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KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 401k Plan overview

Plan NameKAHLIG AUTO GROUP HEALTH BENEFIT PLAN
Plan identification number 514

KAHLIG AUTO GROUP HEALTH BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

KAHLIG AUTO GROUP HEALTH BENEFIT TRUST has sponsored the creation of one or more 401k plans.

Company Name:KAHLIG AUTO GROUP HEALTH BENEFIT TRUST
Employer identification number (EIN):464230139
NAIC Classification:441110
NAIC Description:New Car Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KAHLIG AUTO GROUP HEALTH BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5142021-12-01
5142020-12-01
5142019-12-01
5142018-12-01
5142017-12-01THOMAS KEENAN2019-08-22
5142016-12-01
5142015-12-01
5142014-12-01
5142013-12-01CLARENCE J. KAHLIG II

Plan Statistics for KAHLIG AUTO GROUP HEALTH BENEFIT PLAN

401k plan membership statisitcs for KAHLIG AUTO GROUP HEALTH BENEFIT PLAN

Measure Date Value
2021: KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-12-01988
Total number of active participants reported on line 7a of the Form 55002021-12-01985
Number of retired or separated participants receiving benefits2021-12-012
Total of all active and inactive participants2021-12-01987
2020: KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-12-01957
Total number of active participants reported on line 7a of the Form 55002020-12-01984
Number of retired or separated participants receiving benefits2020-12-014
Total of all active and inactive participants2020-12-01988
2019: KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-12-01937
Total number of active participants reported on line 7a of the Form 55002019-12-01950
Number of retired or separated participants receiving benefits2019-12-017
Total of all active and inactive participants2019-12-01957
2018: KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-12-01900
Total number of active participants reported on line 7a of the Form 55002018-12-01932
Number of retired or separated participants receiving benefits2018-12-015
Total of all active and inactive participants2018-12-01937
2017: KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-12-01849
Total number of active participants reported on line 7a of the Form 55002017-12-01895
Number of retired or separated participants receiving benefits2017-12-015
Number of other retired or separated participants entitled to future benefits2017-12-010
Total of all active and inactive participants2017-12-01900
2016: KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-12-01783
Total number of active participants reported on line 7a of the Form 55002016-12-01841
Number of retired or separated participants receiving benefits2016-12-018
Number of other retired or separated participants entitled to future benefits2016-12-010
Total of all active and inactive participants2016-12-01849
2015: KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-12-01825
Total number of active participants reported on line 7a of the Form 55002015-12-01772
Number of retired or separated participants receiving benefits2015-12-0111
Number of other retired or separated participants entitled to future benefits2015-12-010
Total of all active and inactive participants2015-12-01783
2014: KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-12-01729
Total number of active participants reported on line 7a of the Form 55002014-12-01818
Number of retired or separated participants receiving benefits2014-12-017
Number of other retired or separated participants entitled to future benefits2014-12-010
Total of all active and inactive participants2014-12-01825
2013: KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-12-01622
Total number of active participants reported on line 7a of the Form 55002013-12-01724
Number of retired or separated participants receiving benefits2013-12-015
Number of other retired or separated participants entitled to future benefits2013-12-010
Total of all active and inactive participants2013-12-01729

Financial Data on KAHLIG AUTO GROUP HEALTH BENEFIT PLAN

Measure Date Value
2022 : KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-11-30$190,910
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-11-30$377,797
Total income from all sources (including contributions)2022-11-30$8,085,454
Total of all expenses incurred2022-11-30$8,043,267
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-11-30$7,859,186
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-11-30$8,064,245
Value of total assets at end of year2022-11-30$2,213,780
Value of total assets at beginning of year2022-11-30$2,358,480
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-11-30$184,081
Total interest from all sources2022-11-30$21,209
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-11-30No
Administrative expenses professional fees incurred2022-11-30$36,151
Was this plan covered by a fidelity bond2022-11-30Yes
Value of fidelity bond cover2022-11-30$400,000
If this is an individual account plan, was there a blackout period2022-11-30No
Were there any nonexempt tranactions with any party-in-interest2022-11-30No
