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UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 401k Plan overview

Plan NameUFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND
Plan identification number 502

UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND Benefits

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

401k Sponsoring company profile

BOARD OF TRUSTEES, UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND has sponsored the creation of one or more 401k plans.

Company Name:BOARD OF TRUSTEES, UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND
Employer identification number (EIN):526044428
NAIC Classification:525100
NAIC Description: Insurance and Employee Benefit Funds

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01MARK FEDERICI2023-10-10 WILLIAM SEEHAFER2023-10-11
5022021-01-01MARK FEDERICI2023-01-22 WILLIAM SEEHAFER2023-01-10
5022020-01-01MARK FEDERICI2021-10-14 WILLIAM SEEHAFER2021-10-14
5022019-01-01MARK FEDERICI2020-09-30 WILLIAM SEEHAFER2020-10-04
5022018-01-01MARK FEDERICI2019-10-08 DONNA GWIN2019-10-08
5022017-01-01
5022016-01-01
5022015-01-01MARK FEDERICI
5022014-01-01
5022013-01-01
5022012-01-01DONNA M. GWIN MARK FEDERICI2013-10-15
5022011-01-01THOMAS P. MCNUTT ALIA SAMAD-SALAMEH2012-10-15
5022009-01-01THOMAS P. MCNUTT JULIE MCWILLIAMS2010-10-15

Plan Statistics for UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND

401k plan membership statisitcs for UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND

Measure Date Value
2022: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2022 401k membership
Total participants, beginning-of-year2022-01-011,286
Total number of active participants reported on line 7a of the Form 55002022-01-01770
Number of retired or separated participants receiving benefits2022-01-01383
Total of all active and inactive participants2022-01-011,153
Number of employers contributing to the scheme2022-01-014
2021: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2021 401k membership
Total participants, beginning-of-year2021-01-011,466
Total number of active participants reported on line 7a of the Form 55002021-01-01872
Number of retired or separated participants receiving benefits2021-01-01414
Total of all active and inactive participants2021-01-011,286
Number of employers contributing to the scheme2021-01-015
2020: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2020 401k membership
Total participants, beginning-of-year2020-01-012,040
Total number of active participants reported on line 7a of the Form 55002020-01-011,032
Number of retired or separated participants receiving benefits2020-01-01434
Total of all active and inactive participants2020-01-011,466
Number of employers contributing to the scheme2020-01-015
2019: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2019 401k membership
Total participants, beginning-of-year2019-01-012,222
Total number of active participants reported on line 7a of the Form 55002019-01-011,590
Number of retired or separated participants receiving benefits2019-01-01450
Total of all active and inactive participants2019-01-012,040
Number of employers contributing to the scheme2019-01-016
2018: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2018 401k membership
Total participants, beginning-of-year2018-01-015,388
Total number of active participants reported on line 7a of the Form 55002018-01-011,752
Number of retired or separated participants receiving benefits2018-01-01470
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-012,222
Number of employers contributing to the scheme2018-01-017
2017: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2017 401k membership
Total participants, beginning-of-year2017-01-015,839
Total number of active participants reported on line 7a of the Form 55002017-01-014,911
Number of retired or separated participants receiving benefits2017-01-01477
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-015,388
Number of employers contributing to the scheme2017-01-018
2016: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2016 401k membership
Total participants, beginning-of-year2016-01-015,963
Total number of active participants reported on line 7a of the Form 55002016-01-015,089
Number of retired or separated participants receiving benefits2016-01-01750
Total of all active and inactive participants2016-01-015,839
Number of employers contributing to the scheme2016-01-019
2015: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2015 401k membership
Total participants, beginning-of-year2015-01-017,576
Total number of active participants reported on line 7a of the Form 55002015-01-015,245
Number of retired or separated participants receiving benefits2015-01-01718
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-015,963
Number of employers contributing to the scheme2015-01-019
2014: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2014 401k membership
Total participants, beginning-of-year2014-01-018,346
Total number of active participants reported on line 7a of the Form 55002014-01-016,749
Number of retired or separated participants receiving benefits2014-01-01827
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-017,576
Number of employers contributing to the scheme2014-01-0110
2013: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2013 401k membership
Total participants, beginning-of-year2013-01-017,721
Total number of active participants reported on line 7a of the Form 55002013-01-017,522
Number of retired or separated participants receiving benefits2013-01-01824
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-018,346
Number of employers contributing to the scheme2013-01-0112
2012: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2012 401k membership
Total participants, beginning-of-year2012-01-0110,272
Total number of active participants reported on line 7a of the Form 55002012-01-016,866
Number of retired or separated participants receiving benefits2012-01-01855
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-017,721
Number of employers contributing to the scheme2012-01-0112
2011: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2011 401k membership
Total participants, beginning-of-year2011-01-0110,101
Total number of active participants reported on line 7a of the Form 55002011-01-019,408
Number of retired or separated participants receiving benefits2011-01-01864
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-0110,272
Number of employers contributing to the scheme2011-01-0113
2009: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2009 401k membership
Total participants, beginning-of-year2009-01-019,541
Total number of active participants reported on line 7a of the Form 55002009-01-019,032
Number of retired or separated participants receiving benefits2009-01-01750
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-019,782
Number of employers contributing to the scheme2009-01-0113

