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GROUP INSURANCE PLAN 401k Plan overview

Plan NameGROUP INSURANCE PLAN
Plan identification number 501

GROUP INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover

401k Sponsoring company profile

OMAHA STEAKS INTERNATIONAL LLC has sponsored the creation of one or more 401k plans.

Company Name:OMAHA STEAKS INTERNATIONAL LLC
Employer identification number (EIN):470460284
NAIC Classification:311110
NAIC Description: Animal Food Manufacturing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012024-01-01ROLLAND JOHNS
5012023-01-01
5012023-01-01ROLLAND JOHNS
5012022-01-01
5012022-01-01DAVID L. HERSHISER
5012021-01-01
5012021-01-01DAVID L. HERSHISER
5012020-01-01
5012019-01-01
5012018-01-01DAVID L. HERSHISER
5012017-01-01DAVID L. HERSHISER
5012016-01-01DAVID L. HERSHISER
5012015-01-01DAVID L. HERSHISER
5012014-01-01DAVID L. HERSHISER
5012013-01-01DAVID L. HERSHISER
5012012-01-01DAVID L. HERSHISER
5012011-01-01DAVID L HERSHISER
5012010-01-01DAVID L HERSHISER
5012009-01-01DAVID L HERSHISER

Plan Statistics for GROUP INSURANCE PLAN

401k plan membership statisitcs for GROUP INSURANCE PLAN

Measure Date Value
2023: GROUP INSURANCE PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-011,017
Total number of active participants reported on line 7a of the Form 55002023-01-011,016
Number of retired or separated participants receiving benefits2023-01-0110
Total of all active and inactive participants2023-01-011,026
Total participants2023-01-011,026
2022: GROUP INSURANCE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01995
Total number of active participants reported on line 7a of the Form 55002022-01-011,015
Number of retired or separated participants receiving benefits2022-01-012
Total of all active and inactive participants2022-01-011,017
Total participants2022-01-011,017
2021: GROUP INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-011,047
Total number of active participants reported on line 7a of the Form 55002021-01-01991
Number of retired or separated participants receiving benefits2021-01-014
Total of all active and inactive participants2021-01-01995
Total participants2021-01-01995
2020: GROUP INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-011,056
Total number of active participants reported on line 7a of the Form 55002020-01-011,038
Number of retired or separated participants receiving benefits2020-01-019
Total of all active and inactive participants2020-01-011,047
Total participants2020-01-011,047
2019: GROUP INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-011,081
Total number of active participants reported on line 7a of the Form 55002019-01-011,047
Number of retired or separated participants receiving benefits2019-01-019
Total of all active and inactive participants2019-01-011,056
Total participants2019-01-011,056
Number of participants with account balances2019-01-010
2018: GROUP INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-011,115
Total number of active participants reported on line 7a of the Form 55002018-01-011,065
Number of retired or separated participants receiving benefits2018-01-0116
Total of all active and inactive participants2018-01-011,081
Total participants2018-01-011,081
2017: GROUP INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-011,062
Total number of active participants reported on line 7a of the Form 55002017-01-011,101
Number of retired or separated participants receiving benefits2017-01-0114
Total of all active and inactive participants2017-01-011,115
Total participants2017-01-011,115
2016: GROUP INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-011,065
Total number of active participants reported on line 7a of the Form 55002016-01-011,049
Number of retired or separated participants receiving benefits2016-01-0113
Total of all active and inactive participants2016-01-011,062
Total participants2016-01-010
2015: GROUP INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-011,009
Total number of active participants reported on line 7a of the Form 55002015-01-011,049
Number of retired or separated participants receiving benefits2015-01-0116
Total of all active and inactive participants2015-01-011,065
Total participants2015-01-010
2014: GROUP INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01998
Total number of active participants reported on line 7a of the Form 55002014-01-01993
Number of retired or separated participants receiving benefits2014-01-0116
Total of all active and inactive participants2014-01-011,009
Total participants2014-01-010
2013: GROUP INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-011,001
Total number of active participants reported on line 7a of the Form 55002013-01-01981
Number of retired or separated participants receiving benefits2013-01-0117
Total of all active and inactive participants2013-01-01998
Total participants2013-01-010
2012: GROUP INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-011,016
Total number of active participants reported on line 7a of the Form 55002012-01-01987
Number of retired or separated participants receiving benefits2012-01-0114
Total of all active and inactive participants2012-01-011,001
Total participants2012-01-010
2011: GROUP INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01934
Total number of active participants reported on line 7a of the Form 55002011-01-011,009
Number of retired or separated participants receiving benefits2011-01-017
Total of all active and inactive participants2011-01-011,016
Total participants2011-01-011,016
2010: GROUP INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-011,051
Total number of active participants reported on line 7a of the Form 55002010-01-01919
Number of retired or separated participants receiving benefits2010-01-0115
Total of all active and inactive participants2010-01-01934
Total participants2010-01-01934
2009: GROUP INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-011,123
Total number of active participants reported on line 7a of the Form 55002009-01-011,040
Number of retired or separated participants receiving benefits2009-01-0111
Total of all active and inactive participants2009-01-011,051
Total participants2009-01-011,051