Contributions received from participants2022-11-30$4,109,597
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-11-30$10,761
Liabilities. Value of operating payables at beginning of year2022-11-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-11-30No
Value of net income/loss2022-11-30$42,187
Value of net assets at end of year (total assets less liabilities)2022-11-30$2,022,870
Value of net assets at beginning of year (total assets less liabilities)2022-11-30$1,980,683
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-11-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-11-30No
Were any leases to which the plan was party in default or uncollectible2022-11-30No
Investment advisory and management fees2022-11-30$11,145
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-11-30$1,932,468
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-11-30$2,347,719
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-11-30$2,347,719
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-11-30$21,209
Expenses. Payments to insurance carriers foe the provision of benefits2022-11-30$449,962
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-11-30Yes
Was there a failure to transmit to the plan any participant contributions2022-11-30No
Has the plan failed to provide any benefit when due under the plan2022-11-30No
Contributions received in cash from employer2022-11-30$3,954,648
Employer contributions (assets) at end of year2022-11-30$281,312
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-11-30$7,409,224
Contract administrator fees2022-11-30$136,785
Liabilities. Value of benefit claims payable at end of year2022-11-30$190,910
Liabilities. Value of benefit claims payable at beginning of year2022-11-30$377,797
Did the plan have assets held for investment2022-11-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-11-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-11-30No
Opinion of an independent qualified public accountant for this plan2022-11-30Unqualified
Accountancy firm name2022-11-30LANE GORMAN TRUBITT LLC
Accountancy firm EIN2022-11-30751044330
2021 : KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-11-30$377,797
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-11-30$154,998
Total income from all sources (including contributions)2021-11-30$7,240,285
Total of all expenses incurred2021-11-30$7,549,691
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-11-30$7,302,277
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-11-30$7,240,043
Value of total assets at end of year2021-11-30$2,358,480
Value of total assets at beginning of year2021-11-30$2,445,087
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-11-30$247,414
Total interest from all sources2021-11-30$242
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-11-30No
Administrative expenses professional fees incurred2021-11-30$52,956
Was this plan covered by a fidelity bond2021-11-30Yes
Value of fidelity bond cover2021-11-30$200,000
Were there any nonexempt tranactions with any party-in-interest2021-11-30No
Contributions received from participants2021-11-30$3,204,254
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-11-30$10,761
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-11-30$761
Administrative expenses (other) incurred2021-11-30$205
Liabilities. Value of operating payables at end of year2021-11-30$0
Liabilities. Value of operating payables at beginning of year2021-11-30$73,807
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-11-30No
Value of net income/loss2021-11-30$-309,406
Value of net assets at end of year (total assets less liabilities)2021-11-30$1,980,683
Value of net assets at beginning of year (total assets less liabilities)2021-11-30$2,290,089
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-11-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-11-30No
Were any leases to which the plan was party in default or uncollectible2021-11-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-11-30$2,347,719
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-11-30$2,444,326
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-11-30$2,444,326
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-11-30$242
Expenses. Payments to insurance carriers foe the provision of benefits2021-11-30$444,902
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-11-30Yes
Was there a failure to transmit to the plan any participant contributions2021-11-30No
Has the plan failed to provide any benefit when due under the plan2021-11-30No
Contributions received in cash from employer2021-11-30$4,035,789
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-11-30$6,857,375
Contract administrator fees2021-11-30$194,253
Liabilities. Value of benefit claims payable at end of year2021-11-30$377,797
Liabilities. Value of benefit claims payable at beginning of year2021-11-30$81,191
Did the plan have assets held for investment2021-11-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-11-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-11-30No
Opinion of an independent qualified public accountant for this plan2021-11-30Unqualified
Accountancy firm name2021-11-30LANE GORMAN TRUBITT LLC
