of year | 2015-05-31 | $1,212,113 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-05-31 | $132,660 |
| Total interest from all sources | 2015-05-31 | $6,115 |
| Total dividends received (eg from common stock, registered investment company shares) | 2015-05-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-05-31 | No |
| Administrative expenses professional fees incurred | 2015-05-31 | $24,760 |
| Was this plan covered by a fidelity bond | 2015-05-31 | Yes |
| Value of fidelity bond cover | 2015-05-31 | $190,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2015-05-31 | No |
| Income. Received or receivable in cash from other sources (including rollovers) | 2015-05-31 | $4,992 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-05-31 | $52,391 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-05-31 | $46,863 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2015-05-31 | $7,673 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2015-05-31 | $7,167 |
| Administrative expenses (other) incurred | 2015-05-31 | $107,900 |
| Total non interest bearing cash at end of year | 2015-05-31 | $211,862 |
| Total non interest bearing cash at beginning of year | 2015-05-31 | $87,651 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-05-31 | No |
| Value of net income/loss | 2015-05-31 | $373,278 |
| Value of net assets at end of year (total assets less liabilities) | 2015-05-31 | $1,578,224 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-05-31 | $1,204,946 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-05-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-05-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-05-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-05-31 | $1,192,346 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-05-31 | $977,505 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-05-31 | $977,505 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-05-31 | $6,115 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-05-31 | $603,699 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-05-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2015-05-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-05-31 | No |
| Contributions received in cash from employer | 2015-05-31 | $1,098,530 |
| Employer contributions (assets) at end of year | 2015-05-31 | $129,298 |
| Employer contributions (assets) at beginning of year | 2015-05-31 | $100,094 |
| Did the plan have assets held for investment | 2015-05-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-05-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-05-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-05-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-05-31 | Unqualified |
| Accountancy firm name | 2015-05-31 | PLANTE & MORAN, PLLC |
| Accountancy firm EIN | 2015-05-31 | 381357951 |
| 2014 : SHOPMEN'S LOCAL UNION NO. 508 HEALTH & WELFARE PLAN 2014 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2014-05-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-05-31 | $7,167 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-05-31 | $1,539 |
| Total income from all sources (including contributions) | 2014-05-31 | $966,542 |
| Total loss/gain on sale of assets | 2014-05-31 | $0 |
| Total of all expenses incurred | 2014-05-31 | $707,519 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-05-31 | $567,301 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-05-31 | $965,359 |
| Value of total assets at end of year | 2014-05-31 | $1,212,113 |
| Value of total assets at beginning of year | 2014-05-31 | $947,462 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-05-31 | $140,218 |
| Total interest from all sources | 2014-05-31 | $1,183 |
| Total dividends received (eg from common stock, registered investment company shares) | 2014-05-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-05-31 | No |
| Administrative expenses professional fees incurred | 2014-05-31 | $24,457 |
| Was this plan covered by a fidelity bond | 2014-05-31 | Yes |
| Value of fidelity bond cover | 2014-05-31 | $190,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2014-05-31 | No |
| Income. Received or receivable in cash from other sources (including rollovers) | 2014-05-31 | $4,847 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-05-31 | $46,863 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-05-31 | $13,975 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2014-05-31 | $7,167 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2014-05-31 | $1,539 |
| Administrative expenses (other) incurred | 2014-05-31 | $115,761 |
| Total non interest bearing cash at end of year | 2014-05-31 | $87,651 |
| Total non interest bearing cash at beginning of year | 2014-05-31 | $182,299 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-05-31 | No |
| Value of net income/loss | 2014-05-31 | $259,023 |
| Value of net assets at end of year (total assets less liabilities) | 2014-05-31 | $1,204,946 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-05-31 | $945,923 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-05-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-05-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-05-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-05-31 | $977,505 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-05-31 | $650,838 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-05-31 | $650,838 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-05-31 | $1,183 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-05-31 | $567,301 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-05-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2014-05-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-05-31 | No |
| Contributions received in cash from employer | 2014-05-31 | $960,512 |
| Employer contributions (assets) at end of year | 2014-05-31 | $100,094 |
| Employer contributions (assets) at beginning of year | 2014-05-31 | $100,350 |
| Did the plan have assets held for investment | 2014-05-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-05-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-05-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-05-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-05-31 | Unqualified |
| Accountancy firm name | 2014-05-31 | PLANTE & MORAN, PLLC |
| Accountancy firm EIN | 2014-05-31 | 381357951 |
