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RICHLAND COUNTY PUBLIC LIBRARY 401k Plan overview

Plan NameRICHLAND COUNTY PUBLIC LIBRARY
Plan identification number 640

RICHLAND COUNTY PUBLIC LIBRARY Benefits

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

401k Sponsoring company profile

RICHLAND COUNTY PUBLIC LIBRARY has sponsored the creation of one or more 401k plans.

Company Name:RICHLAND COUNTY PUBLIC LIBRARY
Employer identification number (EIN):576000396
NAIC Classification:519100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RICHLAND COUNTY PUBLIC LIBRARY

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
6402018-07-01
6402017-07-01SARAH SULLIVAN SARAH SULLIVAN2019-01-03
6402016-07-01SARAH SULLIVAN
6402015-07-01SARAH SULLIVAN
6402014-07-01WILMA BECK
6402013-01-01BECKY BROWN
6402012-07-01SARAH SULLIVAN SARAH SULLIVAN2014-01-21
6402011-07-01SARAH SULLIVAN
6402008-07-01SARAH SULLIVAN

Plan Statistics for RICHLAND COUNTY PUBLIC LIBRARY

401k plan membership statisitcs for RICHLAND COUNTY PUBLIC LIBRARY

Measure Date Value
2018: RICHLAND COUNTY PUBLIC LIBRARY 2018 401k membership
Total participants, beginning-of-year2018-07-01272
Total number of active participants reported on line 7a of the Form 55002018-07-01279
Number of retired or separated participants receiving benefits2018-07-0116
Total of all active and inactive participants2018-07-01295
Total participants2018-07-01295
Number of employers contributing to the scheme2018-07-010
2017: RICHLAND COUNTY PUBLIC LIBRARY 2017 401k membership
Total participants, beginning-of-year2017-07-01277
Total number of active participants reported on line 7a of the Form 55002017-07-01252
Number of retired or separated participants receiving benefits2017-07-0120
Total of all active and inactive participants2017-07-01272
Total participants2017-07-01272
Number of participants with account balances2017-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-07-010
Number of employers contributing to the scheme2017-07-010
2016: RICHLAND COUNTY PUBLIC LIBRARY 2016 401k membership
Total participants, beginning-of-year2016-07-01275
Total number of active participants reported on line 7a of the Form 55002016-07-01254
Number of retired or separated participants receiving benefits2016-07-0123
Total of all active and inactive participants2016-07-01277
Total participants2016-07-01277
Number of participants with account balances2016-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-07-010
Number of employers contributing to the scheme2016-07-010
2015: RICHLAND COUNTY PUBLIC LIBRARY 2015 401k membership
Total participants, beginning-of-year2015-07-01275
Total number of active participants reported on line 7a of the Form 55002015-07-01254
Number of retired or separated participants receiving benefits2015-07-0121
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-01275
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-07-010
Total participants2015-07-01275
Number of participants with account balances2015-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-07-010
Number of employers contributing to the scheme2015-07-010
2014: RICHLAND COUNTY PUBLIC LIBRARY 2014 401k membership
Total participants, beginning-of-year2014-07-01243
Total number of active participants reported on line 7a of the Form 55002014-07-01242
Number of retired or separated participants receiving benefits2014-07-0118
Total of all active and inactive participants2014-07-01260
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-07-010
Total participants2014-07-01260
Number of participants with account balances2014-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-07-010
Number of employers contributing to the scheme2014-07-010
2013: RICHLAND COUNTY PUBLIC LIBRARY 2013 401k membership
Total participants, beginning-of-year2013-01-01243
Total number of active participants reported on line 7a of the Form 55002013-01-01242
Number of retired or separated participants receiving benefits2013-01-0118
Total of all active and inactive participants2013-01-01260
Total participants2013-01-01260
2012: RICHLAND COUNTY PUBLIC LIBRARY 2012 401k membership
Total participants, beginning-of-year2012-07-01242
Total number of active participants reported on line 7a of the Form 55002012-07-01228
Number of retired or separated participants receiving benefits2012-07-0115
Total of all active and inactive participants2012-07-01243
Total participants2012-07-01243
2011: RICHLAND COUNTY PUBLIC LIBRARY 2011 401k membership
Total participants, beginning-of-year2011-07-01242
Total number of active participants reported on line 7a of the Form 55002011-07-01229
Number of retired or separated participants receiving benefits2011-07-0113
Total of all active and inactive participants2011-07-01242
Total participants2011-07-01242
2008: RICHLAND COUNTY PUBLIC LIBRARY 2008 401k membership
Total participants, beginning-of-year2008-07-01209
Total number of active participants reported on line 7a of the Form 55002008-07-01199
Number of retired or separated participants receiving benefits2008-07-0127
Total of all active and inactive participants2008-07-01226
Total participants2008-07-01226