Accountancy firm EIN2021-11-30751044330
2020 : KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-11-30$154,998
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-11-30$316,074
Total income from all sources (including contributions)2020-11-30$7,652,141
Total of all expenses incurred2020-11-30$6,822,344
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-11-30$6,517,547
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-11-30$7,642,170
Value of total assets at end of year2020-11-30$2,445,087
Value of total assets at beginning of year2020-11-30$1,776,366
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-11-30$304,797
Total interest from all sources2020-11-30$9,971
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-11-30No
Administrative expenses professional fees incurred2020-11-30$64,820
Was this plan covered by a fidelity bond2020-11-30Yes
Value of fidelity bond cover2020-11-30$200,000
Were there any nonexempt tranactions with any party-in-interest2020-11-30No
Contributions received from participants2020-11-30$3,460,826
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-11-30$761
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-11-30$10,761
Administrative expenses (other) incurred2020-11-30$11,654
Liabilities. Value of operating payables at end of year2020-11-30$73,807
Liabilities. Value of operating payables at beginning of year2020-11-30$74,986
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-11-30No
Value of net income/loss2020-11-30$829,797
Value of net assets at end of year (total assets less liabilities)2020-11-30$2,290,089
Value of net assets at beginning of year (total assets less liabilities)2020-11-30$1,460,292
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-11-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-11-30No
Were any leases to which the plan was party in default or uncollectible2020-11-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-11-30$2,444,326
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-11-30$1,677,905
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-11-30$1,677,905
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-11-30$9,971
Expenses. Payments to insurance carriers foe the provision of benefits2020-11-30$589,391
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-11-30Yes
Was there a failure to transmit to the plan any participant contributions2020-11-30No
Has the plan failed to provide any benefit when due under the plan2020-11-30No
Contributions received in cash from employer2020-11-30$4,181,344
Employer contributions (assets) at beginning of year2020-11-30$87,700
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-11-30$5,928,156
Contract administrator fees2020-11-30$228,323
Liabilities. Value of benefit claims payable at end of year2020-11-30$81,191
Liabilities. Value of benefit claims payable at beginning of year2020-11-30$241,088
Did the plan have assets held for investment2020-11-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-11-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-11-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-11-30Yes
Opinion of an independent qualified public accountant for this plan2020-11-30Disclaimer
Accountancy firm name2020-11-30LANE GORMAN TRUBITT LLC
Accountancy firm EIN2020-11-30751044330
2019 : KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-11-30$316,074
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-11-30$417,465
Total income from all sources (including contributions)2019-11-30$7,371,717
Total of all expenses incurred2019-11-30$6,524,593
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-11-30$6,142,095
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-11-30$7,347,004
Value of total assets at end of year2019-11-30$1,776,366
Value of total assets at beginning of year2019-11-30$1,030,633
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-11-30$382,498
Total interest from all sources2019-11-30$24,713
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-11-30No
Administrative expenses professional fees incurred2019-11-30$69,568
Was this plan covered by a fidelity bond2019-11-30Yes
Value of fidelity bond cover2019-11-30$200,000
If this is an individual account plan, was there a blackout period2019-11-30No
Were there any nonexempt tranactions with any party-in-interest2019-11-30No
Contributions received from participants2019-11-30$3,248,259
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-11-30$10,761
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-11-30$1,228
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-11-30$0
Administrative expenses (other) incurred2019-11-30$2,400
Liabilities. Value of operating payables at end of year2019-11-30$74,986
Liabilities. Value of operating payables at beginning of year2019-11-30$56,442
Total non interest bearing cash at beginning of year2019-11-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-11-30No
Value of net income/loss2019-11-30$847,124
Value of net assets at end of year (total assets less liabilities)2019-11-30$1,460,292
Value of net assets at beginning of year (total assets less liabilities)2019-11-30$613,168