Financial Data on UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND

Measure Date Value
2022 : UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$0
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$1,596,876
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$2,918,831
Total income from all sources (including contributions)2022-12-31$13,954,102
Total loss/gain on sale of assets2022-12-31$-54,108
Total of all expenses incurred2022-12-31$12,727,414
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$11,400,297
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$13,909,330
Value of total assets at end of year2022-12-31$4,704,636
Value of total assets at beginning of year2022-12-31$4,799,903
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$1,327,117
Total interest from all sources2022-12-31$72,020
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$0
Administrative expenses professional fees incurred2022-12-31$642,490
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$138,422
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-12-31$1,260,057
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$573,380
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$830,370
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$133,142
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$133,142
Other income not declared elsewhere2022-12-31$26,860
Administrative expenses (other) incurred2022-12-31$481,313
Liabilities. Value of operating payables at end of year2022-12-31$188,708
Liabilities. Value of operating payables at beginning of year2022-12-31$136,615
Total non interest bearing cash at end of year2022-12-31$916,154
Total non interest bearing cash at beginning of year2022-12-31$529
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$1,226,688
Value of net assets at end of year (total assets less liabilities)2022-12-31$3,107,760
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$1,881,072
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$4,781
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$1,981,542
Interest earned on other investments2022-12-31$38,639
Income. Interest from US Government securities2022-12-31$11,776
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$2,283,662
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$21,605
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$3,201,736
Asset value of US Government securities at beginning of year2022-12-31$352,110
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31Yes
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$13,770,908
Employer contributions (assets) at end of year2022-12-31$909,398
Employer contributions (assets) at beginning of year2022-12-31$899,132
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$6,938,504
Asset. Corporate debt instrument debt (other) at beginning of year2022-12-31$723,374
Contract administrator fees2022-12-31$198,533
Liabilities. Value of benefit claims payable at end of year2022-12-31$1,275,026
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$2,649,074
Assets. Value of buildings and other operty used in plan operation at end of year2022-12-31$22,042
Assets. Value of buildings and other operty used in plan operation at beginning of year2022-12-31$12,846
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Aggregate proceeds on sale of assets2022-12-31$1,098,970
Aggregate carrying amount (costs) on sale of assets2022-12-31$1,153,078
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31WITHUMSMITH+BROWN, PC
Accountancy firm EIN2022-12-31222027092
2021 : UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2021-12-31$51,447
Total unrealized appreciation/depreciation of assets2021-12-31$51,447
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$2,918,831
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$1,616,782
Total income from all sources (including contributions)2021-12-31$10,366,424
Total loss/gain on sale of assets2021-12-31$-134,118
Total of all expenses incurred2021-12-31$15,414,548
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$14,213,249
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$10,331,024
Value of total assets at end of year2021-12-31$4,799,903
Value of total assets at beginning of year2021-12-31$8,545,978
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$1,201,299
Total interest from all sources2021-12-31$56,148
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$711
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$711
Administrative expenses professional fees incurred2021-12-31$415,391
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$164,155
Assets. Other investments not covered elsewhere at end of year2021-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2021-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2021-12-31$1,372,017
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$830,370
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$694,739
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$133,142
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$133,142
Other income not declared elsewhere2021-12-31$61,212
Administrative expenses (other) incurred2021-12-31$556,336
Liabilities. Value of operating payables at end of year2021-12-31$136,615
Liabilities. Value of operating payables at beginning of year2021-12-31$103,808
Total non interest bearing cash at end of year2021-12-31$529
Total non interest bearing cash at beginning of year2021-12-31$2,580
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$-5,048,124
Value of net assets at end of year (total assets less liabilities)2021-12-31$1,881,072
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$6,929,196
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$9,299
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$1,981,542
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$4,957,937
Interest earned on other investments2021-12-31$56,148
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$2,995,887
Asset value of US Government securities at end of year2021-12-31$352,110
Asset value of US Government securities at beginning of year2021-12-31$724,604
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31Yes
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$10,166,869
Employer contributions (assets) at end of year2021-12-31$899,132
Employer contributions (assets) at beginning of year2021-12-31$786,447
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$9,845,345
Asset. Corporate debt instrument debt (other) at end of year2021-12-31$723,374
Asset. Corporate debt instrument debt (other) at beginning of year2021-12-31$1,359,914
Contract administrator fees2021-12-31$220,273
Liabilities. Value of benefit claims payable at end of year2021-12-31$2,649,074
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$1,379,832
Assets. Value of buildings and other operty used in plan operation at end of year2021-12-31$12,846
Assets. Value of buildings and other operty used in plan operation at beginning of year2021-12-31$19,757
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Aggregate proceeds on sale of assets2021-12-31$1,598,181
Aggregate carrying amount (costs) on sale of assets2021-12-31$1,732,299
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31WITHUMSMITH+BROWN, PC
Accountancy firm EIN2021-12-31222027092
2020 : UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2020-12-31$54,881
Total unrealized appreciation/depreciation of assets2020-12-31$54,881
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$1,616,782
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$2,144,235
Total income from all sources (including contributions)2020-12-31$11,769,817
Total loss/gain on sale of assets2020-12-31$10,542
Total of all expenses incurred2020-12-31$16,522,155
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$15,269,028
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$11,586,778
Value of total assets at end of year2020-12-31$8,545,978
Value of total assets at beginning of year2020-12-31$13,825,769
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$1,253,127
Total interest from all sources2020-12-31$53,934
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$40,907
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$40,907
Administrative expenses professional fees incurred2020-12-31$296,088
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$193,666
Assets. Other investments not covered elsewhere at end of year2020-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2020-12-31$56,503
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-12-31$1,591,378
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$694,739
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$752,129
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$133,142
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$133,142
Other income not declared elsewhere2020-12-31$22,775
Administrative expenses (other) incurred2020-12-31$622,265
Liabilities. Value of operating payables at end of year2020-12-31$103,808
Liabilities. Value of operating payables at beginning of year2020-12-31$132,564
Total non interest bearing cash at end of year2020-12-31$2,580
Total non interest bearing cash at beginning of year2020-12-31$1,145
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$-4,752,338
Value of net assets at end of year (total assets less liabilities)2020-12-31$6,929,196
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$11,681,534
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Investment advisory and management fees2020-12-31$9,637
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$4,957,937
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$9,320,269
Interest earned on other investments2020-12-31$53,934
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$4,021,642
Asset value of US Government securities at end of year2020-12-31$724,604
Asset value of US Government securities at beginning of year2020-12-31$732,026
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31Yes
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$11,393,112
Employer contributions (assets) at end of year2020-12-31$786,447
Employer contributions (assets) at beginning of year2020-12-31$1,710,240
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$9,656,008
Asset. Corporate debt instrument debt (other) at end of year2020-12-31$1,359,914
