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EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN 401k Plan overview

Plan NameEAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN
Plan identification number 505

EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Vision
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

URS CH2M OAK RIDGE LLC has sponsored the creation of one or more 401k plans.

Company Name:URS CH2M OAK RIDGE LLC
Employer identification number (EIN):452178216
NAIC Classification:561210
NAIC Description:Facilities Support Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052020-01-01CHARLES MALARKEY2021-09-29
5052019-01-01CHARLES MALARKEY2020-09-21
5052018-01-01TED MYERS2019-10-01
5052017-01-01
5052016-01-01
5052015-01-01TED MYERS

Plan Statistics for EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN

401k plan membership statisitcs for EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN

Measure Date Value
2020: EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0182
Total number of active participants reported on line 7a of the Form 55002020-01-010
Number of retired or separated participants receiving benefits2020-01-0164
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0164
2019: EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01128
Total number of active participants reported on line 7a of the Form 55002019-01-010
Number of retired or separated participants receiving benefits2019-01-01127
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01127
2018: EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0156
Total number of active participants reported on line 7a of the Form 55002018-01-010
Number of retired or separated participants receiving benefits2018-01-0193
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-0193
2017: EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01121
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-01122
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01122
2016: EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01418
Total number of active participants reported on line 7a of the Form 55002016-01-010
Number of retired or separated participants receiving benefits2016-01-01414
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01414
2015: EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-011,191
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-011,226
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-011,226

Financial Data on EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN

Measure Date Value
2017 : EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$831,787
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$1,758,365
Total income from all sources (including contributions)2017-12-31$3,869,032
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$4,195,118
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$4,195,118
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$3,869,032
Value of total assets at end of year2017-12-31$1,162,211
Value of total assets at beginning of year2017-12-31$2,414,875
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$0
Total interest from all sources2017-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
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
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$2,577,518
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$330,445
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$656,510
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$336,821
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$576,645
Total non interest bearing cash at end of year2017-12-31$750,023
Total non interest bearing cash at beginning of year2017-12-31$1,758,365
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-326,086
Value of net assets at end of year (total assets less liabilities)2017-12-31$330,424
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$656,510
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
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$4,195,118
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$1,291,514
Employer contributions (assets) at end of year2017-12-31$81,743
Employer contributions (assets) at beginning of year2017-12-31$0
Liabilities. Value of benefit claims payable at end of year2017-12-31$494,966
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$1,181,720
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party 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
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 name2017-12-31MCCONNELL & JONES LLP
Accountancy firm EIN2017-12-31760488832
2016 : EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$1,758,365
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$1,211,256
Total income from all sources (including contributions)2016-12-31$8,933,802
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$8,614,679
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$8,614,679
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$8,933,802
Value of total assets at end of year2016-12-31$2,414,875
Value of total assets at beginning of year2016-12-31$1,548,643
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$0
Total interest from all sources2016-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
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
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$3,024,788
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$319,123
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$656,510
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$337,387
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$576,645
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$566,809
Total non interest bearing cash at end of year2016-12-31$1,758,365
Total non interest bearing cash at beginning of year2016-12-31$1,211,256
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$319,123
Value of net assets at end of year (total assets less liabilities)2016-12-31$656,510
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$337,387
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
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$8,614,679
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$5,589,891
Liabilities. Value of benefit claims payable at end of year2016-12-31$1,181,720
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$644,447
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party 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
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 name2016-12-31MCCONNELL & JONES LLP
Accountancy firm EIN2016-12-31760488832
2015 : EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total transfer of assets to this plan2015-12-31$281,650
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$1,211,256
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$8,687,414
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$8,631,677
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$8,631,677
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$8,687,414
Value of total assets at end of year2015-12-31$1,548,643
Value of total assets at beginning of year2015-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$0
Total interest from all sources2015-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
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
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$2,895,143
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$337,387
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$337,387
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$566,809
Total non interest bearing cash at end of year2015-12-31$1,211,256
Total non interest bearing cash at beginning of year2015-12-31$0
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$55,737
Value of net assets at end of year (total assets less liabilities)2015-12-31$337,387
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$0
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
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$8,631,677
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$5,454,884
Liabilities. Value of benefit claims payable at end of year2015-12-31$644,447
Did the plan have assets held for investment2015-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party 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
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 name2015-12-31MCCONNELL & JONES LLP
Accountancy firm EIN2015-12-31760488832

Form 5500 Responses for EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN

2020: EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN 2020 form 5500 responses
2020-01-01Type of plan entityMulitple employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entityMulitple employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN 2018 form 5500 responses
2018-01-01Type of plan entityMulitple employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN 2017 form 5500 responses
2017-01-01Type of plan entityMulitple employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN 2016 form 5500 responses
2016-01-01Type of plan entityMulitple employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: EAST TENNESSEE TECHNOLOGY PARK RETIREE MEDICAL PLAN 2015 form 5500 responses
2015-01-01Type of plan entityDFE (Diect Filing Entity)
2015-01-01First time form 5500 has been submittedYes
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0720018-RETIRED
Policy instance 1
Insurance contract or identification number0720018-RETIRED
Number of Individuals Covered177
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $2,296,079
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0720018-RETIRED
Policy instance 1
Insurance contract or identification number0720018-RETIRED
Number of Individuals Covered185
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $2,720,338
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0720018-RETIRED
Policy instance 1
Insurance contract or identification number0720018-RETIRED
Number of Individuals Covered218
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $3,164,047
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0720018-RETIRED
Policy instance 1
Insurance contract or identification number0720018-RETIRED
Number of Individuals Covered216
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $3,596,588
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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