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-11-30No
Were any loans by the plan or fixed income obligations due to the plan in default2019-11-30No
Were any leases to which the plan was party in default or uncollectible2019-11-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-11-30$1,677,905
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-11-30$1,029,405
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-11-30$1,029,405
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-11-30$24,713
Expenses. Payments to insurance carriers foe the provision of benefits2019-11-30$563,238
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-11-30Yes
Was there a failure to transmit to the plan any participant contributions2019-11-30No
Has the plan failed to provide any benefit when due under the plan2019-11-30No
Contributions received in cash from employer2019-11-30$4,098,745
Employer contributions (assets) at end of year2019-11-30$87,700
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-11-30$5,578,857
Contract administrator fees2019-11-30$310,530
Liabilities. Value of benefit claims payable at end of year2019-11-30$241,088
Liabilities. Value of benefit claims payable at beginning of year2019-11-30$361,023
Did the plan have assets held for investment2019-11-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-11-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-11-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-11-30Yes
Opinion of an independent qualified public accountant for this plan2019-11-30Disclaimer
Accountancy firm name2019-11-30LANE GORMAN TRUBITT LLC
Accountancy firm EIN2019-11-30751044330
2018 : KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-11-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-11-30$417,465
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-11-30$252,310
Total income from all sources (including contributions)2018-11-30$6,260,314
Total loss/gain on sale of assets2018-11-30$0
Total of all expenses incurred2018-11-30$6,351,483
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-11-30$5,956,979
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-11-30$6,249,537
Value of total assets at end of year2018-11-30$1,030,633
Value of total assets at beginning of year2018-11-30$956,647
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-11-30$394,504
Total interest from all sources2018-11-30$10,777
Total dividends received (eg from common stock, registered investment company shares)2018-11-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-11-30No
Administrative expenses professional fees incurred2018-11-30$64,448
Was this plan covered by a fidelity bond2018-11-30Yes
Value of fidelity bond cover2018-11-30$200,000
Were there any nonexempt tranactions with any party-in-interest2018-11-30No
Contributions received from participants2018-11-30$3,029,182
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-11-30$1,228
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-11-30$716
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-11-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-11-30$0
Liabilities. Value of operating payables at end of year2018-11-30$56,442
Liabilities. Value of operating payables at beginning of year2018-11-30$750
Total non interest bearing cash at end of year2018-11-30$0
Total non interest bearing cash at beginning of year2018-11-30$499,320
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-11-30No
Value of net income/loss2018-11-30$-91,169
Value of net assets at end of year (total assets less liabilities)2018-11-30$613,168
Value of net assets at beginning of year (total assets less liabilities)2018-11-30$704,337
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-11-30No
Were any loans by the plan or fixed income obligations due to the plan in default2018-11-30No
Were any leases to which the plan was party in default or uncollectible2018-11-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-11-30$1,029,405
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-11-30$456,611
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-11-30$456,611
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-11-30$10,777
Expenses. Payments to insurance carriers foe the provision of benefits2018-11-30$440,093
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-11-30Yes
Was there a failure to transmit to the plan any participant contributions2018-11-30No
Has the plan failed to provide any benefit when due under the plan2018-11-30No
Contributions received in cash from employer2018-11-30$3,220,355
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-11-30$5,516,886
Contract administrator fees2018-11-30$330,056
Liabilities. Value of benefit claims payable at end of year2018-11-30$361,023
Liabilities. Value of benefit claims payable at beginning of year2018-11-30$251,560
Did the plan have assets held for investment2018-11-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-11-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-11-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-11-30Yes
Opinion of an independent qualified public accountant for this plan2018-11-30Disclaimer
