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HUGOS EMPLOYEE INSURANCE 401k Plan overview

Plan NameHUGOS EMPLOYEE INSURANCE
Plan identification number 501

HUGOS EMPLOYEE INSURANCE Benefits

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

401k Sponsoring company profile

VALLEY MARKETS INC has sponsored the creation of one or more 401k plans.

Company Name:VALLEY MARKETS INC
Employer identification number (EIN):450273731
NAIC Classification:445110
NAIC Description:Supermarkets and Other Grocery (except Convenience) Stores

Additional information about VALLEY MARKETS INC

Jurisdiction of Incorporation: California Department of State
Incorporation Date:
Company Identification Number: C0251845

More information about VALLEY MARKETS INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HUGOS EMPLOYEE INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01KRISTI MAGNUSON NELSON2019-10-11
5012017-08-01
5012017-01-01
5012016-01-01
5012015-01-01KRISTI MAGNUSON-NELSON
5012015-01-01
5012014-01-01KRISTI MAGNUSON-NELSON
5012013-01-01KRISTI MAGNUSON-NELSON
5012012-01-01KRISTI MAGNUSON-NELSON
5012011-01-01KRISTI MAGNUSON-NELSON
5012010-01-01KRISTI MAGNUSON-NELSON
5012009-01-01KRISTI MAGNUSON-NELSON

Plan Statistics for HUGOS EMPLOYEE INSURANCE

401k plan membership statisitcs for HUGOS EMPLOYEE INSURANCE

Measure Date Value
2018: HUGOS EMPLOYEE INSURANCE 2018 401k membership
Total participants, beginning-of-year2018-01-01428
Total number of active participants reported on line 7a of the Form 55002018-01-010
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-010
2017: HUGOS EMPLOYEE INSURANCE 2017 401k membership
Total participants, beginning-of-year2017-08-01109
Total number of active participants reported on line 7a of the Form 55002017-08-01109
Total of all active and inactive participants2017-08-01109
Total participants2017-08-01109
Total participants, beginning-of-year2017-01-01427
Total number of active participants reported on line 7a of the Form 55002017-01-01406
Number of retired or separated participants receiving benefits2017-01-017
Total of all active and inactive participants2017-01-01413
2016: HUGOS EMPLOYEE INSURANCE 2016 401k membership
Total participants, beginning-of-year2016-01-01418
Total number of active participants reported on line 7a of the Form 55002016-01-01426
Number of other retired or separated participants entitled to future benefits2016-01-015
Total of all active and inactive participants2016-01-01431
2015: HUGOS EMPLOYEE INSURANCE 2015 401k membership
Total participants, beginning-of-year2015-01-01393
Total number of active participants reported on line 7a of the Form 55002015-01-01402
Number of retired or separated participants receiving benefits2015-01-019
Total of all active and inactive participants2015-01-01411
2014: HUGOS EMPLOYEE INSURANCE 2014 401k membership
Total participants, beginning-of-year2014-01-01322
Total number of active participants reported on line 7a of the Form 55002014-01-01323
Total of all active and inactive participants2014-01-01323
2013: HUGOS EMPLOYEE INSURANCE 2013 401k membership
Total participants, beginning-of-year2013-01-01288
Total number of active participants reported on line 7a of the Form 55002013-01-01322
Total of all active and inactive participants2013-01-01322
2012: HUGOS EMPLOYEE INSURANCE 2012 401k membership
Total participants, beginning-of-year2012-01-01250
Total number of active participants reported on line 7a of the Form 55002012-01-01288
Total of all active and inactive participants2012-01-01288
2011: HUGOS EMPLOYEE INSURANCE 2011 401k membership
Total participants, beginning-of-year2011-01-01247
Total number of active participants reported on line 7a of the Form 55002011-01-01250
Total of all active and inactive participants2011-01-01250
2010: HUGOS EMPLOYEE INSURANCE 2010 401k membership
Total participants, beginning-of-year2010-01-01256
Total number of active participants reported on line 7a of the Form 55002010-01-01247
Total of all active and inactive participants2010-01-01247
2009: HUGOS EMPLOYEE INSURANCE 2009 401k membership
Total participants, beginning-of-year2009-01-01234
Total number of active participants reported on line 7a of the Form 55002009-01-01256
Total of all active and inactive participants2009-01-01256