Financial Data on GROUP INSURANCE PLAN

Measure Date Value
2016 : GROUP INSURANCE PLAN 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$2,866,578
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$3,065,450
Total income from all sources (including contributions)2016-12-31$2,867,765
Total of all expenses incurred2016-12-31$3,298,609
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$3,298,609
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$2,866,578
Value of total assets at end of year2016-12-31$2,867,817
Value of total assets at beginning of year2016-12-31$3,497,533
Total interest from all sources2016-12-31$1,187
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$1,000,000
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
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$51
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$167,990
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$2,866,578
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$2,738,575
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-430,844
Value of net assets at end of year (total assets less liabilities)2016-12-31$1,239
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$432,083
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 in common/collective trusts at end of year2016-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$2,867,766
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$3,149,734
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$3,149,734
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$1,187
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31Yes
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$2,866,578
Employer contributions (assets) at beginning of year2016-12-31$179,809
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$3,298,609
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$326,875
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
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 name2016-12-31BKD, LLP
Accountancy firm EIN2016-12-31440160260
2015 : GROUP INSURANCE PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$3,065,450
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$3,320,246
Total income from all sources (including contributions)2015-12-31$11,006,106
Total of all expenses incurred2015-12-31$10,436,122
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$9,862,348
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$11,005,930
Value of total assets at end of year2015-12-31$3,497,533
Value of total assets at beginning of year2015-12-31$3,182,345
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$573,774
Total interest from all sources2015-12-31$176
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$1,000,000
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$8,006,819
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$167,990
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$191,752
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$2,738,575
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$2,435,246
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$569,984
Value of net assets at end of year (total assets less liabilities)2015-12-31$432,083
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$-137,901
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 in common/collective trusts at end of year2015-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$3,149,734
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$2,831,890
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$2,831,890
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$176
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$1,108,159
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31Yes
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$2,999,111
Employer contributions (assets) at end of year2015-12-31$179,809
Employer contributions (assets) at beginning of year2015-12-31$158,703
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$8,754,189
Contract administrator fees2015-12-31$573,774
Liabilities. Value of benefit claims payable at end of year2015-12-31$326,875
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$885,000
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
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 name2015-12-31BKD, LLP
Accountancy firm EIN2015-12-31440160260
2014 : GROUP INSURANCE PLAN 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$3,320,246
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$2,968,008
Total income from all sources (including contributions)2014-12-31$11,056,211
Total of all expenses incurred2014-12-31$11,264,029
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$10,668,299
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$11,056,064
Value of total assets at end of year2014-12-31$3,182,345
Value of total assets at beginning of year2014-12-31$3,037,925
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$595,730
Total interest from all sources2014-12-31$147
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$1,000,000
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$7,723,584
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$191,752
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$16,322
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$2,435,246
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$2,377,865
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-207,818
Value of net assets at end of year (total assets less liabilities)2014-12-31$-137,901
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$69,917
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 in common/collective trusts at end of year2014-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$2,831,890
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$2,779,492
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$2,779,492
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$147
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$1,103,201
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
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$3,332,480
Employer contributions (assets) at end of year2014-12-31$158,703
Employer contributions (assets) at beginning of year2014-12-31$242,111
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$9,565,098
Contract administrator fees2014-12-31$595,730
Liabilities. Value of benefit claims payable at end of year2014-12-31$885,000
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$590,143
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
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 name2014-12-31BKD, LLP
Accountancy firm EIN2014-12-31440160260
2013 : GROUP INSURANCE PLAN 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$2,968,008
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$2,967,780
Total income from all sources (including contributions)2013-12-31$10,453,454
Total of all expenses incurred2013-12-31$10,581,405
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$10,125,611
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$10,453,336
Value of total assets at end of year2013-12-31$3,037,925
Value of total assets at beginning of year2013-12-31$3,165,648
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$455,794
Total interest from all sources2013-12-31$118
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$1,000,000
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$3,125,963
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$16,322
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$126,567
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$2,377,865
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$2,248,734
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-127,951
Value of net assets at end of year (total assets less liabilities)2013-12-31$69,917