Accountancy firm name2018-11-30CROWE LLP
Accountancy firm EIN2018-11-30350921680
2017 : KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-11-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-11-30$252,310
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-11-30$330,183
Total income from all sources (including contributions)2017-11-30$5,956,503
Total loss/gain on sale of assets2017-11-30$0
Total of all expenses incurred2017-11-30$6,104,772
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-11-30$5,713,726
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-11-30$5,948,942
Value of total assets at end of year2017-11-30$956,647
Value of total assets at beginning of year2017-11-30$1,182,789
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-11-30$391,046
Total interest from all sources2017-11-30$7,561
Total dividends received (eg from common stock, registered investment company shares)2017-11-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-11-30No
Administrative expenses professional fees incurred2017-11-30$38,774
Was this plan covered by a fidelity bond2017-11-30Yes
Value of fidelity bond cover2017-11-30$200,000
Were there any nonexempt tranactions with any party-in-interest2017-11-30No
Contributions received from participants2017-11-30$2,853,674
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-11-30$716
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-11-30$224
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-11-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-11-30$35,988
Liabilities. Value of operating payables at end of year2017-11-30$750
Liabilities. Value of operating payables at beginning of year2017-11-30$66,362
Total non interest bearing cash at end of year2017-11-30$499,320
Total non interest bearing cash at beginning of year2017-11-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-11-30No
Value of net income/loss2017-11-30$-148,269
Value of net assets at end of year (total assets less liabilities)2017-11-30$704,337
Value of net assets at beginning of year (total assets less liabilities)2017-11-30$852,606
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-11-30No
Were any loans by the plan or fixed income obligations due to the plan in default2017-11-30No
Were any leases to which the plan was party in default or uncollectible2017-11-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-11-30$456,611
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-11-30$1,182,565
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-11-30$1,182,565
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-11-30$7,561
Expenses. Payments to insurance carriers foe the provision of benefits2017-11-30$562,682
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-11-30Yes
Was there a failure to transmit to the plan any participant contributions2017-11-30No
Has the plan failed to provide any benefit when due under the plan2017-11-30No
Contributions received in cash from employer2017-11-30$3,095,268
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-11-30$5,151,044
Contract administrator fees2017-11-30$352,272
Liabilities. Value of benefit claims payable at end of year2017-11-30$251,560
Liabilities. Value of benefit claims payable at beginning of year2017-11-30$227,833
Did the plan have assets held for investment2017-11-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-11-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-11-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-11-30Yes
Opinion of an independent qualified public accountant for this plan2017-11-30Disclaimer
Accountancy firm name2017-11-30CROWE HORWATH LLP
Accountancy firm EIN2017-11-30350921680
2016 : KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-11-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-11-30$330,183
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-11-30$449,666
Total income from all sources (including contributions)2016-11-30$5,932,964
Total loss/gain on sale of assets2016-11-30$0
Total of all expenses incurred2016-11-30$5,873,719
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-11-30$5,373,174
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-11-30$5,930,532
Value of total assets at end of year2016-11-30$1,182,789
Value of total assets at beginning of year2016-11-30$1,243,027
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-11-30$500,545
Total interest from all sources2016-11-30$2,432
Total dividends received (eg from common stock, registered investment company shares)2016-11-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-11-30No
Administrative expenses professional fees incurred2016-11-30$59,585
Was this plan covered by a fidelity bond2016-11-30Yes
Value of fidelity bond cover2016-11-30$200,000
Were there any nonexempt tranactions with any party-in-interest2016-11-30No
Contributions received from participants2016-11-30$2,868,527
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-11-30$224
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-11-30$17
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-11-30$35,988
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-11-30$0