Asset. Corporate debt instrument debt (other) at beginning of year2020-12-31$1,163,419
Contract administrator fees2020-12-31$325,137
Liabilities. Value of benefit claims payable at end of year2020-12-31$1,379,832
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$1,878,529
Assets. Value of buildings and other operty used in plan operation at end of year2020-12-31$19,757
Assets. Value of buildings and other operty used in plan operation at beginning of year2020-12-31$90,038
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Aggregate proceeds on sale of assets2020-12-31$1,077,655
Aggregate carrying amount (costs) on sale of assets2020-12-31$1,067,113
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31WITHUMSMITH+BROWN, PC
Accountancy firm EIN2020-12-31222027092
2019 : UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$43,332
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$43,332
Total unrealized appreciation/depreciation of assets2019-12-31$43,332
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,144,235
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,144,235
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,485,285
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,485,285
Total income from all sources (including contributions)2019-12-31$20,880,922
Total income from all sources (including contributions)2019-12-31$20,880,922
Total loss/gain on sale of assets2019-12-31$17,201
Total loss/gain on sale of assets2019-12-31$17,201
Total of all expenses incurred2019-12-31$19,937,648
Total of all expenses incurred2019-12-31$19,937,648
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$18,574,286
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$18,574,286
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$20,565,317
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$20,565,317
Value of total assets at end of year2019-12-31$13,825,769
Value of total assets at end of year2019-12-31$13,825,769
Value of total assets at beginning of year2019-12-31$13,223,545
Value of total assets at beginning of year2019-12-31$13,223,545
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,363,362
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,363,362
Total interest from all sources2019-12-31$57,257
Total interest from all sources2019-12-31$57,257
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$175,315
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$175,315
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$175,315
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$175,315
Administrative expenses professional fees incurred2019-12-31$208,023
Administrative expenses professional fees incurred2019-12-31$208,023
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
Value of fidelity bond cover2019-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$197,363
Contributions received from participants2019-12-31$197,363
Assets. Other investments not covered elsewhere at end of year2019-12-31$56,503
Assets. Other investments not covered elsewhere at end of year2019-12-31$56,503
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$161,207
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$161,207
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$4,404,784
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$4,404,784
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$752,129
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$752,129
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$853,065
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$853,065
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$133,142
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$133,142
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$133,142
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$133,142
Other income not declared elsewhere2019-12-31$22,500
Other income not declared elsewhere2019-12-31$22,500
Administrative expenses (other) incurred2019-12-31$772,520
Administrative expenses (other) incurred2019-12-31$772,520
Liabilities. Value of operating payables at end of year2019-12-31$132,564
Liabilities. Value of operating payables at end of year2019-12-31$132,564
Liabilities. Value of operating payables at beginning of year2019-12-31$128,588
Liabilities. Value of operating payables at beginning of year2019-12-31$128,588
Total non interest bearing cash at end of year2019-12-31$1,145
Total non interest bearing cash at end of year2019-12-31$1,145
Total non interest bearing cash at beginning of year2019-12-31$25,752
Total non interest bearing cash at beginning of year2019-12-31$25,752
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$943,274
Value of net income/loss2019-12-31$943,274
Value of net assets at end of year (total assets less liabilities)2019-12-31$11,681,534
Value of net assets at end of year (total assets less liabilities)2019-12-31$11,681,534
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$10,738,260
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$10,738,260
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$8,486
Investment advisory and management fees2019-12-31$8,486
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$9,320,269
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$9,059,478
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$9,059,478
Interest earned on other investments2019-12-31$57,257
Interest earned on other investments2019-12-31$57,257
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$1,904,437
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$1,904,437
Asset value of US Government securities at end of year2019-12-31$732,026
Asset value of US Government securities at end of year2019-12-31$732,026
Asset value of US Government securities at beginning of year2019-12-31$565,286
Asset value of US Government securities at beginning of year2019-12-31$565,286
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$20,367,954
Contributions received in cash from employer2019-12-31$20,367,954
Employer contributions (assets) at end of year2019-12-31$1,710,240
Employer contributions (assets) at end of year2019-12-31$1,710,240
Employer contributions (assets) at beginning of year2019-12-31$1,436,222
Employer contributions (assets) at beginning of year2019-12-31$1,436,222
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$12,265,065
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$12,265,065
Asset. Corporate debt instrument debt (other) at end of year2019-12-31$1,163,419
Asset. Corporate debt instrument debt (other) at end of year2019-12-31$1,163,419
Asset. Corporate debt instrument debt (other) at beginning of year2019-12-31$1,107,131
Asset. Corporate debt instrument debt (other) at beginning of year2019-12-31$1,107,131
Contract administrator fees2019-12-31$374,333
Contract administrator fees2019-12-31$374,333
Liabilities. Value of benefit claims payable at end of year2019-12-31$1,878,529
Liabilities. Value of benefit claims payable at end of year2019-12-31$1,878,529
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$2,223,555
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$2,223,555
Assets. Value of buildings and other operty used in plan operation at end of year2019-12-31$90,038
Assets. Value of buildings and other operty used in plan operation at end of year2019-12-31$90,038
Assets. Value of buildings and other operty used in plan operation at beginning of year2019-12-31$15,404
Assets. Value of buildings and other operty used in plan operation at beginning of year2019-12-31$15,404
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Aggregate proceeds on sale of assets2019-12-31$1,614,344
Aggregate proceeds on sale of assets2019-12-31$1,614,344
Aggregate carrying amount (costs) on sale of assets2019-12-31$1,597,143
Aggregate carrying amount (costs) on sale of assets2019-12-31$1,597,143
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31WITHUMSMITH+BROWN PC
Accountancy firm name2019-12-31WITHUMSMITH+BROWN PC
Accountancy firm EIN2019-12-31222027092
Accountancy firm EIN2019-12-31222027092
2018 : UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$1,983
Total unrealized appreciation/depreciation of assets2018-12-31$1,983
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$2,485,285
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$3,870,212
Total income from all sources (including contributions)2018-12-31$26,506,133
Total loss/gain on sale of assets2018-12-31$-23,280
Total of all expenses incurred2018-12-31$21,315,734
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$19,549,714
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$26,333,487
Value of total assets at end of year2018-12-31$13,223,545
Value of total assets at beginning of year2018-12-31$9,418,073
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$1,766,020
Total interest from all sources2018-12-31$56,089
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$115,308
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$115,308
Administrative expenses professional fees incurred2018-12-31$307,823
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$269,781
Assets. Other investments not covered elsewhere at end of year2018-12-31$161,207
Assets. Other investments not covered elsewhere at beginning of year2018-12-31$123,453
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$3,843,961
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$853,065
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$337,039
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$133,142
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$130,307
Other income not declared elsewhere2018-12-31$22,546
Administrative expenses (other) incurred2018-12-31$986,396
Liabilities. Value of operating payables at end of year2018-12-31$128,588
Liabilities. Value of operating payables at beginning of year2018-12-31$213,335
Total non interest bearing cash at end of year2018-12-31$25,752
Total non interest bearing cash at beginning of year2018-12-31$176,317
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$5,190,399
Value of net assets at end of year (total assets less liabilities)2018-12-31$10,738,260
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$5,547,861
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Investment advisory and management fees2018-12-31$6,650
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$9,059,478
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$4,823,712