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$197,868
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 in common/collective trusts at end of year2013-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$2,779,492
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$2,727,771
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$2,727,771
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$118
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$1,072,790
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31Yes
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$7,327,373
Employer contributions (assets) at end of year2013-12-31$242,111
Employer contributions (assets) at beginning of year2013-12-31$311,310
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$9,052,821
Contract administrator fees2013-12-31$455,794
Liabilities. Value of benefit claims payable at end of year2013-12-31$590,143
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$719,046
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
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 name2013-12-31BKD, LLP
Accountancy firm EIN2013-12-31440160260
2012 : GROUP INSURANCE PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$2,967,780
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$2,949,488
Total income from all sources (including contributions)2012-12-31$11,567,782
Total of all expenses incurred2012-12-31$11,545,034
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$10,924,505
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$11,567,612
Value of total assets at end of year2012-12-31$3,165,648
Value of total assets at beginning of year2012-12-31$3,124,608
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$620,529
Total interest from all sources2012-12-31$170
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$1,000,000
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$3,038,186
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$126,567
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$167,806
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$2,248,734
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$2,247,536
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$22,748
Value of net assets at end of year (total assets less liabilities)2012-12-31$197,868
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$175,120
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 in common/collective trusts at end of year2012-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$2,727,771
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$2,875,872
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$2,875,872
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$170
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$917,573
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31Yes
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$8,529,426
Employer contributions (assets) at end of year2012-12-31$311,310
Employer contributions (assets) at beginning of year2012-12-31$80,930
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$10,006,932
Contract administrator fees2012-12-31$620,529
Liabilities. Value of benefit claims payable at end of year2012-12-31$719,046
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$701,952
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
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 name2012-12-31BKD, LLP
Accountancy firm EIN2012-12-31440160260
2011 : GROUP INSURANCE PLAN 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$2,949,488
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$2,677,118
Total income from all sources (including contributions)2011-12-31$12,161,366
Total of all expenses incurred2011-12-31$12,166,599
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$11,865,504
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$12,161,233
Value of total assets at end of year2011-12-31$3,124,608
Value of total assets at beginning of year2011-12-31$2,857,471
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$301,095
Total interest from all sources2011-12-31$133
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$1,000,000
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$2,818,307
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$167,806
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$118,736
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$2,247,536
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$2,096,177
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-5,233
Value of net assets at end of year (total assets less liabilities)2011-12-31$175,120
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$180,353
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$2,875,872
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$2,465,525
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$2,465,525
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$133
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$1,019,641
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
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$9,342,926
Employer contributions (assets) at end of year2011-12-31$80,930
Employer contributions (assets) at beginning of year2011-12-31$273,210
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$10,845,863
Contract administrator fees2011-12-31$301,095
Liabilities. Value of benefit claims payable at end of year2011-12-31$701,952
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$580,941
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
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 name2011-12-31BKD, LLP
Accountancy firm EIN2011-12-31440160260
2010 : GROUP INSURANCE PLAN 2010 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$2,677,118
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$2,580,077
Total income from all sources (including contributions)2010-12-31$11,244,384
Total of all expenses incurred2010-12-31$11,690,057
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$11,389,044
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$11,244,266
Value of total assets at end of year2010-12-31$2,857,471
Value of total assets at beginning of year2010-12-31$3,206,103
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$301,013
Total interest from all sources2010-12-31$118
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$1,000,000
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$2,568,364
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$118,736
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$570,277
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$2,096,177
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$1,943,669
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-445,673
Value of net assets at end of year (total assets less liabilities)2010-12-31$180,353
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$626,026
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$2,465,525
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$2,478,028
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$2,478,028
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$118
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$984,061
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
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$8,675,902
Employer contributions (assets) at end of year2010-12-31$273,210
Employer contributions (assets) at beginning of year2010-12-31$157,798
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$10,404,983
Contract administrator fees2010-12-31$301,013
Liabilities. Value of benefit claims payable at end of year2010-12-31$580,941
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$636,408
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
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 name2010-12-31BKD, LLP
Accountancy firm EIN2010-12-31440160260