Liabilities. Value of operating payables at end of year2016-11-30$66,362
Liabilities. Value of operating payables at beginning of year2016-11-30$144,100
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-11-30No
Value of net income/loss2016-11-30$59,245
Value of net assets at end of year (total assets less liabilities)2016-11-30$852,606
Value of net assets at beginning of year (total assets less liabilities)2016-11-30$793,361
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-11-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-11-30No
Were any leases to which the plan was party in default or uncollectible2016-11-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-11-30$1,182,565
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-11-30$1,243,010
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-11-30$1,243,010
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-11-30$2,432
Expenses. Payments to insurance carriers foe the provision of benefits2016-11-30$605,248
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-11-30Yes
Was there a failure to transmit to the plan any participant contributions2016-11-30No
Has the plan failed to provide any benefit when due under the plan2016-11-30No
Contributions received in cash from employer2016-11-30$3,062,005
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-11-30$4,767,926
Contract administrator fees2016-11-30$440,960
Liabilities. Value of benefit claims payable at end of year2016-11-30$227,833
Liabilities. Value of benefit claims payable at beginning of year2016-11-30$305,566
Did the plan have assets held for investment2016-11-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-11-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-11-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-11-30Yes
Opinion of an independent qualified public accountant for this plan2016-11-30Disclaimer
Accountancy firm name2016-11-30CROWE HORWATH LLP
Accountancy firm EIN2016-11-30350921680
2015 : KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-11-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-11-30$449,666
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-11-30$467,211
Total income from all sources (including contributions)2015-11-30$5,580,880
Total loss/gain on sale of assets2015-11-30$0
Total of all expenses incurred2015-11-30$5,192,012
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-11-30$4,640,459
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-11-30$5,580,610
Value of total assets at end of year2015-11-30$1,243,027
Value of total assets at beginning of year2015-11-30$871,704
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-11-30$551,553
Total interest from all sources2015-11-30$270
Total dividends received (eg from common stock, registered investment company shares)2015-11-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-11-30No
Administrative expenses professional fees incurred2015-11-30$9,460
Was this plan covered by a fidelity bond2015-11-30Yes
Value of fidelity bond cover2015-11-30$200,000
Were there any nonexempt tranactions with any party-in-interest2015-11-30No
Contributions received from participants2015-11-30$2,689,602
Participant contributions at end of year2015-11-30$0
Participant contributions at beginning of year2015-11-30$15,794
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-11-30$17
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-11-30$31,462
Administrative expenses (other) incurred2015-11-30$24,325
Liabilities. Value of operating payables at end of year2015-11-30$144,100
Liabilities. Value of operating payables at beginning of year2015-11-30$216,740
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-11-30No
Value of net income/loss2015-11-30$388,868
Value of net assets at end of year (total assets less liabilities)2015-11-30$793,361
Value of net assets at beginning of year (total assets less liabilities)2015-11-30$404,493
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-11-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-11-30No
Were any leases to which the plan was party in default or uncollectible2015-11-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-11-30$1,243,010
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-11-30$824,448
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-11-30$824,448
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-11-30$270
Expenses. Payments to insurance carriers foe the provision of benefits2015-11-30$609,522
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-11-30Yes
Was there a failure to transmit to the plan any participant contributions2015-11-30No
Has the plan failed to provide any benefit when due under the plan2015-11-30No
Contributions received in cash from employer2015-11-30$2,891,008
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-11-30$4,030,937
Contract administrator fees2015-11-30$517,768
Liabilities. Value of benefit claims payable at end of year2015-11-30$305,566
Liabilities. Value of benefit claims payable at beginning of year2015-11-30$250,471