Interest earned on other investments2018-12-31$56,089
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$2,156,641
Asset value of US Government securities at end of year2018-12-31$565,286
Asset value of US Government securities at beginning of year2018-12-31$606,932
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31Yes
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$26,063,706
Employer contributions (assets) at end of year2018-12-31$1,436,222
Employer contributions (assets) at beginning of year2018-12-31$2,254,549
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$13,549,112
Asset. Corporate debt instrument debt (other) at end of year2018-12-31$1,107,131
Asset. Corporate debt instrument debt (other) at beginning of year2018-12-31$1,079,462
Contract administrator fees2018-12-31$465,151
Liabilities. Value of benefit claims payable at end of year2018-12-31$2,223,555
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$3,526,570
Assets. Value of buildings and other operty used in plan operation at end of year2018-12-31$15,404
Assets. Value of buildings and other operty used in plan operation at beginning of year2018-12-31$16,609
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Aggregate proceeds on sale of assets2018-12-31$578,678
Aggregate carrying amount (costs) on sale of assets2018-12-31$601,958
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31WITHUMSMITH&BROWN
Accountancy firm EIN2018-12-31222027092
2017 : UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2017-12-31$15,879
Total unrealized appreciation/depreciation of assets2017-12-31$15,879
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$3,870,212
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$4,822,063
Total income from all sources (including contributions)2017-12-31$48,221,183
Total loss/gain on sale of assets2017-12-31$-19,779
Total of all expenses incurred2017-12-31$46,514,483
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$42,192,208
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$48,115,764
Value of total assets at end of year2017-12-31$9,418,073
Value of total assets at beginning of year2017-12-31$8,663,224
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$4,322,275
Total interest from all sources2017-12-31$56,535
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$30,284
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$30,284
Administrative expenses professional fees incurred2017-12-31$948,533
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$532,678
Assets. Other investments not covered elsewhere at end of year2017-12-31$123,453
Assets. Other investments not covered elsewhere at beginning of year2017-12-31$160,905
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-12-31$12,381,121
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$337,039
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$695,569
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$130,307
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$0
Other income not declared elsewhere2017-12-31$22,500
Administrative expenses (other) incurred2017-12-31$2,681,915
Liabilities. Value of operating payables at end of year2017-12-31$213,335
Liabilities. Value of operating payables at beginning of year2017-12-31$489,521
Total non interest bearing cash at end of year2017-12-31$176,317
Total non interest bearing cash at beginning of year2017-12-31$25,183
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$1,706,700
Value of net assets at end of year (total assets less liabilities)2017-12-31$5,547,861
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$3,841,161
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Investment advisory and management fees2017-12-31$5,899
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$4,823,712
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$3,237,562
Interest earned on other investments2017-12-31$56,535
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$3,320,842
Asset value of US Government securities at end of year2017-12-31$606,932
Asset value of US Government securities at beginning of year2017-12-31$581,205
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31Yes
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$47,583,086
Employer contributions (assets) at end of year2017-12-31$2,254,549
Employer contributions (assets) at beginning of year2017-12-31$2,937,508
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$26,490,245
Asset. Corporate debt instrument debt (other) at end of year2017-12-31$1,079,462
Asset. Corporate debt instrument debt (other) at beginning of year2017-12-31$1,006,259
Contract administrator fees2017-12-31$685,928
Liabilities. Value of benefit claims payable at end of year2017-12-31$3,526,570
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$4,332,542
Assets. Value of buildings and other operty used in plan operation at end of year2017-12-31$16,609
Assets. Value of buildings and other operty used in plan operation at beginning of year2017-12-31$19,033
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Aggregate proceeds on sale of assets2017-12-31$858,083
Aggregate carrying amount (costs) on sale of assets2017-12-31$877,862
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31WITHUMSMITH&BROWN
Accountancy firm EIN2017-12-31222027092
2016 : UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2016-12-31$3,617
Total unrealized appreciation/depreciation of assets2016-12-31$3,617
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$4,822,063
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$6,474,506
Total income from all sources (including contributions)2016-12-31$49,070,308
Total loss/gain on sale of assets2016-12-31$26,893
Total of all expenses incurred2016-12-31$47,695,037
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$43,416,364
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$48,926,554
Value of total assets at end of year2016-12-31$8,663,224
Value of total assets at beginning of year2016-12-31$8,940,396
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$4,278,673
Total interest from all sources2016-12-31$86,911
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$3,833
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$3,833
Administrative expenses professional fees incurred2016-12-31$554,271
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$833,916
Assets. Other investments not covered elsewhere at end of year2016-12-31$160,905
Assets. Other investments not covered elsewhere at beginning of year2016-12-31$252,963
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-12-31$12,195,879
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$695,569
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$663,352
Other income not declared elsewhere2016-12-31$22,500
Administrative expenses (other) incurred2016-12-31$2,991,976
Liabilities. Value of operating payables at end of year2016-12-31$489,521
Liabilities. Value of operating payables at beginning of year2016-12-31$1,050,087
Total non interest bearing cash at end of year2016-12-31$25,183
Total non interest bearing cash at beginning of year2016-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$1,375,271
Value of net assets at end of year (total assets less liabilities)2016-12-31$3,841,161
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$2,465,890
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
Investment advisory and management fees2016-12-31$9,023
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$3,237,562
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$2,119,520
Interest earned on other investments2016-12-31$117,218
Income. Interest from US Government securities2016-12-31$-7,325
Income. Interest from corporate debt instruments2016-12-31$-22,982
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$3,580,476
Asset value of US Government securities at end of year2016-12-31$581,205
Asset value of US Government securities at beginning of year2016-12-31$1,516,502
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$48,092,638
Employer contributions (assets) at end of year2016-12-31$2,937,508
Employer contributions (assets) at beginning of year2016-12-31$2,013,149
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$27,640,009
Asset. Corporate debt instrument debt (other) at end of year2016-12-31$1,006,259
Asset. Corporate debt instrument debt (other) at beginning of year2016-12-31$2,362,418
Contract administrator fees2016-12-31$723,403
Liabilities. Value of benefit claims payable at end of year2016-12-31$4,332,542
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$5,424,419
Assets. Value of buildings and other operty used in plan operation at end of year2016-12-31$19,033
Assets. Value of buildings and other operty used in plan operation at beginning of year2016-12-31$12,492
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Aggregate proceeds on sale of assets2016-12-31$3,471,801
Aggregate carrying amount (costs) on sale of assets2016-12-31$3,444,908
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31BOND BEEBE PC
Accountancy firm EIN2016-12-31521044197
2015 : UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2015-12-31$-76,431
Total unrealized appreciation/depreciation of assets2015-12-31$-76,431
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$6,474,506
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$5,521,238
Total income from all sources (including contributions)2015-12-31$48,750,753
Total loss/gain on sale of assets2015-12-31$2,719
Total of all expenses incurred2015-12-31$51,494,756
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$46,750,783
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$48,640,754
Value of total assets at end of year2015-12-31$8,940,396
Value of total assets at beginning of year2015-12-31$10,731,131
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$4,743,973
Total interest from all sources2015-12-31$158,602
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$552
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$552
Administrative expenses professional fees incurred2015-12-31$645,589
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$832,056
Assets. Other investments not covered elsewhere at end of year2015-12-31$252,963
Assets. Other investments not covered elsewhere at beginning of year2015-12-31$492,373
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-12-31$14,993,254