| 2013 : SHOPMEN'S LOCAL UNION NO. 508 HEALTH & WELFARE PLAN 2013 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2013-05-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-05-31 | $1,539 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-05-31 | $26,854 |
| Total income from all sources (including contributions) | 2013-05-31 | $1,035,460 |
| Total loss/gain on sale of assets | 2013-05-31 | $0 |
| Total of all expenses incurred | 2013-05-31 | $657,624 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-05-31 | $528,792 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-05-31 | $989,441 |
| Value of total assets at end of year | 2013-05-31 | $947,462 |
| Value of total assets at beginning of year | 2013-05-31 | $594,941 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-05-31 | $128,832 |
| Total interest from all sources | 2013-05-31 | $1,160 |
| Total dividends received (eg from common stock, registered investment company shares) | 2013-05-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-05-31 | No |
| Administrative expenses professional fees incurred | 2013-05-31 | $23,194 |
| Was this plan covered by a fidelity bond | 2013-05-31 | Yes |
| Value of fidelity bond cover | 2013-05-31 | $190,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2013-05-31 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-05-31 | $13,975 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-05-31 | $9,300 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2013-05-31 | $1,539 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2013-05-31 | $26,854 |
| Other income not declared elsewhere | 2013-05-31 | $44,859 |
| Administrative expenses (other) incurred | 2013-05-31 | $105,638 |
| Total non interest bearing cash at end of year | 2013-05-31 | $182,299 |
| Total non interest bearing cash at beginning of year | 2013-05-31 | $154,279 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-05-31 | No |
| Value of net income/loss | 2013-05-31 | $377,836 |
| Value of net assets at end of year (total assets less liabilities) | 2013-05-31 | $945,923 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-05-31 | $568,087 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-05-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-05-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-05-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-05-31 | $650,838 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-05-31 | $347,669 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-05-31 | $347,669 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-05-31 | $1,160 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-05-31 | $528,792 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-05-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2013-05-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-05-31 | No |
| Contributions received in cash from employer | 2013-05-31 | $989,441 |
| Employer contributions (assets) at end of year | 2013-05-31 | $100,350 |
| Employer contributions (assets) at beginning of year | 2013-05-31 | $83,693 |
| Did the plan have assets held for investment | 2013-05-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-05-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-05-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-05-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-05-31 | Unqualified |
| Accountancy firm name | 2013-05-31 | PLANTE & MORAN, PLLC |
| Accountancy firm EIN | 2013-05-31 | 381357951 |
| 2012 : SHOPMEN'S LOCAL UNION NO. 508 HEALTH & WELFARE PLAN 2012 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2012-05-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-05-31 | $26,854 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-05-31 | $24,730 |
| Total income from all sources (including contributions) | 2012-05-31 | $905,326 |
| Total loss/gain on sale of assets | 2012-05-31 | $0 |
| Total of all expenses incurred | 2012-05-31 | $757,475 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-05-31 | $619,516 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-05-31 | $904,380 |
| Value of total assets at end of year | 2012-05-31 | $594,941 |
| Value of total assets at beginning of year | 2012-05-31 | $444,966 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-05-31 | $137,959 |
| Total interest from all sources | 2012-05-31 | $946 |
| Total dividends received (eg from common stock, registered investment company shares) | 2012-05-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-05-31 | No |
| Administrative expenses professional fees incurred | 2012-05-31 | $25,441 |
| Was this plan covered by a fidelity bond | 2012-05-31 | Yes |
| Value of fidelity bond cover | 2012-05-31 | $190,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2012-05-31 | No |
| Income. Received or receivable in cash from other sources (including rollovers) | 2012-05-31 | $4,563 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2012-05-31 | $388,018 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-05-31 | $9,300 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-05-31 | $102,751 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2012-05-31 | $26,854 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2012-05-31 | $24,730 |
| Administrative expenses (other) incurred | 2012-05-31 | $112,518 |
| Liabilities. Value of operating payables at beginning of year | 2012-05-31 | $0 |
| Total non interest bearing cash at end of year | 2012-05-31 | $154,279 |
| Total non interest bearing cash at beginning of year | 2012-05-31 | $220,745 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-05-31 | No |
| Value of net income/loss | 2012-05-31 | $147,851 |
| Value of net assets at end of year (total assets less liabilities) | 2012-05-31 | $568,087 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-05-31 | $420,236 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-05-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-05-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-05-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-05-31 | $347,669 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-05-31 | $47,000 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-05-31 | $47,000 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-05-31 | $946 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-05-31 | $231,498 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-05-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2012-05-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-05-31 | No |
