VERNE C. KNIGHT TRUST has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST
| Measure | Date | Value |
|---|
| 2023 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2023 401k financial data |
|---|
| Total income from all sources | 2023-12-31 | $26,061 |
| Expenses. Total of all expenses incurred | 2023-12-31 | $31,673 |
| Benefits paid (including direct rollovers) | 2023-12-31 | $8,760 |
| Total plan assets at end of year | 2023-12-31 | $1,631,535 |
| Total plan assets at beginning of year | 2023-12-31 | $1,637,147 |
| Value of fidelity bond covering the plan | 2023-12-31 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2023-12-31 | $14,500 |
| Other income received | 2023-12-31 | $26,061 |
| Net income (gross income less expenses) | 2023-12-31 | $-5,612 |
| Net plan assets at end of year (total assets less liabilities) | 2023-12-31 | $1,631,535 |
| Net plan assets at beginning of year (total assets less liabilities) | 2023-12-31 | $1,637,147 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2023-12-31 | $8,413 |
| 2022 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2022 401k financial data |
|---|
| Total income from all sources | 2022-12-31 | $16,631 |
| Expenses. Total of all expenses incurred | 2022-12-31 | $38,828 |
| Benefits paid (including direct rollovers) | 2022-12-31 | $15,906 |
| Total plan assets at end of year | 2022-12-31 | $1,637,147 |
| Total plan assets at beginning of year | 2022-12-31 | $1,659,344 |
| Value of fidelity bond covering the plan | 2022-12-31 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2022-12-31 | $16,500 |
| Other income received | 2022-12-31 | $16,631 |
| Net income (gross income less expenses) | 2022-12-31 | $-22,197 |
| Net plan assets at end of year (total assets less liabilities) | 2022-12-31 | $1,637,147 |
| Net plan assets at beginning of year (total assets less liabilities) | 2022-12-31 | $1,659,344 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2022-12-31 | $6,422 |
| 2021 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2021 401k financial data |
|---|
| Total income from all sources | 2021-12-31 | $23,234 |
| Expenses. Total of all expenses incurred | 2021-12-31 | $39,327 |
| Benefits paid (including direct rollovers) | 2021-12-31 | $16,056 |
| Total plan assets at end of year | 2021-12-31 | $1,659,344 |
| Total plan assets at beginning of year | 2021-12-31 | $1,675,437 |
| Value of fidelity bond covering the plan | 2021-12-31 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2021-12-31 | $16,500 |
| Other income received | 2021-12-31 | $23,234 |
| Net income (gross income less expenses) | 2021-12-31 | $-16,093 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-31 | $1,659,344 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-31 | $1,675,437 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2021-12-31 | $6,771 |
| 2020 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2020 401k financial data |
|---|
| Total income from all sources | 2020-12-31 | $42,086 |
| Expenses. Total of all expenses incurred | 2020-12-31 | $46,995 |
| Benefits paid (including direct rollovers) | 2020-12-31 | $15,599 |
| Total plan assets at end of year | 2020-12-31 | $1,675,437 |
| Total plan assets at beginning of year | 2020-12-31 | $1,680,346 |
| Value of fidelity bond covering the plan | 2020-12-31 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2020-12-31 | $17,500 |
| Other income received | 2020-12-31 | $42,086 |
| Net income (gross income less expenses) | 2020-12-31 | $-4,909 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $1,675,437 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-31 | $1,680,346 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-12-31 | $13,896 |
| 2019 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2019 401k financial data |
|---|
| Total income from all sources | 2019-12-31 | $45,605 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $55,726 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $24,407 |
| Total plan assets at end of year | 2019-12-31 | $1,680,346 |
| Total plan assets at beginning of year | 2019-12-31 | $1,690,467 |
| Value of fidelity bond covering the plan | 2019-12-31 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2019-12-31 | $22,500 |
| Other income received | 2019-12-31 | $45,605 |
| Net income (gross income less expenses) | 2019-12-31 | $-10,121 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $1,680,346 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $1,690,467 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $8,819 |
| 2018 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2018 401k financial data |
|---|
| Total income from all sources | 2018-12-31 | $45,221 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $57,934 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $30,401 |
| Total plan assets at end of year | 2018-12-31 | $1,690,467 |
| Total plan assets at beginning of year | 2018-12-31 | $1,703,180 |
| Value of fidelity bond covering the plan | 2018-12-31 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2018-12-31 | $500 |
| Other income received | 2018-12-31 | $45,221 |
| Net income (gross income less expenses) | 2018-12-31 | $-12,713 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $1,690,467 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $1,703,180 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $27,033 |
| 2017 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2017 401k financial data |
|---|
| Total income from all sources | 2017-12-31 | $44,913 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $64,145 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $34,848 |
| Total plan assets at end of year | 2017-12-31 | $1,703,179 |