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$663,352
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$459,300
Other income not declared elsewhere2015-12-31$24,557
Administrative expenses (other) incurred2015-12-31$3,322,097
Liabilities. Value of operating payables at end of year2015-12-31$1,050,087
Liabilities. Value of operating payables at beginning of year2015-12-31$1,005,564
Total non interest bearing cash at end of year2015-12-31$0
Total non interest bearing cash at beginning of year2015-12-31$24,849
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-2,744,003
Value of net assets at end of year (total assets less liabilities)2015-12-31$2,465,890
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$5,209,893
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
Investment advisory and management fees2015-12-31$11,801
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$2,119,520
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$3,391,694
Interest earned on other investments2015-12-31$9,435
Income. Interest from US Government securities2015-12-31$39,635
Income. Interest from corporate debt instruments2015-12-31$109,532
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$3,452,880
Asset value of US Government securities at end of year2015-12-31$1,516,502
Asset value of US Government securities at beginning of year2015-12-31$2,702,505
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$47,808,698
Employer contributions (assets) at end of year2015-12-31$2,013,149
Employer contributions (assets) at beginning of year2015-12-31$39,524
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$28,304,649
Asset. Corporate debt instrument debt (other) at end of year2015-12-31$2,362,418
Asset. Corporate debt instrument debt (other) at beginning of year2015-12-31$3,608,373
Contract administrator fees2015-12-31$764,486
Liabilities. Value of benefit claims payable at end of year2015-12-31$5,424,419
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$4,515,674
Assets. Value of buildings and other operty used in plan operation at end of year2015-12-31$12,492
Assets. Value of buildings and other operty used in plan operation at beginning of year2015-12-31$12,513
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Aggregate proceeds on sale of assets2015-12-31$5,254,350
Aggregate carrying amount (costs) on sale of assets2015-12-31$5,251,631
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 name2015-12-31BOND BEEBE P.C.
Accountancy firm EIN2015-12-31521044197
2014 : UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-12-31$89,951
Total unrealized appreciation/depreciation of assets2014-12-31$89,951
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$5,521,238
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$4,061,011
Total income from all sources (including contributions)2014-12-31$46,584,067
Total loss/gain on sale of assets2014-12-31$-22,523
Total of all expenses incurred2014-12-31$53,381,295
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$48,221,434
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$46,229,464
Value of total assets at end of year2014-12-31$10,731,131
Value of total assets at beginning of year2014-12-31$16,068,132
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$5,159,861
Total interest from all sources2014-12-31$275,831
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$630
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$630
Administrative expenses professional fees incurred2014-12-31$546,103
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$1,121,222
Assets. Other investments not covered elsewhere at end of year2014-12-31$492,373
Assets. Other investments not covered elsewhere at beginning of year2014-12-31$490,302
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-12-31$17,693,115
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$459,300
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$669,571
Other income not declared elsewhere2014-12-31$10,714
Administrative expenses (other) incurred2014-12-31$3,779,016
Liabilities. Value of operating payables at end of year2014-12-31$1,005,564
Liabilities. Value of operating payables at beginning of year2014-12-31$221,973
Total non interest bearing cash at end of year2014-12-31$24,849
Total non interest bearing cash at beginning of year2014-12-31$25,091
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-6,797,228
Value of net assets at end of year (total assets less liabilities)2014-12-31$5,209,893
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$12,007,121
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
Investment advisory and management fees2014-12-31$22,029
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$3,391,694
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$2,169,674
Interest on participant loans2014-12-31$0
Income. Interest from loans (other than to participants)2014-12-31$0
Interest earned on other investments2014-12-31$17,966
Income. Interest from US Government securities2014-12-31$89,052
Income. Interest from corporate debt instruments2014-12-31$168,813
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$3,524,996
Asset value of US Government securities at end of year2014-12-31$2,702,505
Asset value of US Government securities at beginning of year2014-12-31$4,344,439
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$0
Net investment gain or loss from common/collective trusts2014-12-31$0
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$45,108,242
Employer contributions (assets) at end of year2014-12-31$39,524
Employer contributions (assets) at beginning of year2014-12-31$1,974,459
Income. Dividends from preferred stock2014-12-31$0
Income. Dividends from common stock2014-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$27,003,323
Asset. Corporate debt instrument debt (other) at end of year2014-12-31$3,608,373
Asset. Corporate debt instrument debt (other) at beginning of year2014-12-31$6,382,584
Contract administrator fees2014-12-31$812,713
Liabilities. Value of benefit claims payable at end of year2014-12-31$4,515,674
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$3,839,038
Assets. Value of buildings and other operty used in plan operation at end of year2014-12-31$12,513
Assets. Value of buildings and other operty used in plan operation at beginning of year2014-12-31$12,012
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Aggregate proceeds on sale of assets2014-12-31$8,581,222
Aggregate carrying amount (costs) on sale of assets2014-12-31$8,603,745
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31BOND BEEBE P.C.
Accountancy firm EIN2014-12-31521044197
2013 : UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$-740,462
Total unrealized appreciation/depreciation of assets2013-12-31$-740,462
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$4,061,011
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$6,754,546
Total income from all sources (including contributions)2013-12-31$46,103,190
Total loss/gain on sale of assets2013-12-31$174,483
Total of all expenses incurred2013-12-31$46,437,945
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$41,493,789
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$46,249,685
Value of total assets at end of year2013-12-31$16,068,132
Value of total assets at beginning of year2013-12-31$19,096,422
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$4,944,156
Total interest from all sources2013-12-31$413,734
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$446
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$446
Administrative expenses professional fees incurred2013-12-31$829,595
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$1,099,123
Assets. Other investments not covered elsewhere at end of year2013-12-31$490,302
Assets. Other investments not covered elsewhere at beginning of year2013-12-31$798,559
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$14,267,779
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$669,571
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$502,793
Other income not declared elsewhere2013-12-31$5,304
Administrative expenses (other) incurred2013-12-31$3,161,191
Liabilities. Value of operating payables at end of year2013-12-31$221,973
Liabilities. Value of operating payables at beginning of year2013-12-31$204,429
Total non interest bearing cash at end of year2013-12-31$25,091
Total non interest bearing cash at beginning of year2013-12-31$25,352
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-334,755
Value of net assets at end of year (total assets less liabilities)2013-12-31$12,007,121
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$12,341,876
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
Investment advisory and management fees2013-12-31$28,562
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$2,169,674
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$1,810,549
Interest earned on other investments2013-12-31$23,286
Income. Interest from US Government securities2013-12-31$122,787
Income. Interest from corporate debt instruments2013-12-31$267,661
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$3,787,003
Asset value of US Government securities at end of year2013-12-31$4,344,439
Asset value of US Government securities at beginning of year2013-12-31$4,970,578
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$45,150,562
Employer contributions (assets) at end of year2013-12-31$1,974,459
Employer contributions (assets) at beginning of year2013-12-31$3,308,768
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$23,439,007
Asset. Corporate debt instrument debt (other) at end of year2013-12-31$6,382,584
Asset. Corporate debt instrument debt (other) at beginning of year2013-12-31$7,679,823
Contract administrator fees2013-12-31$924,808
Liabilities. Value of benefit claims payable at end of year2013-12-31$3,839,038
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$6,550,117
Assets. Value of buildings and other operty used in plan operation at end of year2013-12-31$12,012
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Aggregate proceeds on sale of assets2013-12-31$8,835,765
Aggregate carrying amount (costs) on sale of assets2013-12-31$8,661,282
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31BOND BEEBE, P.C.
Accountancy firm EIN2013-12-31521044197