Financial Data on HUGOS EMPLOYEE INSURANCE

Measure Date Value
2018 : HUGOS EMPLOYEE INSURANCE 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$0
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$181,000
Total income from all sources (including contributions)2018-12-31$267,374
Total loss/gain on sale of assets2018-12-31$30
Total of all expenses incurred2018-12-31$294,054
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$260,517
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$231,575
Value of total assets at end of year2018-12-31$1,139,637
Value of total assets at beginning of year2018-12-31$1,347,317
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$33,537
Total interest from all sources2018-12-31$18,359
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2018-12-31$0
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$80,182
Participant contributions at end of year2018-12-31$0
Participant contributions at beginning of year2018-12-31$79,626
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$45,138
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$29,790
Other income not declared elsewhere2018-12-31$17,410
Total non interest bearing cash at end of year2018-12-31$8,663
Total non interest bearing cash at beginning of year2018-12-31$8,663
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-26,680
Value of net assets at end of year (total assets less liabilities)2018-12-31$1,139,637
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$1,166,317
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$1,085,836
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$1,079,653
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$1,079,653
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$18,359
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$120,294
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$151,393
Employer contributions (assets) at end of year2018-12-31$0
Employer contributions (assets) at beginning of year2018-12-31$149,585
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$140,223
Contract administrator fees2018-12-31$33,537
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Liabilities. Value of benefit claims payable at end of year2018-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$181,000
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Aggregate proceeds on sale of assets2018-12-31$801,000
Aggregate carrying amount (costs) on sale of assets2018-12-31$800,970
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31BRADY MARTZ & ASSOCIATES, P.C.
Accountancy firm EIN2018-12-31450310328
2017 : HUGOS EMPLOYEE INSURANCE 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2017-12-31$-3,966
Total unrealized appreciation/depreciation of assets2017-12-31$-3,966
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$181,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$284,426
Total income from all sources (including contributions)2017-12-31$2,834,159
Total loss/gain on sale of assets2017-12-31$167
Total of all expenses incurred2017-12-31$2,876,870
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$2,691,286
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$2,827,755
Value of total assets at end of year2017-12-31$1,347,317
Value of total assets at beginning of year2017-12-31$1,493,454
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$185,584
Total interest from all sources2017-12-31$10,203
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$980,773
Participant contributions at end of year2017-12-31$79,626
Participant contributions at beginning of year2017-12-31$76,187
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$29,790
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$33,464
Administrative expenses (other) incurred2017-12-31$18
Total non interest bearing cash at end of year2017-12-31$8,663
Total non interest bearing cash at beginning of year2017-12-31$1,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-42,711
Value of net assets at end of year (total assets less liabilities)2017-12-31$1,166,317
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$1,209,028
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$1,079,653
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$1,234,510
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$1,234,510
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$10,203
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$721,062
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$1,846,982
Employer contributions (assets) at end of year2017-12-31$149,585
Employer contributions (assets) at beginning of year2017-12-31$148,293
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$1,970,224
Contract administrator fees2017-12-31$185,566
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Liabilities. Value of benefit claims payable at end of year2017-12-31$181,000
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$284,426
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Aggregate proceeds on sale of assets2017-12-31$1,157,000
Aggregate carrying amount (costs) on sale of assets2017-12-31$1,156,833
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31BRADY MARTZ & ASSOCIATES, P.C.
Accountancy firm EIN2017-12-31450310328
2016 : HUGOS EMPLOYEE INSURANCE 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2016-12-31$-4,376
Total unrealized appreciation/depreciation of assets2016-12-31$-4,376
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$284,426
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$188,299
Total income from all sources (including contributions)2016-12-31$2,690,217
Total loss/gain on sale of assets2016-12-31$107
Total of all expenses incurred2016-12-31$2,838,068
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$2,657,960
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$2,684,795
Value of total assets at end of year2016-12-31$1,493,454
Value of total assets at beginning of year2016-12-31$1,545,178
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$180,108
Total interest from all sources2016-12-31$9,691
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$918,440
Participant contributions at end of year2016-12-31$76,187
Participant contributions at beginning of year2016-12-31$73,890
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$33,464
Total non interest bearing cash at end of year2016-12-31$1,000
Total non interest bearing cash at beginning of year2016-12-31$33,928
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-147,851
Value of net assets at end of year (total assets less liabilities)2016-12-31$1,209,028
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$1,356,879
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$1,234,510
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$1,305,951
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$1,305,951
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$9,691
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$595,479
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$1,766,355
Employer contributions (assets) at end of year2016-12-31$148,293
Employer contributions (assets) at beginning of year2016-12-31$131,409
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$2,062,481
Contract administrator fees2016-12-31$180,108
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Liabilities. Value of benefit claims payable at end of year2016-12-31$284,426
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$188,299
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Aggregate proceeds on sale of assets2016-12-31$945,000