| Total plan assets at beginning of year | 2017-12-31 | $1,722,411 |
| Value of fidelity bond covering the plan | 2017-12-31 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2017-12-31 | $2,304 |
| Other income received | 2017-12-31 | $44,913 |
| Net income (gross income less expenses) | 2017-12-31 | $-19,232 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $1,703,179 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $1,722,411 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $26,993 |
| 2016 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2016 401k financial data |
|---|
| Total income from all sources | 2016-12-31 | $45,983 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $67,233 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $32,507 |
| Total plan assets at end of year | 2016-12-31 | $1,722,411 |
| Total plan assets at beginning of year | 2016-12-31 | $1,743,661 |
| Value of fidelity bond covering the plan | 2016-12-31 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2016-12-31 | $2,500 |
| Other income received | 2016-12-31 | $45,983 |
| Net income (gross income less expenses) | 2016-12-31 | $-21,250 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $1,722,411 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $1,743,661 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $32,226 |
| 2015 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2015 401k financial data |
|---|
| Total income from all sources | 2015-12-31 | $53,855 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $83,879 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $50,306 |
| Total plan assets at end of year | 2015-12-31 | $1,743,661 |
| Total plan assets at beginning of year | 2015-12-31 | $1,773,685 |
| Value of fidelity bond covering the plan | 2015-12-31 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2015-12-31 | $2,500 |
| Other income received | 2015-12-31 | $53,855 |
| Net income (gross income less expenses) | 2015-12-31 | $-30,024 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $1,743,661 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $1,773,685 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $31,073 |
| 2014 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2014 401k financial data |
|---|
| Total income from all sources | 2014-12-31 | $56,421 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $154,150 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $118,967 |
| Total plan assets at end of year | 2014-12-31 | $1,773,685 |
| Total plan assets at beginning of year | 2014-12-31 | $1,871,414 |
| Value of fidelity bond covering the plan | 2014-12-31 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2014-12-31 | $2,500 |
| Other income received | 2014-12-31 | $56,421 |
| Net income (gross income less expenses) | 2014-12-31 | $-97,729 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $1,773,685 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $1,871,414 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-12-31 | $32,683 |
| 2013 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2013 401k financial data |
|---|
| Total income from all sources | 2013-12-31 | $64,536 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $167,449 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $130,748 |
| Total plan assets at end of year | 2013-12-31 | $1,871,414 |
| Total plan assets at beginning of year | 2013-12-31 | $1,974,327 |
| Value of fidelity bond covering the plan | 2013-12-31 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2013-12-31 | $2,500 |
| Other income received | 2013-12-31 | $64,536 |
| Net income (gross income less expenses) | 2013-12-31 | $-102,913 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $1,871,414 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $1,974,327 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-12-31 | $34,201 |
| 2012 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2012 401k financial data |
|---|
| Total income from all sources | 2012-12-31 | $135,491 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $195,528 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $157,459 |
| Total plan assets at end of year | 2012-12-31 | $1,974,327 |
| Total plan assets at beginning of year | 2012-12-31 | $2,034,364 |
| Value of fidelity bond covering the plan | 2012-12-31 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2012-12-31 | $2,500 |
| Other income received | 2012-12-31 | $135,491 |
| Net income (gross income less expenses) | 2012-12-31 | $-60,037 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $1,974,327 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $2,034,364 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2012-12-31 | $35,569 |
| 2011 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2011 401k financial data |
|---|
| Total income from all sources | 2011-12-31 | $89,911 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $181,857 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $145,391 |
| Total plan assets at end of year | 2011-12-31 | $2,034,364 |
| Total plan assets at beginning of year | 2011-12-31 | $2,126,310 |
| Value of fidelity bond covering the plan | 2011-12-31 | $2,000,000 |
| Other income received | 2011-12-31 | $89,911 |
| Net income (gross income less expenses) | 2011-12-31 | $-91,946 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $2,034,364 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $2,126,310 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-12-31 | $36,466 |
| 2010 : KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2010 401k financial data |
|---|
| Total plan liabilities at beginning of year | 2010-12-31 | $39,773 |