Did the plan have assets held for investment2015-11-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-11-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-11-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-11-30Yes
Opinion of an independent qualified public accountant for this plan2015-11-30Disclaimer
Accountancy firm name2015-11-30CROWE HORWATH LLP
Accountancy firm EIN2015-11-30350921680
2014 : KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-11-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-11-30$467,211
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-11-30$0
Total income from all sources (including contributions)2014-11-30$4,810,966
Total loss/gain on sale of assets2014-11-30$0
Total of all expenses incurred2014-11-30$4,406,473
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-11-30$4,009,855
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-11-30$4,810,914
Value of total assets at end of year2014-11-30$871,704
Value of total assets at beginning of year2014-11-30$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-11-30$396,618
Total interest from all sources2014-11-30$52
Total dividends received (eg from common stock, registered investment company shares)2014-11-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-11-30No
Administrative expenses professional fees incurred2014-11-30$7,407
Was this plan covered by a fidelity bond2014-11-30No
Were there any nonexempt tranactions with any party-in-interest2014-11-30No
Contributions received from participants2014-11-30$2,335,236
Participant contributions at end of year2014-11-30$15,794
Participant contributions at beginning of year2014-11-30$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-11-30$31,462
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-11-30$0
Administrative expenses (other) incurred2014-11-30$2,250
Liabilities. Value of operating payables at end of year2014-11-30$216,740
Liabilities. Value of operating payables at beginning of year2014-11-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-11-30No
Value of net income/loss2014-11-30$404,493
Value of net assets at end of year (total assets less liabilities)2014-11-30$404,493
Value of net assets at beginning of year (total assets less liabilities)2014-11-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-11-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-11-30No
Were any leases to which the plan was party in default or uncollectible2014-11-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-11-30$824,448
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-11-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-11-30$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-11-30$52
Expenses. Payments to insurance carriers foe the provision of benefits2014-11-30$569,048
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-11-30Yes
Was there a failure to transmit to the plan any participant contributions2014-11-30No
Has the plan failed to provide any benefit when due under the plan2014-11-30No
Contributions received in cash from employer2014-11-30$2,475,678
Employer contributions (assets) at end of year2014-11-30$0
Employer contributions (assets) at beginning of year2014-11-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-11-30$3,440,807
Contract administrator fees2014-11-30$386,961
Liabilities. Value of benefit claims payable at end of year2014-11-30$250,471
Liabilities. Value of benefit claims payable at beginning of year2014-11-30$0
Did the plan have assets held for investment2014-11-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-11-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-11-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-11-30Yes
Opinion of an independent qualified public accountant for this plan2014-11-30Disclaimer
Accountancy firm name2014-11-30CROWE HORWATH LLP
Accountancy firm EIN2014-11-30350921680

Form 5500 Responses for KAHLIG AUTO GROUP HEALTH BENEFIT PLAN

2021: KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2021 form 5500 responses
2021-12-01Type of plan entitySingle employer plan
2021-12-01Plan funding arrangement – InsuranceYes
2021-12-01Plan funding arrangement – TrustYes
2021-12-01Plan benefit arrangement – InsuranceYes
2021-12-01Plan benefit arrangement - TrustYes
2020: KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2020 form 5500 responses
2020-12-01Type of plan entitySingle employer plan
2020-12-01Plan funding arrangement – InsuranceYes
2020-12-01Plan funding arrangement – TrustYes
2020-12-01Plan benefit arrangement – InsuranceYes
2020-12-01Plan benefit arrangement - TrustYes
2019: KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2019 form 5500 responses
2019-12-01Type of plan entitySingle employer plan
2019-12-01Plan funding arrangement – InsuranceYes
2019-12-01Plan funding arrangement – TrustYes
2019-12-01Plan benefit arrangement – InsuranceYes
2019-12-01Plan benefit arrangement - TrustYes
2018: KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2018 form 5500 responses
2018-12-01Type of plan entitySingle employer plan
2018-12-01Plan funding arrangement – InsuranceYes
2018-12-01Plan funding arrangement – TrustYes
2018-12-01Plan benefit arrangement – InsuranceYes
2018-12-01Plan benefit arrangement - TrustYes
