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SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN 401k Plan overview

Plan NameSAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN
Plan identification number 502

SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

HYDRO EXTRUSION USA, LLC has sponsored the creation of one or more 401k plans.

Company Name:HYDRO EXTRUSION USA, LLC
Employer identification number (EIN):582216096
NAIC Classification:332810

Additional information about HYDRO EXTRUSION USA, LLC

Jurisdiction of Incorporation: Virginia Secretary of State
Incorporation Date: 2011-08-30
Company Identification Number: F187212
Legal Registered Office Address: 100 SHOCKOE SLIP
2ND FLOOR
RICHMOND
United States of America (USA)
23219

More information about HYDRO EXTRUSION USA, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022015-06-08ROBERT RUBICKY ROBERT RUBICKY2017-03-17
5022015-06-08ROBERT J. RUBICKY
5022014-06-08ROBERT RUBICKY ROBERT RUBICKY2017-03-17
5022013-06-08ROBERT RUBICKY ROBERT RUBICKY2017-03-17
5022012-06-08ROBERT RUBICKY ROBERT RUBICKY2017-03-17
5022011-06-08ROBERT RUBICKY ROBERT RUBICKY2017-03-17
5022010-06-08ROBERT RUBICKY ROBERT RUBICKY2017-03-17
5022009-06-08ROBERT RUBICKY ROBERT RUBICKY2017-03-17
5022008-06-08ROBERT RUBICKY ROBERT RUBICKY2017-03-17
5022007-06-08ROBERT RUBICKY ROBERT RUBICKY2017-03-17

Plan Statistics for SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN

401k plan membership statisitcs for SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN

Measure Date Value
2015: SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-06-084,353
Total number of active participants reported on line 7a of the Form 55002015-06-084,353
Number of retired or separated participants receiving benefits2015-06-080
Number of other retired or separated participants entitled to future benefits2015-06-080
Total of all active and inactive participants2015-06-084,353
Total participants2015-06-084,353
2014: SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN 2014 401k membership
Total participants, beginning-of-year2014-06-084,353
Total number of active participants reported on line 7a of the Form 55002014-06-084,353
Number of retired or separated participants receiving benefits2014-06-080
Number of other retired or separated participants entitled to future benefits2014-06-080
Total of all active and inactive participants2014-06-084,353
Total participants2014-06-084,353
2013: SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN 2013 401k membership
Total participants, beginning-of-year2013-06-084,353
Total number of active participants reported on line 7a of the Form 55002013-06-084,353
Number of retired or separated participants receiving benefits2013-06-080
Number of other retired or separated participants entitled to future benefits2013-06-080
Total of all active and inactive participants2013-06-084,353
Total participants2013-06-084,353
2012: SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-06-083,152
Total number of active participants reported on line 7a of the Form 55002012-06-083,152
Number of retired or separated participants receiving benefits2012-06-080
Number of other retired or separated participants entitled to future benefits2012-06-080
Total of all active and inactive participants2012-06-083,152
Total participants2012-06-083,152
2011: SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN 2011 401k membership
Total participants, beginning-of-year2011-06-083,152
Total number of active participants reported on line 7a of the Form 55002011-06-083,152
Number of retired or separated participants receiving benefits2011-06-080
Number of other retired or separated participants entitled to future benefits2011-06-080
Total of all active and inactive participants2011-06-083,152
Total participants2011-06-083,152
2010: SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN 2010 401k membership
Total participants, beginning-of-year2010-06-083,152
Total number of active participants reported on line 7a of the Form 55002010-06-083,152
Number of retired or separated participants receiving benefits2010-06-080
Number of other retired or separated participants entitled to future benefits2010-06-080
Total of all active and inactive participants2010-06-083,152
Total participants2010-06-083,152
2009: SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN 2009 401k membership
Total participants, beginning-of-year2009-06-083,076
Total number of active participants reported on line 7a of the Form 55002009-06-083,076
Number of retired or separated participants receiving benefits2009-06-080
Number of other retired or separated participants entitled to future benefits2009-06-080
Total of all active and inactive participants2009-06-083,076
Total participants2009-06-083,076
2008: SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN 2008 401k membership
Total participants, beginning-of-year2008-06-083,076
Total number of active participants reported on line 7a of the Form 55002008-06-083,076
Number of retired or separated participants receiving benefits2008-06-080
Number of other retired or separated participants entitled to future benefits2008-06-080
Total of all active and inactive participants2008-06-083,076
Total participants2008-06-083,076
2007: SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN 2007 401k membership
Total participants, beginning-of-year2007-06-083,076
Total number of active participants reported on line 7a of the Form 55002007-06-083,076
Number of retired or separated participants receiving benefits2007-06-080
Number of other retired or separated participants entitled to future benefits2007-06-080
Total of all active and inactive participants2007-06-083,076
Total participants2007-06-083,076