| Total income from all sources | 2010-12-31 | $93,276 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $203,128 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $166,337 |
| Total plan assets at end of year | 2010-12-31 | $2,126,310 |
| Total plan assets at beginning of year | 2010-12-31 | $2,275,935 |
| Value of fidelity bond covering the plan | 2010-12-31 | $2,000,000 |
| Other income received | 2010-12-31 | $93,276 |
| Net income (gross income less expenses) | 2010-12-31 | $-109,852 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $2,126,310 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $2,236,162 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2010-12-31 | $36,791 |
| 2023: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2023 form 5500 responses |
|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Plan funding arrangement – Trust | Yes |
| 2023-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement - Trust | Yes |
| 2022: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Trust | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement - Trust | Yes |
| 2021: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Trust | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement - Trust | Yes |
| 2020: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Trust | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement - Trust | Yes |
| 2019: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Trust | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement - Trust | Yes |
| 2018: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Trust | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement - Trust | Yes |
| 2017: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Trust | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement - Trust | Yes |
| 2016: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Trust | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Trust | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
| 2014: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Trust | Yes |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement - Trust | Yes |
| 2013: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Trust | Yes |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement - Trust | Yes |
| 2012: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement - Trust | Yes |
| 2011: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Trust | Yes |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement - Trust | Yes |
| 2010: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Trust | Yes |
| 2010-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement - Trust | Yes |
| 2009: KNIGHT REFRIGERATION RETIREES MEDICAL INSURANCE TRUST 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | Plan funding arrangement – Trust | Yes |
| 2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement - Trust | Yes |
| EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 1 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $60 | | Welfare Benefit Premiums Paid to Carrier | USD $5,316 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | AGP-3888 |
| Policy instance | 1 |
| Insurance contract or identification number | AGP-3888 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $231 | | Welfare Benefit Premiums Paid to Carrier | USD $3,407 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 1 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $110 | | Welfare Benefit Premiums Paid to Carrier | USD $9,306 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | AGP-3888 |
| Policy instance | 1 |
| Insurance contract or identification number | AGP-3888 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $403 | | Welfare Benefit Premiums Paid to Carrier | USD $5,988 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | AGP-3888 |
| Policy instance | 1 |
| EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
| Policy contract number | |
| Policy instance | 2 |
| EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
| Policy contract number | |
| Policy instance | 2 |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | AGP-3888 |
| Policy instance | 1 |
| EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
| Policy contract number | |
| Policy instance | 2 |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | AGP-3888 |
| Policy instance | 1 |
| EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
| Policy contract number | |
| Policy instance | 2 |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | AGP-3888 |
| Policy instance | 1 |
| EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
| Policy contract number | BXMA |
| Policy instance | 2 |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | AGP-3888 |
| Policy instance | 1 |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | AGP-3888 |
| Policy instance | 1 |
| EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
| Policy contract number | BXMA |
| Policy instance | 2 |
| EXPRESS SCRIPTS, INC. (National Association of Insurance Commissioners NAIC id number: 60025 ) |
| Policy contract number | BXMA |
| Policy instance | 3 |
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 007022968-19/20 |
| Policy instance | 1 |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | AGP-3888 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 007022968-19/20 |
| Policy instance | 1 |
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 007022968-19/20 |
| Policy instance | 1 |
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 25961-900/901 |
| Policy instance | 1 |
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) |
| Policy contract number | 25961-900/901 |
| Policy instance | 1 |