2012 : UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$-187,379
Total unrealized appreciation/depreciation of assets2012-12-31$-187,379
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$6,754,546
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$5,560,818
Total income from all sources (including contributions)2012-12-31$49,350,786
Total loss/gain on sale of assets2012-12-31$242,877
Total of all expenses incurred2012-12-31$51,867,750
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$47,471,395
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$48,745,679
Value of total assets at end of year2012-12-31$19,096,422
Value of total assets at beginning of year2012-12-31$20,419,658
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$4,396,355
Total interest from all sources2012-12-31$544,139
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$1,304
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$1,304
Administrative expenses professional fees incurred2012-12-31$350,039
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$1,149,940
Assets. Other investments not covered elsewhere at end of year2012-12-31$798,559
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-12-31$15,290,624
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$502,793
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$562,833
Other income not declared elsewhere2012-12-31$4,166
Administrative expenses (other) incurred2012-12-31$3,019,015
Liabilities. Value of operating payables at end of year2012-12-31$204,429
Liabilities. Value of operating payables at beginning of year2012-12-31$240,276
Total non interest bearing cash at end of year2012-12-31$25,352
Total non interest bearing cash at beginning of year2012-12-31$256,855
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-2,516,964
Value of net assets at end of year (total assets less liabilities)2012-12-31$12,341,876
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$14,858,840
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
Investment advisory and management fees2012-12-31$33,828
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$1,810,549
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$3,384,136
Interest earned on other investments2012-12-31$34,304
Income. Interest from US Government securities2012-12-31$172,386
Income. Interest from corporate debt instruments2012-12-31$337,449
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$3,794,189
Asset value of US Government securities at end of year2012-12-31$4,970,578
Asset value of US Government securities at beginning of year2012-12-31$7,191,002
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$47,595,739
Employer contributions (assets) at end of year2012-12-31$3,308,768
Employer contributions (assets) at beginning of year2012-12-31$1,310,250
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$28,386,582
Asset. Corporate debt instrument debt (other) at end of year2012-12-31$7,679,823
Asset. Corporate debt instrument debt (other) at beginning of year2012-12-31$7,714,582
Contract administrator fees2012-12-31$993,473
Liabilities. Value of benefit claims payable at end of year2012-12-31$6,550,117
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$5,320,542
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Aggregate proceeds on sale of assets2012-12-31$7,224,842
Aggregate carrying amount (costs) on sale of assets2012-12-31$6,981,965
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 name2012-12-31BOND BEEBE, P.C.
Accountancy firm EIN2012-12-31521044197
2011 : UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$191,036
Total unrealized appreciation/depreciation of assets2011-12-31$191,036
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$5,560,818
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$6,566,443
Total income from all sources (including contributions)2011-12-31$50,105,982
Total loss/gain on sale of assets2011-12-31$176,486
Total of all expenses incurred2011-12-31$52,441,167
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$47,707,402
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$49,048,388
Value of total assets at end of year2011-12-31$20,419,658
Value of total assets at beginning of year2011-12-31$23,760,468
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$4,733,765
Total interest from all sources2011-12-31$592,516
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$1,385
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$1,385
Administrative expenses professional fees incurred2011-12-31$455,537
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$1,042,948
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-12-31$4,605,965
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$562,833
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$1,135,684
Other income not declared elsewhere2011-12-31$96,171
Administrative expenses (other) incurred2011-12-31$3,249,122
Liabilities. Value of operating payables at end of year2011-12-31$240,276
Liabilities. Value of operating payables at beginning of year2011-12-31$276,328
Total non interest bearing cash at end of year2011-12-31$256,855
Total non interest bearing cash at beginning of year2011-12-31$24,775
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-2,335,185
Value of net assets at end of year (total assets less liabilities)2011-12-31$14,858,840
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$17,194,025
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
Investment advisory and management fees2011-12-31$35,633
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$3,384,136
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$5,164,498
Interest earned on other investments2011-12-31$34,501
Income. Interest from US Government securities2011-12-31$241,264
Income. Interest from corporate debt instruments2011-12-31$316,751
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$12,929,453
Asset value of US Government securities at end of year2011-12-31$7,191,002
Asset value of US Government securities at beginning of year2011-12-31$6,773,739
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$48,005,440
Employer contributions (assets) at end of year2011-12-31$1,310,250
Employer contributions (assets) at beginning of year2011-12-31$3,875,363
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$30,171,984
Asset. Corporate debt instrument debt (other) at end of year2011-12-31$7,714,582
Asset. Corporate debt instrument debt (other) at beginning of year2011-12-31$6,786,409
Contract administrator fees2011-12-31$993,473
Liabilities. Value of benefit claims payable at end of year2011-12-31$5,320,542
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$6,290,115
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Aggregate proceeds on sale of assets2011-12-31$4,004,006
Aggregate carrying amount (costs) on sale of assets2011-12-31$3,827,520
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 name2011-12-31BOND BEEBE, P.C.
Accountancy firm EIN2011-12-31521044197
2010 : UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$200,521
Total unrealized appreciation/depreciation of assets2010-12-31$200,521
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$6,566,443
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$6,344,337
Total income from all sources (including contributions)2010-12-31$49,682,114
Total loss/gain on sale of assets2010-12-31$170,452
Total of all expenses incurred2010-12-31$52,246,410
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$47,729,999
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$48,038,943
Value of total assets at end of year2010-12-31$23,760,468
Value of total assets at beginning of year2010-12-31$26,102,658
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$4,516,411
Total interest from all sources2010-12-31$782,431
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$1,467
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$1,467
Administrative expenses professional fees incurred2010-12-31$370,866
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$1,067,408
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$41,007,553
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$1,135,684
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$752,438
Other income not declared elsewhere2010-12-31$488,300
Administrative expenses (other) incurred2010-12-31$3,036,190
Liabilities. Value of operating payables at end of year2010-12-31$276,328
Liabilities. Value of operating payables at beginning of year2010-12-31$249,207
Total non interest bearing cash at end of year2010-12-31$24,775
Total non interest bearing cash at beginning of year2010-12-31$94,167
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-2,564,296
Value of net assets at end of year (total assets less liabilities)2010-12-31$17,194,025
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$19,758,321
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
Investment advisory and management fees2010-12-31$37,714
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$5,164,498
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$3,823,442
Interest earned on other investments2010-12-31$33,054
Income. Interest from US Government securities2010-12-31$312,826
Income. Interest from corporate debt instruments2010-12-31$436,551
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$4,605,794
Asset value of US Government securities at end of year2010-12-31$6,773,739
Asset value of US Government securities at beginning of year2010-12-31$10,095,710
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$46,971,535
Employer contributions (assets) at end of year2010-12-31$3,875,363
Employer contributions (assets) at beginning of year2010-12-31$1,402,193
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$2,116,652
Asset. Corporate debt instrument debt (other) at end of year2010-12-31$6,786,409
Asset. Corporate debt instrument debt (other) at beginning of year2010-12-31$9,934,708
Contract administrator fees2010-12-31$1,071,641
Liabilities. Value of benefit claims payable at end of year2010-12-31$6,290,115
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$6,095,130
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$12,096,230
Aggregate carrying amount (costs) on sale of assets2010-12-31$11,925,778
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 name2010-12-31BOND BEEBE, P.C.
Accountancy firm EIN2010-12-31521044197