Financial Data on RICHLAND COUNTY PUBLIC LIBRARY

Measure Date Value
2019 : RICHLAND COUNTY PUBLIC LIBRARY 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-06-30$0
Total income from all sources (including contributions)2019-06-30$0
Total loss/gain on sale of assets2019-06-30$0
Total of all expenses incurred2019-06-30$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-06-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-06-30$0
Value of total assets at end of year2019-06-30$0
Value of total assets at beginning of year2019-06-30$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-06-30$0
Total interest from all sources2019-06-30$0
Total dividends received (eg from common stock, registered investment company shares)2019-06-30$0
Was this plan covered by a fidelity bond2019-06-30No
Were there any nonexempt tranactions with any party-in-interest2019-06-30No
Value of net income/loss2019-06-30$0
Value of net assets at end of year (total assets less liabilities)2019-06-30$0
Value of net assets at beginning of year (total assets less liabilities)2019-06-30$0
Were any loans by the plan or fixed income obligations due to the plan in default2019-06-30No
2018 : RICHLAND COUNTY PUBLIC LIBRARY 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-06-30$0
Total income from all sources (including contributions)2018-06-30$0
Total loss/gain on sale of assets2018-06-30$0
Total of all expenses incurred2018-06-30$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-06-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-06-30$0
Value of total assets at end of year2018-06-30$0
Value of total assets at beginning of year2018-06-30$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-06-30$0
Total interest from all sources2018-06-30$0
Total dividends received (eg from common stock, registered investment company shares)2018-06-30$0
Was this plan covered by a fidelity bond2018-06-30No
Value of net income/loss2018-06-30$0
Value of net assets at end of year (total assets less liabilities)2018-06-30$0
Value of net assets at beginning of year (total assets less liabilities)2018-06-30$0
Were any loans by the plan or fixed income obligations due to the plan in default2018-06-30No
2017 : RICHLAND COUNTY PUBLIC LIBRARY 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-06-30$0
Total income from all sources (including contributions)2017-06-30$0
Total loss/gain on sale of assets2017-06-30$0
Total of all expenses incurred2017-06-30$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-06-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-06-30$0
Value of total assets at end of year2017-06-30$0
Value of total assets at beginning of year2017-06-30$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-06-30$0
Total interest from all sources2017-06-30$0
Total dividends received (eg from common stock, registered investment company shares)2017-06-30$0
Was this plan covered by a fidelity bond2017-06-30No
Value of net income/loss2017-06-30$0
Value of net assets at end of year (total assets less liabilities)2017-06-30$0
Value of net assets at beginning of year (total assets less liabilities)2017-06-30$0
Were any loans by the plan or fixed income obligations due to the plan in default2017-06-30No
2016 : RICHLAND COUNTY PUBLIC LIBRARY 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-06-30$0
Total income from all sources (including contributions)2016-06-30$0
Total loss/gain on sale of assets2016-06-30$0
Total of all expenses incurred2016-06-30$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-06-30$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-06-30$0
Value of total assets at end of year2016-06-30$0
Value of total assets at beginning of year2016-06-30$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-06-30$0
Total interest from all sources2016-06-30$0
Total dividends received (eg from common stock, registered investment company shares)2016-06-30$0
Was this plan covered by a fidelity bond2016-06-30No
Value of net income/loss2016-06-30$0
Value of net assets at end of year (total assets less liabilities)2016-06-30$0
Value of net assets at beginning of year (total assets less liabilities)2016-06-30$0
Were any loans by the plan or fixed income obligations due to the plan in default2016-06-30No