Aggregate carrying amount (costs) on sale of assets2016-12-31$944,893
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31BRADY MARTZ & ASSOCIATES, P.C.
Accountancy firm EIN2016-12-31450310328
2015 : HUGOS EMPLOYEE INSURANCE 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2015-12-31$-6,511
Total unrealized appreciation/depreciation of assets2015-12-31$-6,511
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$188,299
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$116,000
Total income from all sources (including contributions)2015-12-31$2,490,114
Total loss/gain on sale of assets2015-12-31$-231
Total of all expenses incurred2015-12-31$2,728,884
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$2,555,226
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$2,487,086
Value of total assets at end of year2015-12-31$1,545,178
Value of total assets at beginning of year2015-12-31$1,711,649
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$173,658
Total interest from all sources2015-12-31$9,770
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$875,254
Participant contributions at end of year2015-12-31$73,890
Participant contributions at beginning of year2015-12-31$59,818
Administrative expenses (other) incurred2015-12-31$9
Total non interest bearing cash at end of year2015-12-31$33,928
Total non interest bearing cash at beginning of year2015-12-31$29,829
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-238,770
Value of net assets at end of year (total assets less liabilities)2015-12-31$1,356,879
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$1,595,649
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$1,305,951
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$1,505,082
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$1,505,082
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$9,770
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$508,502
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$1,611,832
Employer contributions (assets) at end of year2015-12-31$131,409
Employer contributions (assets) at beginning of year2015-12-31$116,920
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$2,046,724
Contract administrator fees2015-12-31$173,649
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
Liabilities. Value of benefit claims payable at end of year2015-12-31$188,299
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$116,000
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Aggregate proceeds on sale of assets2015-12-31$1,025,000
Aggregate carrying amount (costs) on sale of assets2015-12-31$1,025,231
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31BRADY MARTZ & ASSOCIATES, P.C.
Accountancy firm EIN2015-12-31450310328
2014 : HUGOS EMPLOYEE INSURANCE 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-12-31$-2,000
Total unrealized appreciation/depreciation of assets2014-12-31$-2,000
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$116,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$218,832
Total income from all sources (including contributions)2014-12-31$2,241,334
Total loss/gain on sale of assets2014-12-31$-174
Total of all expenses incurred2014-12-31$2,453,018
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$2,281,425
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$2,238,860
Value of total assets at end of year2014-12-31$1,711,649
Value of total assets at beginning of year2014-12-31$2,026,165
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$171,593
Total interest from all sources2014-12-31$4,648
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$801,813
Participant contributions at end of year2014-12-31$59,818
Participant contributions at beginning of year2014-12-31$63,760
Administrative expenses (other) incurred2014-12-31$3,934
Total non interest bearing cash at end of year2014-12-31$29,829
Total non interest bearing cash at beginning of year2014-12-31$4,892
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-211,684
Value of net assets at end of year (total assets less liabilities)2014-12-31$1,595,649
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$1,807,333
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$1,505,082
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$1,833,163
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$1,833,163
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$4,648
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$454,940
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$1,437,047
Employer contributions (assets) at end of year2014-12-31$116,920
Employer contributions (assets) at beginning of year2014-12-31$124,350
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$1,826,485
Contract administrator fees2014-12-31$167,659
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31No
Liabilities. Value of benefit claims payable at end of year2014-12-31$116,000
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$218,832
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Aggregate proceeds on sale of assets2014-12-31$970,000
Aggregate carrying amount (costs) on sale of assets2014-12-31$970,174
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31DREES, RISKEY & VALLAGER, LTD.
Accountancy firm EIN2014-12-31450338391
2013 : HUGOS EMPLOYEE INSURANCE 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$-1,489
Total unrealized appreciation/depreciation of assets2013-12-31$-1,489
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$218,832
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$102,142
Total income from all sources (including contributions)2013-12-31$2,405,285
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$2,414,804
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$2,278,634
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$2,400,204
Value of total assets at end of year2013-12-31$2,026,165
Value of total assets at beginning of year2013-12-31$1,918,994
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$136,170
Total interest from all sources2013-12-31$6,570
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$871,454
Participant contributions at end of year2013-12-31$63,760
Participant contributions at beginning of year2013-12-31$62,466
Administrative expenses (other) incurred2013-12-31$4,417
Total non interest bearing cash at end of year2013-12-31$4,892
Total non interest bearing cash at beginning of year2013-12-31$4,891
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-9,519
Value of net assets at end of year (total assets less liabilities)2013-12-31$1,807,333
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$1,816,852
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$1,833,163
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$1,732,224
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$1,732,224
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$6,570
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$423,752
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$1,528,750
Employer contributions (assets) at end of year2013-12-31$124,350
Employer contributions (assets) at beginning of year2013-12-31$119,413
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$1,854,882
Contract administrator fees2013-12-31$131,753
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31No
Liabilities. Value of benefit claims payable at end of year2013-12-31$218,832
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$102,142