| Contributions received in cash from employer | 2012-05-31 | $899,817 |
| Employer contributions (assets) at end of year | 2012-05-31 | $83,693 |
| Employer contributions (assets) at beginning of year | 2012-05-31 | $74,470 |
| Did the plan have assets held for investment | 2012-05-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-05-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-05-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-05-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-05-31 | Unqualified |
| Accountancy firm name | 2012-05-31 | PLANTE & MORAN, PLLC |
| Accountancy firm EIN | 2012-05-31 | 381357951 |
| 2011 : SHOPMEN'S LOCAL UNION NO. 508 HEALTH & WELFARE PLAN 2011 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2011-05-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-05-31 | $24,730 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-05-31 | $208,724 |
| Total income from all sources (including contributions) | 2011-05-31 | $1,968,497 |
| Total loss/gain on sale of assets | 2011-05-31 | $0 |
| Total of all expenses incurred | 2011-05-31 | $1,917,733 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-05-31 | $1,772,070 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-05-31 | $1,967,849 |
| Value of total assets at end of year | 2011-05-31 | $444,966 |
| Value of total assets at beginning of year | 2011-05-31 | $578,196 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-05-31 | $145,663 |
| Total interest from all sources | 2011-05-31 | $648 |
| Total dividends received (eg from common stock, registered investment company shares) | 2011-05-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-05-31 | No |
| Administrative expenses professional fees incurred | 2011-05-31 | $40,454 |
| Was this plan covered by a fidelity bond | 2011-05-31 | Yes |
| Value of fidelity bond cover | 2011-05-31 | $400,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2011-05-31 | No |
| Income. Received or receivable in cash from other sources (including rollovers) | 2011-05-31 | $131,541 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2011-05-31 | $1,111,134 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-05-31 | $102,751 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-05-31 | $2,604 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2011-05-31 | $24,730 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2011-05-31 | $6,828 |
| Administrative expenses (other) incurred | 2011-05-31 | $105,209 |
| Liabilities. Value of operating payables at end of year | 2011-05-31 | $0 |
| Liabilities. Value of operating payables at beginning of year | 2011-05-31 | $201,896 |
| Total non interest bearing cash at end of year | 2011-05-31 | $220,745 |
| Total non interest bearing cash at beginning of year | 2011-05-31 | $508,313 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-05-31 | No |
| Value of net income/loss | 2011-05-31 | $50,764 |
| Value of net assets at end of year (total assets less liabilities) | 2011-05-31 | $420,236 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-05-31 | $369,472 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-05-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-05-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-05-31 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-05-31 | $47,000 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-05-31 | $0 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-05-31 | $0 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-05-31 | $648 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-05-31 | $660,936 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-05-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2011-05-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-05-31 | No |
| Contributions received in cash from employer | 2011-05-31 | $1,836,308 |
| Employer contributions (assets) at end of year | 2011-05-31 | $74,470 |
| Employer contributions (assets) at beginning of year | 2011-05-31 | $67,279 |
| Did the plan have assets held for investment | 2011-05-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-05-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-05-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-05-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-05-31 | Unqualified |
| Accountancy firm name | 2011-05-31 | PLANTE & MORAN, PLLC |
| Accountancy firm EIN | 2011-05-31 | 381357951 |
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 0009786 |
| Policy instance | 4 |
| Insurance contract or identification number | 0009786 | | Number of Individuals Covered | 532 | | Insurance policy start date | 2022-06-01 | | Insurance policy end date | 2023-05-31 | | 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 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 | Yes | | 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 | | 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 number | 12668-1 |
| Policy instance | 3 |
| Insurance contract or identification number | 12668-1 | | Number of Individuals Covered | 574 | | Insurance policy start date | 2022-06-01 | | Insurance policy end date | 2023-05-31 | | 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 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 | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | HEARING | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30026500 |
| Policy instance | 2 |
| Insurance contract or identification number | 30026500 | | Number of Individuals Covered | 303 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | 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 | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G3212, C4482 |
| Policy instance | 1 |
| Insurance contract or identification number | G3212, C4482 | | Number of Individuals Covered | 346 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | 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 | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | 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 $189,897 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G3212, C4482 |
| Policy instance | 1 |