Form 5500 Responses for SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN

2015: SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN 2015 form 5500 responses
2015-06-08Type of plan entitySingle employer plan
2015-06-08Submission has been amendedNo
2015-06-08This submission is the final filingNo
2015-06-08This return/report is a short plan year return/report (less than 12 months)No
2015-06-08Plan is a collectively bargained planYes
2015-06-08Plan funding arrangement – InsuranceYes
2015-06-08Plan benefit arrangement – InsuranceYes
2014: SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN 2014 form 5500 responses
2014-06-08Type of plan entitySingle employer plan
2014-06-08Submission has been amendedNo
2014-06-08This submission is the final filingNo
2014-06-08This return/report is a short plan year return/report (less than 12 months)No
2014-06-08Plan is a collectively bargained planYes
2014-06-08Plan funding arrangement – InsuranceYes
2014-06-08Plan benefit arrangement – InsuranceYes
2013: SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN 2013 form 5500 responses
2013-06-08Type of plan entitySingle employer plan
2013-06-08Submission has been amendedNo
2013-06-08This submission is the final filingNo
2013-06-08This return/report is a short plan year return/report (less than 12 months)No
2013-06-08Plan is a collectively bargained planYes
2013-06-08Plan funding arrangement – InsuranceYes
2013-06-08Plan benefit arrangement – InsuranceYes
2012: SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN 2012 form 5500 responses
2012-06-08Type of plan entitySingle employer plan
2012-06-08Submission has been amendedNo
2012-06-08This submission is the final filingNo
2012-06-08This return/report is a short plan year return/report (less than 12 months)No
2012-06-08Plan is a collectively bargained planYes
2012-06-08Plan funding arrangement – InsuranceYes
2012-06-08Plan benefit arrangement – InsuranceYes
2011: SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN 2011 form 5500 responses
2011-06-08Type of plan entitySingle employer plan
2011-06-08Submission has been amendedNo
2011-06-08This submission is the final filingNo
2011-06-08This return/report is a short plan year return/report (less than 12 months)No
2011-06-08Plan is a collectively bargained planYes
2011-06-08Plan funding arrangement – InsuranceYes
2011-06-08Plan benefit arrangement – InsuranceYes
2010: SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN 2010 form 5500 responses
2010-06-08Type of plan entitySingle employer plan
2010-06-08Submission has been amendedNo
2010-06-08This submission is the final filingNo
2010-06-08This return/report is a short plan year return/report (less than 12 months)No
2010-06-08Plan is a collectively bargained planYes
2010-06-08Plan funding arrangement – InsuranceYes
2010-06-08Plan benefit arrangement – InsuranceYes
2009: SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN 2009 form 5500 responses
2009-06-08Type of plan entitySingle employer plan
2009-06-08Submission has been amendedNo
2009-06-08This submission is the final filingNo
2009-06-08This return/report is a short plan year return/report (less than 12 months)No
2009-06-08Plan is a collectively bargained planYes
2009-06-08Plan funding arrangement – InsuranceYes
2009-06-08Plan benefit arrangement – InsuranceYes
2008: SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN 2008 form 5500 responses
2008-06-08Type of plan entitySingle employer plan
2008-06-08Submission has been amendedNo
2008-06-08This submission is the final filingNo
2008-06-08This return/report is a short plan year return/report (less than 12 months)No
2008-06-08Plan is a collectively bargained planYes
2008-06-08Plan funding arrangement – InsuranceYes
2008-06-08Plan benefit arrangement – InsuranceYes
2007: SAPA EXTRUSIONS, INC. BUSINESS TRAVEL ACCIDENT PLAN 2007 form 5500 responses
2007-06-08Type of plan entitySingle employer plan
2007-06-08First time form 5500 has been submittedYes
2007-06-08Submission has been amendedNo
2007-06-08This submission is the final filingNo
2007-06-08This return/report is a short plan year return/report (less than 12 months)No
2007-06-08Plan is a collectively bargained planYes
2007-06-08Plan funding arrangement – InsuranceYes
2007-06-08Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000099063115
Policy instance 1
Insurance contract or identification number000099063115
Number of Individuals Covered4353
Insurance policy start date2015-06-08
Insurance policy end date2016-06-07
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
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
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 $8,412
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000099063115
Policy instance 1
Insurance contract or identification number000099063115
Number of Individuals Covered4353
Insurance policy start date2014-06-08
Insurance policy end date2015-06-07
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
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
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 $8,412
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000099063115
Policy instance 1
Insurance contract or identification number000099063115
Number of Individuals Covered4353
Insurance policy start date2013-06-08
Insurance policy end date2014-06-07
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
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
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 $6,463
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000099063115
Policy instance 1
Insurance contract or identification number000099063115
Number of Individuals Covered3152
Insurance policy start date2012-06-08
Insurance policy end date2013-06-07
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
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
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 $6,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000099063115
Policy instance 1
Insurance contract or identification number000099063115
Number of Individuals Covered3152
Insurance policy start date2011-06-08
Insurance policy end date2012-06-07
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
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
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 $6,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000099063115
Policy instance 1
Insurance contract or identification number000099063115
Number of Individuals Covered3152
Insurance policy start date2010-06-08
Insurance policy end date2011-06-07
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
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
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 $6,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000099063115
Policy instance 1
Insurance contract or identification number000099063115
Number of Individuals Covered3076
Insurance policy start date2009-06-08
Insurance policy end date2010-06-07
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
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
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 $6,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000099063115
Policy instance 1
Insurance contract or identification number000099063115
Number of Individuals Covered3076
Insurance policy start date2008-06-08
Insurance policy end date2009-06-07
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
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
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 $6,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )
Policy contract number000099063115
Policy instance 1
Insurance contract or identification number000099063115
Number of Individuals Covered3076
Insurance policy start date2007-06-08
Insurance policy end date2008-06-07
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
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
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 $6,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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