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Aggregate proceeds on sale of assets2013-12-31$1,057,000
Aggregate carrying amount (costs) on sale of assets2013-12-31$1,057,000
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31DREES, RISKEY & VALLAGER, LTD.
Accountancy firm EIN2013-12-31450338391
2012 : HUGOS EMPLOYEE INSURANCE 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$-2,732
Total unrealized appreciation/depreciation of assets2012-12-31$-2,732
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$102,142
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$112,393
Total income from all sources (including contributions)2012-12-31$2,069,678
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$1,709,660
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$1,623,440
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$2,067,566
Value of total assets at end of year2012-12-31$1,918,994
Value of total assets at beginning of year2012-12-31$1,569,227
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$86,220
Total interest from all sources2012-12-31$4,844
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$762,162
Participant contributions at end of year2012-12-31$62,466
Participant contributions at beginning of year2012-12-31$56,025
Administrative expenses (other) incurred2012-12-31$3,688
Total non interest bearing cash at end of year2012-12-31$4,891
Total non interest bearing cash at beginning of year2012-12-31$4,018
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$360,018
Value of net assets at end of year (total assets less liabilities)2012-12-31$1,816,852
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$1,456,834
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$1,732,224
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$1,404,581
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$1,404,581
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$4,844
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$349,193
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$1,305,404
Employer contributions (assets) at end of year2012-12-31$119,413
Employer contributions (assets) at beginning of year2012-12-31$104,603
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$1,274,247
Contract administrator fees2012-12-31$82,532
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31No
Liabilities. Value of benefit claims payable at end of year2012-12-31$102,142
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$112,393
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Aggregate proceeds on sale of assets2012-12-31$996,000
Aggregate carrying amount (costs) on sale of assets2012-12-31$996,000
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31DREES, RISKEY & VALLAGER, LTD.
Accountancy firm EIN2012-12-31450338391
2011 : HUGOS EMPLOYEE INSURANCE 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$-2,959
Total unrealized appreciation/depreciation of assets2011-12-31$-2,959
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$112,393
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$137,505
Total income from all sources (including contributions)2011-12-31$1,920,600
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$1,598,033
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$1,515,602
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$1,918,041
Value of total assets at end of year2011-12-31$1,569,227
Value of total assets at beginning of year2011-12-31$1,271,772
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$82,431
Total interest from all sources2011-12-31$5,518
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$731,059
Participant contributions at end of year2011-12-31$56,025
Participant contributions at beginning of year2011-12-31$46,949
Administrative expenses (other) incurred2011-12-31$3,030
Total non interest bearing cash at end of year2011-12-31$4,018
Total non interest bearing cash at beginning of year2011-12-31$2,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$322,567
Value of net assets at end of year (total assets less liabilities)2011-12-31$1,456,834
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$1,134,267
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$1,404,581
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$1,139,224
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$1,139,224
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$5,518
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$285,296
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$1,186,982
Employer contributions (assets) at end of year2011-12-31$104,603
Employer contributions (assets) at beginning of year2011-12-31$83,599
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$1,230,306
Contract administrator fees2011-12-31$79,401
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Liabilities. Value of benefit claims payable at end of year2011-12-31$112,393
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$137,505
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Aggregate proceeds on sale of assets2011-12-31$954,000
Aggregate carrying amount (costs) on sale of assets2011-12-31$954,000
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31DREES, RISKEY & VALLAGER, LTD.
Accountancy firm EIN2011-12-31450338391
2010 : HUGOS EMPLOYEE INSURANCE 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$-2,559
Total unrealized appreciation/depreciation of assets2010-12-31$-2,559
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$137,505
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$74,286
Total income from all sources (including contributions)2010-12-31$1,651,474
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$1,746,638
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$1,658,865
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$1,650,339
Value of total assets at end of year2010-12-31$1,271,772
Value of total assets at beginning of year2010-12-31$1,303,717
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$87,773
Total interest from all sources2010-12-31$3,694
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$500,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$645,052
Total non interest bearing cash at end of year2010-12-31$2,000
Total non interest bearing cash at beginning of year2010-12-31$2,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-95,164
Value of net assets at end of year (total assets less liabilities)2010-12-31$1,134,267
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$1,229,431
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$1,139,224
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$1,179,435
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$1,179,435
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$3,694
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$242,787
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$1,005,287
Employer contributions (assets) at end of year2010-12-31$130,548
Employer contributions (assets) at beginning of year2010-12-31$122,282
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$1,416,078
Contract administrator fees2010-12-31$87,773
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Liabilities. Value of benefit claims payable at end of year2010-12-31$137,505
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$74,286
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$1,214,000
Aggregate carrying amount (costs) on sale of assets2010-12-31$1,214,000
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31DREES, RISKEY & VALLAGER, LTD.
Accountancy firm EIN2010-12-31450338391