Form 5500 Responses for UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND

2022: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2022 form 5500 responses
2022-01-01Type of plan entityMulti-employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2021 form 5500 responses
2021-01-01Type of plan entityMulti-employer plan
2021-01-01Submission has been amendedYes
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2020 form 5500 responses
2020-01-01Type of plan entityMulti-employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2019 form 5500 responses
2019-01-01Type of plan entityMulti-employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2018 form 5500 responses
2018-01-01Type of plan entityMulti-employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2017 form 5500 responses
2017-01-01Type of plan entityMulti-employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2016 form 5500 responses
2016-01-01Type of plan entityMulti-employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2015 form 5500 responses
2015-01-01Type of plan entityMulti-employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2014 form 5500 responses
2014-01-01Type of plan entityMulti-employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2013 form 5500 responses
2013-01-01Type of plan entityMulti-employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2012 form 5500 responses
2012-01-01Type of plan entityMulti-employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2011 form 5500 responses
2011-01-01Type of plan entityMulti-employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: UFCW UNIONS AND PARTICIPATING EMPLOYERS HEALTH AND WELFARE FUND 2009 form 5500 responses
2009-01-01Type of plan entityMulti-employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

VALUEOPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 62199 )
Policy contract number
Policy instance 1
Number of Individuals Covered446
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
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedEAP PROGRAM
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,678
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number526044
Policy instance 5
Insurance contract or identification number526044
Number of Individuals Covered2737
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $161,903
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DENTEGRA INS CO (National Association of Insurance Commissioners NAIC id number: 73474 )
Policy contract number21549
Policy instance 2
Insurance contract or identification number21549
Number of Individuals Covered1523
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
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
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 $419,981
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 number12030-7,8
Policy instance 3
Insurance contract or identification number12030-7,8
Number of Individuals Covered1542
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
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number1313
Policy instance 4
Insurance contract or identification number1313
Number of Individuals Covered9
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $63,243
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GROUP DENTAL SERVICE OF MARYLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95846 )
Policy contract number01GDS01
Policy instance 3
Insurance contract or identification number01GDS01
Number of Individuals Covered1911
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
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 $554,913
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 number12030-7,8
Policy instance 2
Insurance contract or identification number12030-7,8
Number of Individuals Covered1757
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number1313
Policy instance 4
Insurance contract or identification number1313
Number of Individuals Covered229
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $660,801
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number526044
Policy instance 5
Insurance contract or identification number526044
Number of Individuals Covered3358
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $212,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VALUEOPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 62199 )
Policy contract number
Policy instance 1
Number of Individuals Covered550
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedEAP PROGRAM
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 $4,718
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VALUEOPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 62199 )
Policy contract number
Policy instance 1
Number of Individuals Covered611
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedEAP PROGRAM
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 $6,284
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 number12030-7,8
Policy instance 2
Insurance contract or identification number12030-7,8
Number of Individuals Covered2193
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number1313
Policy instance 4
Insurance contract or identification number1313
Number of Individuals Covered231
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $647,757
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number526044
Policy instance 5
Insurance contract or identification number526044
Number of Individuals Covered4465
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $80,683
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GROUP DENTAL SERVICE OF MARYLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95846 )
Policy contract number01GDS01
Policy instance 3
Insurance contract or identification number01GDS01
Number of Individuals Covered2196
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
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 $684,066
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VALUEOPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 62199 )
Policy contract number
Policy instance 1
Number of Individuals Covered951
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedEAP PROGRAM
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 $8,134
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 number12030-7,8
Policy instance 2
Insurance contract or identification number12030-7,8
Number of Individuals Covered3053
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number526044
Policy instance 5
Insurance contract or identification number526044
Number of Individuals Covered4276
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $132,551
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number1313
Policy instance 4
Insurance contract or identification number1313
Number of Individuals Covered25
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $93,116
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GROUP DENTAL SERVICE OF MARYLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95846 )
Policy contract number01GDS01
Policy instance 3
Insurance contract or identification number01GDS01
Number of Individuals Covered3058
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
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 $907,305
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 number12030-7,8,10,11
Policy instance 1
Insurance contract or identification number12030-7,8,10,11
Number of Individuals Covered7555
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GROUP DENTAL SERVICE OF MARYLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95846 )
Policy contract number01GDS01
Policy instance 2
Insurance contract or identification number01GDS01
Number of Individuals Covered3340
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
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 $1,041,467
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number526044
Policy instance 4
Insurance contract or identification number526044
Number of Individuals Covered1426
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $152,344
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number1313
Policy instance 3
Insurance contract or identification number1313
Number of Individuals Covered25
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $93,116
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4396628
Policy instance 1
Insurance contract or identification numberE4396628
Number of Individuals Covered109
Insurance policy start date2016-02-01
Insurance policy end date2017-01-31
Total amount of commissions paid to insurance brokerUSD $9,022
Total amount of fees paid to insurance companyUSD $396
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $70,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,857
Amount paid for insurance broker fees272
Additional information about fees paid to insurance brokerBONUSES AND NON CASH INCENTIVES
Insurance broker organization code?3
Insurance broker nameJEFFREY MOTSCO
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number526044
Policy instance 5
Insurance contract or identification number526044
Number of Individuals Covered4921
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $246,851
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number1313
Policy instance 4
Insurance contract or identification number1313
Number of Individuals Covered37
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $117,286
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GROUP DENTAL SERVICE OF MARYLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95846 )
Policy contract number01GDS01
Policy instance 3
Insurance contract or identification number01GDS01