2017: KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2017 form 5500 responses
2017-12-01Type of plan entitySingle employer plan
2017-12-01Submission has been amendedNo
2017-12-01This submission is the final filingNo
2017-12-01This return/report is a short plan year return/report (less than 12 months)No
2017-12-01Plan is a collectively bargained planNo
2017-12-01Plan funding arrangement – InsuranceYes
2017-12-01Plan funding arrangement – TrustYes
2017-12-01Plan benefit arrangement – InsuranceYes
2017-12-01Plan benefit arrangement - TrustYes
2016: KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2016 form 5500 responses
2016-12-01Type of plan entitySingle employer plan
2016-12-01Submission has been amendedNo
2016-12-01This submission is the final filingNo
2016-12-01This return/report is a short plan year return/report (less than 12 months)No
2016-12-01Plan is a collectively bargained planNo
2016-12-01Plan funding arrangement – InsuranceYes
2016-12-01Plan funding arrangement – TrustYes
2016-12-01Plan benefit arrangement – InsuranceYes
2016-12-01Plan benefit arrangement - TrustYes
2015: KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2015 form 5500 responses
2015-12-01Type of plan entitySingle employer plan
2015-12-01Submission has been amendedNo
2015-12-01This submission is the final filingNo
2015-12-01This return/report is a short plan year return/report (less than 12 months)No
2015-12-01Plan is a collectively bargained planNo
2015-12-01Plan funding arrangement – InsuranceYes
2015-12-01Plan funding arrangement – TrustYes
2015-12-01Plan benefit arrangement – InsuranceYes
2015-12-01Plan benefit arrangement - TrustYes
2014: KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2014 form 5500 responses
2014-12-01Type of plan entitySingle employer plan
2014-12-01Submission has been amendedNo
2014-12-01This submission is the final filingNo
2014-12-01This return/report is a short plan year return/report (less than 12 months)No
2014-12-01Plan is a collectively bargained planNo
2014-12-01Plan funding arrangement – InsuranceYes
2014-12-01Plan funding arrangement – TrustYes
2014-12-01Plan benefit arrangement – InsuranceYes
2014-12-01Plan benefit arrangement - TrustYes
2013: KAHLIG AUTO GROUP HEALTH BENEFIT PLAN 2013 form 5500 responses
2013-12-01Type of plan entitySingle employer plan
2013-12-01Submission has been amendedNo
2013-12-01This submission is the final filingNo
2013-12-01This return/report is a short plan year return/report (less than 12 months)No
2013-12-01Plan is a collectively bargained planNo
2013-12-01Plan funding arrangement – InsuranceYes
2013-12-01Plan funding arrangement – TrustYes
2013-12-01Plan benefit arrangement – InsuranceYes
2013-12-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number42966
Policy instance 1
Insurance contract or identification number42966
Number of Individuals Covered1753
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $122,406
Total amount of fees paid to insurance companyUSD $27,767
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $122,406
Amount paid for insurance broker fees27767
Additional information about fees paid to insurance brokerOTHER FEES/COMMISSIONS/SPECIAL PROGRAMS
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number42966
Policy instance 1
Insurance contract or identification number42966
Number of Individuals Covered1735
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $121,247
Total amount of fees paid to insurance companyUSD $14,970
Health Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid as a credit?Yes
Welfare Benefit Premiums Paid to CarrierUSD $444,802
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $121,247
Amount paid for insurance broker fees14970
Additional information about fees paid to insurance brokerOTHER COMMISSIONS
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number42966
Policy instance 1
Insurance contract or identification number42966
Number of Individuals Covered1668
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $118,520
Total amount of fees paid to insurance companyUSD $14,355
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $587,808
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number42966
Policy instance 1
Insurance contract or identification number42966
Number of Individuals Covered1633
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $116,256
Total amount of fees paid to insurance companyUSD $12,750
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $562,013
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $116,256
Amount paid for insurance broker fees12750
Additional information about fees paid to insurance brokerOTHER COMMISSIONS
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number42966 165082
Policy instance 1
Insurance contract or identification number42966 165082
Number of Individuals Covered1623
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $108,548
Total amount of fees paid to insurance companyUSD $12,750
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 $533,665
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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