Form 5500 Responses for GROUP INSURANCE PLAN

2023: GROUP INSURANCE PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: GROUP INSURANCE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: GROUP INSURANCE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: GROUP INSURANCE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
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: GROUP INSURANCE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
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: GROUP INSURANCE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
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: GROUP INSURANCE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: GROUP INSURANCE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: GROUP INSURANCE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: GROUP INSURANCE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: GROUP INSURANCE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: GROUP INSURANCE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: GROUP INSURANCE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: GROUP INSURANCE PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: GROUP INSURANCE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0ALGL
Policy instance 3
Insurance contract or identification numberGVTL0ALGL
Number of Individuals Covered389
Insurance policy start date2023-01-01
Insurance policy end date2024-01-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $17,629
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $239,336
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number937525
Policy instance 8
Insurance contract or identification number937525
Number of Individuals Covered731
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $107,531
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $1,374,565
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUD0ALGL
Policy instance 1
Insurance contract or identification numberGUD0ALGL
Number of Individuals Covered583
Insurance policy start date2023-01-01
Insurance policy end date2024-01-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $16,390
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $237,821
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0ALGL
Policy instance 2
Insurance contract or identification numberGLUG0ALGL
Number of Individuals Covered1016
Insurance policy start date2023-01-01
Insurance policy end date2024-01-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,678
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $54,104
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberGMDL0ALGL
Policy instance 4
Insurance contract or identification numberGMDL0ALGL
Number of Individuals Covered1
Insurance policy start date2023-01-01
Insurance policy end date2024-01-01
Total amount of commissions paid to insurance brokerUSD $392
Total amount of fees paid to insurance companyUSD $548
Other welfare benefits providedACCIDENTAL DEATH & DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $2,610
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9694308
Policy instance 5
Insurance contract or identification number9694308
Number of Individuals Covered996
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $55,922
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9833211
Policy instance 6
Insurance contract or identification number9833211
Number of Individuals Covered9
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $189
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number18200
Policy instance 7
Insurance contract or identification number18200
Number of Individuals Covered510
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $34,954
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $147,786
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9833211
Policy instance 6
Insurance contract or identification number9833211
Number of Individuals Covered4
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $296
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUD0ALGL
Policy instance 1
Insurance contract or identification numberGUD0ALGL
Number of Individuals Covered646
Insurance policy start date2022-01-01
Insurance policy end date2023-01-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $15,979
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $234,144
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0ALGL
Policy instance 2
Insurance contract or identification numberGLUG0ALGL
Number of Individuals Covered1015
Insurance policy start date2022-01-01
Insurance policy end date2023-01-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,464
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $52,543
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0ALGL
Policy instance 3
Insurance contract or identification numberGVTL0ALGL
Number of Individuals Covered430
Insurance policy start date2022-01-01
Insurance policy end date2023-01-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $17,644
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $251,849
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberGMDL0ALGL
Policy instance 4
Insurance contract or identification numberGMDL0ALGL
Number of Individuals Covered1
Insurance policy start date2022-01-01
Insurance policy end date2023-01-01
Total amount of commissions paid to insurance brokerUSD $392
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENTAL DEATH & DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $2,610
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9694308
Policy instance 5
Insurance contract or identification number9694308
Number of Individuals Covered1029
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $55,803
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number18200
Policy instance 7
Insurance contract or identification number18200
Number of Individuals Covered467
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $34,594
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $151,849
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number937525
Policy instance 8