| Insurance contract or identification number | G3212, C4482 | | Number of Individuals Covered | 323 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | 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 | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | 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 $179,989 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30026500 |
| Policy instance | 3 |
| Insurance contract or identification number | 30026500 | | Number of Individuals Covered | 278 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | 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 | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 0009786 |
| Policy instance | 2 |
| Insurance contract or identification number | 0009786 | | Number of Individuals Covered | 502 | | Insurance policy start date | 2021-06-01 | | Insurance policy end date | 2022-05-31 | | 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 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 | Yes | | 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 | | 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 number | 12668-1 |
| Policy instance | 4 |
| Insurance contract or identification number | 12668-1 | | Number of Individuals Covered | 569 | | Insurance policy start date | 2021-06-01 | | Insurance policy end date | 2022-05-31 | | 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 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 | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | HEARING | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | 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 number | 12668-1 |
| Policy instance | 3 |
| Insurance contract or identification number | 12668-1 | | Number of Individuals Covered | 553 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2021-05-31 | | 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 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 | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | HEARING | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 0009786 |
| Policy instance | 1 |
| Insurance contract or identification number | 0009786 | | Number of Individuals Covered | 496 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2021-05-31 | | 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 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 | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30026500 |
| Policy instance | 2 |
| Insurance contract or identification number | 30026500 | | Number of Individuals Covered | 295 | | Insurance policy start date | 2020-06-01 | | Insurance policy end date | 2020-06-30 | | 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 | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G3212, C4482 |
| Policy instance | 4 |
| Insurance contract or identification number | G3212, C4482 | | Number of Individuals Covered | 338 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | 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 | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | 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 $189,219 | | 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 number | 12668-1 |
| Policy instance | 2 |
| Insurance contract or identification number | 12668-1 | | Number of Individuals Covered | 626 | | Insurance policy start date | 2019-06-01 | | Insurance policy end date | 2020-05-31 | | 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 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 | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | HEARING | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30026500 |
| Policy instance | 1 |
| Insurance contract or identification number | 30026500 | | Number of Individuals Covered | 297 | | Insurance policy start date | 2019-06-01 | | Insurance policy end date | 2020-05-31 | | 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 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 | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 0009786 |
| Policy instance | 4 |
| Insurance contract or identification number | 0009786 | | Number of Individuals Covered | 543 | | Insurance policy start date | 2019-06-01 | | Insurance policy end date | 2020-05-31 | | 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 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 | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G3212, C4482 |
| Policy instance | 3 |
| Insurance contract or identification number | G3212, C4482 | | Number of Individuals Covered | 349 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | 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 | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | 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 $190,236 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G3212, C4482 |
| Policy instance | 1 |
| Insurance contract or identification number | G3212, C4482 | | Number of Individuals Covered | 355 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | 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 | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | 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 $182,836 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 0009786 |
| Policy instance | 4 |
| Insurance contract or identification number | 0009786 | | Number of Individuals Covered | 528 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | 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 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 | Yes | | 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 | | 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 number | 12668-1 |
| Policy instance | 3 |
| Insurance contract or identification number | 12668-1 | | Number of Individuals Covered | 656 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | 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 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 | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | HEARING | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30026500 |
| Policy instance | 2 |
| Insurance contract or identification number | 30026500 | | Number of Individuals Covered | 292 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | 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 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 | Yes | | 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 | | 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 number | 12668-1 |