Form 5500 Responses for RICHLAND COUNTY PUBLIC LIBRARY

2018: RICHLAND COUNTY PUBLIC LIBRARY 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01First time form 5500 has been submittedYes
2018-07-01Submission has been amendedNo
2018-07-01This submission is the final filingNo
2018-07-01This return/report is a short plan year return/report (less than 12 months)No
2018-07-01Plan is a collectively bargained planNo
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: RICHLAND COUNTY PUBLIC LIBRARY 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01First time form 5500 has been submittedYes
2017-07-01Submission has been amendedNo
2017-07-01This submission is the final filingNo
2017-07-01This return/report is a short plan year return/report (less than 12 months)No
2017-07-01Plan is a collectively bargained planNo
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: RICHLAND COUNTY PUBLIC LIBRARY 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01First time form 5500 has been submittedYes
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: RICHLAND COUNTY PUBLIC LIBRARY 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01First time form 5500 has been submittedYes
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: RICHLAND COUNTY PUBLIC LIBRARY 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01First time form 5500 has been submittedYes
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: RICHLAND COUNTY PUBLIC LIBRARY 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01First time form 5500 has been submittedYes
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 planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: RICHLAND COUNTY PUBLIC LIBRARY 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: RICHLAND COUNTY PUBLIC LIBRARY 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2008: RICHLAND COUNTY PUBLIC LIBRARY 2008 form 5500 responses
2008-07-01Type of plan entitySingle employer plan
2008-07-01Submission has been amendedNo
2008-07-01This submission is the final filingNo
2008-07-01This return/report is a short plan year return/report (less than 12 months)No
2008-07-01Plan is a collectively bargained planNo
2008-07-01Plan funding arrangement – InsuranceYes
2008-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number25-22740-00
Policy instance 3
Insurance contract or identification number25-22740-00
Number of Individuals Covered295
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
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?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
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number25-22740-00
Policy instance 2
Insurance contract or identification number25-22740-00
Number of Individuals Covered297
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
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?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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number25-22740-00
Policy instance 1
Insurance contract or identification number25-22740-00
Number of Individuals Covered295
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
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?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number25-22740-00
Policy instance 3
Insurance contract or identification number25-22740-00
Number of Individuals Covered272
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
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?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
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number25-22740-00
Policy instance 2
Insurance contract or identification number25-22740-00
Number of Individuals Covered276
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
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?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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number25-22740-00
Policy instance 1
Insurance contract or identification number25-22740-00
Number of Individuals Covered272
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
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?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 )
Policy contract number62221000
Policy instance 2
Insurance contract or identification number62221000
Number of Individuals Covered396
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number22-22740-00
Policy instance 1
Insurance contract or identification number22-22740-00
Number of Individuals Covered275
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number22-22740-00
Policy instance 1
Insurance contract or identification number22-22740-00
Number of Individuals Covered260
Insurance policy start date2013-07-01
Insurance policy end date2014-07-01
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number22-22740-00
Policy instance 1
Insurance contract or identification number22-22740-00
Number of Individuals Covered2
Insurance policy start date2013-07-01
Insurance policy end date2014-07-01
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number22-22740-00
Policy instance 1
Insurance contract or identification number22-22740-00
Number of Individuals Covered243
Insurance policy start date2012-07-01
Insurance policy end date2013-07-01
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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number25-22740-00
Policy instance 1
Insurance contract or identification number25-22740-00
Number of Individuals Covered242
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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