Insurance contract or identification number937525
Number of Individuals Covered728
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $70,805
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $1,538,516
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9833211
Policy instance 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number937525
Policy instance 7
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUD0ALGL
Policy instance 1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0ALGL
Policy instance 4
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0ALGL
Policy instance 5
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number18200
Policy instance 6
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberG000ALGL
Policy instance 8
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9694308
Policy instance 2
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10053473
Policy instance 1
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9694308
Policy instance 2
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9833211
Policy instance 3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0ALGL
Policy instance 4
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0ALGL
Policy instance 5
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number18200
Policy instance 6
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number937525
Policy instance 7
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberG000ALGL
Policy instance 8
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10053473
Policy instance 1
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9694308
Policy instance 2
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9833211
Policy instance 3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0ALGL
Policy instance 4
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0ALGL
Policy instance 5
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number18200
Policy instance 6
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )
Policy contract numberERLL19101512001
Policy instance 7
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL32162
Policy instance 7
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number18200
Policy instance 6
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0ALGL
Policy instance 5
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0ALGL
Policy instance 4
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9833211
Policy instance 3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9694308
Policy instance 2
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10053473
Policy instance 1
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10053473
Policy instance 1
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9694308
Policy instance 2
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9833211
Policy instance 3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0ALGL
Policy instance 4
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0ALGL
Policy instance 5
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number18200
Policy instance 6
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL32162
Policy instance 7
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number18200
Policy instance 6
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0ALGL
Policy instance 5
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0ALGL
Policy instance 4
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9833211
Policy instance 3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10053473
Policy instance 1
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9694308
Policy instance 2
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number4052950010SSLS
Policy instance 7
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10053473
Policy instance 1
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9694308
Policy instance 2
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0ALGL
Policy instance 4
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9833211
Policy instance 3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0ALGL
Policy instance 5
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number18200
Policy instance 6
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberSLM540127
Policy instance 7
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10053473
Policy instance 1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0ALGL
Policy instance 4
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number742340
Policy instance 6
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number18200
Policy instance 7
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9694308
Policy instance 2
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9833211
Policy instance 3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0ALGL
Policy instance 5
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9833211
Policy instance 3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10094010
Policy instance 5
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9694308
Policy instance 4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10053473
Policy instance 7
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0ALGL
Policy instance 2
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number4000001000
Policy instance 6
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0ALGL
Policy instance 1
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10053473
Policy instance 4
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9694308
Policy instance 1
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10094010
Policy instance 2
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number4000001000
Policy instance 3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10053473
Policy instance 4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number4000001000
Policy instance 3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10094010
Policy instance 2
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9694308
Policy instance 1

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