| Policy instance | 4 |
| Insurance contract or identification number | 12668-1 | | Number of Individuals Covered | 651 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-05-31 | | 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 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 | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | HEARING | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G3212, C4482 |
| Policy instance | 3 |
| Insurance contract or identification number | G3212, C4482 | | Number of Individuals Covered | 334 | | Insurance policy start date | 2016-07-01 | | Insurance policy end date | 2017-06-30 | | 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 | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT, DEATH BENEFIT | | 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 $213,107 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30026500 |
| Policy instance | 2 |
| Insurance contract or identification number | 30026500 | | Number of Individuals Covered | 311 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-05-31 | | 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 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 | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 0009786 |
| Policy instance | 1 |
| Insurance contract or identification number | 0009786 | | Number of Individuals Covered | 551 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-05-31 | | 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 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 | Yes | | 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 | | 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 number | 12668-1 |
| Policy instance | 4 |
| Insurance contract or identification number | 12668-1 | | Number of Individuals Covered | 1056 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-05-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | HEARING | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 0009786 |
| Policy instance | 2 |
| Insurance contract or identification number | 0009786 | | Number of Individuals Covered | 914 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-05-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G3212, C4482 |
| Policy instance | 3 |
| Insurance contract or identification number | G3212, C4482 | | Number of Individuals Covered | 556 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | 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 | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT, DEATH BENEFIT | | 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 $237,352 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30026500 |
| Policy instance | 1 |
| Insurance contract or identification number | 30026500 | | Number of Individuals Covered | 516 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $22,744 | | 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 | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 22744 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE EXPENSES | | Insurance broker organization code? | 5 | | Insurance broker name | VISION SERVICE PLAN |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 12668-1 |
| Policy instance | 2 |
| Insurance contract or identification number | 12668-1 | | Number of Individuals Covered | 1087 | | Insurance policy start date | 2014-06-01 | | Insurance policy end date | 2015-05-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | HEARING | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G3212, C4482 |
| Policy instance | 3 |
| Insurance contract or identification number | G3212, C4482 | | Number of Individuals Covered | 545 | | Insurance policy start date | 2014-06-01 | | Insurance policy end date | 2015-05-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT, DEATH BENEFIT | | 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 $196,322 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 0009786 |
| Policy instance | 4 |
| Insurance contract or identification number | 0009786 | | Number of Individuals Covered | 928 | | Insurance policy start date | 2014-06-01 | | Insurance policy end date | 2015-05-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30026500 |
| Policy instance | 1 |
| Insurance contract or identification number | 30026500 | | Number of Individuals Covered | 527 | | Insurance policy start date | 2014-06-01 | | Insurance policy end date | 2015-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $22,196 | | 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 | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 22196 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE EXPENSES | | Insurance broker organization code? | 5 | | Insurance broker name | VISION SERVICE PLAN |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 12668-1 |
| Policy instance | 2 |
| Insurance contract or identification number | 12668-1 | | Number of Individuals Covered | 1013 | | Insurance policy start date | 2013-06-01 | | Insurance policy end date | 2014-05-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | HEARING | | 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 $10,952 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G3212, C4482 |
| Policy instance | 3 |
| Insurance contract or identification number | G3212, C4482 | | Number of Individuals Covered | 506 | | Insurance policy start date | 2013-06-01 | | Insurance policy end date | 2014-05-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT, DEATH BENEFIT | | 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 $179,752 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 0009786 |
| Policy instance | 4 |
| Insurance contract or identification number | 0009786 | | Number of Individuals Covered | 898 | | Insurance policy start date | 2013-06-01 | | Insurance policy end date | 2014-05-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30026500 |
| Policy instance | 1 |
| Insurance contract or identification number | 30026500 | | Number of Individuals Covered | 458 | | Insurance policy start date | 2013-06-01 | | Insurance policy end date | 2014-05-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $20,422 | | 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 | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 20422 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE EXPENSES | | Insurance broker organization code? | 5 | | Insurance broker name | VISION SERVICE PLAN |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30026500 |