Form 5500 Responses for HUGOS EMPLOYEE INSURANCE

2018: HUGOS EMPLOYEE INSURANCE 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: HUGOS EMPLOYEE INSURANCE 2017 form 5500 responses
2017-08-01Type of plan entitySingle employer plan
2017-08-01First time form 5500 has been submittedYes
2017-08-01Submission has been amendedNo
2017-08-01This submission is the final filingNo
2017-08-01This return/report is a short plan year return/report (less than 12 months)No
2017-08-01Plan is a collectively bargained planNo
2017-08-01Plan funding arrangement – InsuranceYes
2017-08-01Plan benefit arrangement – InsuranceYes
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: HUGOS EMPLOYEE INSURANCE 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: HUGOS EMPLOYEE INSURANCE 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: HUGOS EMPLOYEE INSURANCE 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: HUGOS EMPLOYEE INSURANCE 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: HUGOS EMPLOYEE INSURANCE 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: HUGOS EMPLOYEE INSURANCE 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: HUGOS EMPLOYEE INSURANCE 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: HUGOS EMPLOYEE INSURANCE 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )
Policy contract number19801+
Policy instance 1
Insurance contract or identification number19801+
Number of Individuals Covered549
Insurance policy start date2018-01-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50006076
Policy instance 1
Insurance contract or identification number50006076
Number of Individuals Covered109
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $3,537
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )
Policy contract number10175+
Policy instance 1
Insurance contract or identification number10175+
Number of Individuals Covered538
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )
Policy contract number10175
Policy instance 1
Insurance contract or identification number10175
Number of Individuals Covered566
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )
Policy contract number10175
Policy instance 1
Insurance contract or identification number10175
Number of Individuals Covered587
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )
Policy contract number10175
Policy instance 1
Insurance contract or identification number10175
Number of Individuals Covered602
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )
Policy contract number10175
Policy instance 1
Insurance contract or identification number10175
Number of Individuals Covered551
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )
Policy contract number10175
Policy instance 1
Insurance contract or identification number10175
Number of Individuals Covered492
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )
Policy contract number10175
Policy instance 1
Insurance contract or identification number10175
Number of Individuals Covered463
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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