Number of Individuals Covered6393
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
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 $1,713,531
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 number12030-7,8,10,11
Policy instance 2
Insurance contract or identification number12030-7,8,10,11
Number of Individuals Covered7878
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number12030-7,8,10,11
Policy instance 1
Insurance contract or identification number12030-7,8,10,11
Number of Individuals Covered8954
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GROUP DENTAL SERVICE OF MARYLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95846 )
Policy contract number01GDS18
Policy instance 2
Insurance contract or identification number01GDS18
Number of Individuals Covered233
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
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 $39,531
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number13228-4
Policy instance 6
Insurance contract or identification number13228-4
Number of Individuals Covered4381
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $155,376
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number526044
Policy instance 5
Insurance contract or identification number526044
Number of Individuals Covered1089
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $79,390
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number1313
Policy instance 4
Insurance contract or identification number1313
Number of Individuals Covered76
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $794,495
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number11215
Policy instance 3
Insurance contract or identification number11215
Number of Individuals Covered281
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $508,762
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 number12030-7,8,10,11
Policy instance 2
Insurance contract or identification number12030-7,8,10,11
Number of Individuals Covered9332
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GROUP DENTAL SERVICE OF MARYLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95846 )
Policy contract number01GDS18
Policy instance 3
Insurance contract or identification number01GDS18
Number of Individuals Covered173
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
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 $36,706
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number1313
Policy instance 4
Insurance contract or identification number1313
Number of Individuals Covered115
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $757,984
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number526044
Policy instance 5
Insurance contract or identification number526044
Number of Individuals Covered1081
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $81,152
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number13228-4
Policy instance 6
Insurance contract or identification number13228-4
Number of Individuals Covered4672
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $159,179
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number11215
Policy instance 1
Insurance contract or identification number11215
Number of Individuals Covered167
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $309,393
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 number12030-7,8,10,11
Policy instance 5
Insurance contract or identification number12030-7,8,10,11
Number of Individuals Covered10327
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number526044
Policy instance 3
Insurance contract or identification number526044
Number of Individuals Covered1134
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $74,104
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GROUP DENTAL SERVICE OF MARYLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95846 )
Policy contract number01GDS18
Policy instance 4
Insurance contract or identification number01GDS18
Number of Individuals Covered69
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
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 $37,203
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number13228-4
Policy instance 2
Insurance contract or identification number13228-4
Number of Individuals Covered4839
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $162,817
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number1313
Policy instance 1
Insurance contract or identification number1313
Number of Individuals Covered153
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $421,755
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number1313
Policy instance 1
Insurance contract or identification number1313
Number of Individuals Covered161
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 $1,437,830
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 number12030-XX
Policy instance 5
Insurance contract or identification number12030-XX
Number of Individuals Covered10186
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GROUP DENTAL SERVICE OF MARYLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95846 )
Policy contract number01GDS18
Policy instance 4
Insurance contract or identification number01GDS18
Number of Individuals Covered170
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
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 $36,038
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number526044
Policy instance 3
Insurance contract or identification number526044
Number of Individuals Covered1214
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $76,044
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number13228-4
Policy instance 2
Insurance contract or identification number13228-4
Number of Individuals Covered5069
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $186,872
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number1313
Policy instance 1
Insurance contract or identification number1313
Number of Individuals Covered430
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 $1,213,158
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number13228-4/AD&D
Policy instance 2
Insurance contract or identification number13228-4/AD&D
Number of Individuals Covered5673
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $24,534
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number13228-4/LIFE
Policy instance 3
Insurance contract or identification number13228-4/LIFE
Number of Individuals Covered5673
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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 $235,465
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GROUP DENTAL SERVICE OF MARYLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95846 )
Policy contract number01GDS18
Policy instance 5
Insurance contract or identification number01GDS18
Number of Individuals Covered212
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
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 $37,585
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 number12030-XX
Policy instance 6
Insurance contract or identification number12030-XX
Number of Individuals Covered11500
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number526044
Policy instance 4
Insurance contract or identification number526044
Number of Individuals Covered1121
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $74,634
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number1313
Policy instance 1
Insurance contract or identification number1313
Number of Individuals Covered380
Insurance policy start date2009-06-01
Insurance policy end date2010-05-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 $1,002,186
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number13228-4/AD&D
Policy instance 2
Insurance contract or identification number13228-4/AD&D
Number of Individuals Covered5784
Insurance policy start date2009-03-01
Insurance policy end date2010-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $255,614
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number526044
Policy instance 4
Insurance contract or identification number526044
Number of Individuals Covered1032
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $64,809
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GROUP DENTAL SERVICE OF MARYLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95846 )
Policy contract number01GDS18
Policy instance 5
Insurance contract or identification number01GDS18
Number of Individuals Covered244
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
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 $33,770
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTIPLE/UFNF
Policy instance 6
Insurance contract or identification numberMULTIPLE/UFNF
Number of Individuals Covered3587
Insurance policy start date2009-07-01
Insurance policy end date2010-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
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 $116,411
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number203140/DPEP
Policy instance 7
Insurance contract or identification number203140/DPEP
Number of Individuals Covered25
Insurance policy start date2009-04-01
Insurance policy end date2010-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
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 $33,145
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number13228-4/LIFE
Policy instance 3
Insurance contract or identification number13228-4/LIFE
Number of Individuals Covered9409
Insurance policy start date2009-03-01
Insurance policy end date2010-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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