| Policy instance | 1 |
| Insurance contract or identification number | 30026500 | | Number of Individuals Covered | 449 | | Insurance policy start date | 2012-06-01 | | Insurance policy end date | 2013-05-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | Yes | | 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 $65,941 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 0009786 |
| Policy instance | 4 |
| Insurance contract or identification number | 0009786 | | Number of Individuals Covered | 923 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-05-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G3212, C4482 |
| Policy instance | 3 |
| Insurance contract or identification number | G3212, C4482 | | Number of Individuals Covered | 489 | | Insurance policy start date | 2012-06-01 | | Insurance policy end date | 2013-05-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT, DEATH BENEFIT | | 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 $167,729 | | 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 number | 12668-1 |
| Policy instance | 2 |
| Insurance contract or identification number | 12668-1 | | Number of Individuals Covered | 1031 | | Insurance policy start date | 2012-06-01 | | Insurance policy end date | 2013-05-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | HEARING | | 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 $10,881 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30026500 |
| Policy instance | 1 |
| Insurance contract or identification number | 30026500 | | Number of Individuals Covered | 424 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-05-31 | | Total amount of commissions paid to insurance broker | USD $2,722 | | 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 | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | 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 $54,444 | | 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 number | 12668-1 |
| Policy instance | 2 |
| Insurance contract or identification number | 12668-1 | | Number of Individuals Covered | 963 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-05-31 | | Total amount of commissions paid to insurance broker | USD $1,086 | | 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 | No | | 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 | | Other welfare benefits provided | HEARING | | 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 $9,869 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | G3212, C4482 |
| Policy instance | 3 |
| Insurance contract or identification number | G3212, C4482 | | Number of Individuals Covered | 456 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-05-31 | | 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 | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT, DEATH BENEFIT | | 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 $132,449 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ASSOCIATED MUTUAL (National Association of Insurance Commissioners NAIC id number: 87882 ) |
| Policy contract number | AM-8001 |
| Policy instance | 5 |
| Insurance contract or identification number | AM-8001 | | Number of Individuals Covered | 385 | | Insurance policy start date | 2011-06-01 | | Insurance policy end date | 2011-06-30 | | 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 | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT, HEARING | | 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 $16,794 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00253726/0001 |
| Policy instance | 4 |
| Insurance contract or identification number | 00253726/0001 | | Number of Individuals Covered | 38 | | Insurance policy start date | 2011-06-01 | | Insurance policy end date | 2011-07-31 | | Total amount of commissions paid to insurance broker | USD $763 | | 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 $17,942 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
| Policy contract number | 0009786 |
| Policy instance | 1 |
| Insurance contract or identification number | 0009786 | | Number of Individuals Covered | 751 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-05-31 | | Total amount of commissions paid to insurance broker | USD $6,410 | | 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 | No | | Dental Insurance Welfare Benefit | Yes | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,410 | | Insurance broker organization code? | 3 | | Insurance broker name | ROBERT G RUTH |
|
| ASSOCIATED MUTUAL (National Association of Insurance Commissioners NAIC id number: 87882 ) |
| Policy contract number | AM-8001 |
| Policy instance | 2 |
| Insurance contract or identification number | AM-8001 | | Number of Individuals Covered | 393 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-05-31 | | 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 | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT, HEARING | | 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 $185,388 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 58916 |
| Policy instance | 4 |
| Insurance contract or identification number | 58916 | | Number of Individuals Covered | 180 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-05-31 | | Total amount of commissions paid to insurance broker | USD $19,174 | | Total amount of fees paid to insurance company | USD $104,189 | | 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 | No | | 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 $101,029 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 104189 | | Additional information about fees paid to insurance broker | CLAIMS ADMINISTRATION | | Insurance broker organization code? | 5 | | Commission paid to Insurance Broker | USD $19,174 | | Insurance broker name | ROBERT G RUTH |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00253726/0001 |
| Policy instance | 3 |
| Insurance contract or identification number | 00253726/0001 | | Number of Individuals Covered | 39 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-05-31 | | Total amount of commissions paid to insurance broker | USD $6,904 | | 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 $158,460 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,904 | | Insurance broker organization code? | 3 | | Insurance broker name | ROBERT G RUTH |
|
