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OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 401k Plan overview

Plan NameOFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN
Plan identification number 510

OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN Benefits

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

401k Sponsoring company profile

OFS FITEL, LLC has sponsored the creation of one or more 401k plans.

Company Name:OFS FITEL, LLC
Employer identification number (EIN):621864622
NAIC Classification:334200

Additional information about OFS FITEL, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 3422471

More information about OFS FITEL, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5102022-01-01
5102021-01-01
5102020-01-01
5102019-01-01
5102018-01-01
5102017-01-01VELETA HOLLAND STEPHANIE STREET2018-07-30
5102016-01-01VELETA HOLLAND STEPHANIE STREET2017-10-16
5102015-01-01VELETA HOLLAND STEPHANIE STREET2016-10-14
5102014-01-01STEPHANIE STREET VELETA HOLLAND2015-10-14
5102013-01-01VELETA HOLLAND STEPHANIE STREET2014-10-15
5102012-01-01STEPHANIE STREET VELETA HOLLAND2013-07-30
5102011-01-01VELETA HOLLAND STEPHANIE STREET2012-10-15
5102009-01-01VELETA HOLLAND VELETA HOLLAND2010-10-15
5102006-01-01VELETA HOLLAND STEPHANIE STREET2013-04-26
5102005-01-01VELETA HOLLAND STEPHANIE STREET2013-04-26
5102003-09-01VELETA HOLLAND STEPHANIE STREET2013-04-26

Plan Statistics for OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN

401k plan membership statisitcs for OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN

Measure Date Value
2022: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01503
Total number of active participants reported on line 7a of the Form 55002022-01-010
Number of retired or separated participants receiving benefits2022-01-01496
Total of all active and inactive participants2022-01-01496
Total participants2022-01-01496
2021: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01507
Number of retired or separated participants receiving benefits2021-01-01505
Total of all active and inactive participants2021-01-01505
Total participants2021-01-01505
2020: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01499
Total number of active participants reported on line 7a of the Form 55002020-01-010
Number of retired or separated participants receiving benefits2020-01-01506
Total of all active and inactive participants2020-01-01506
Total participants2020-01-01506
2019: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01491
Number of retired or separated participants receiving benefits2019-01-01498
Total of all active and inactive participants2019-01-01498
Total participants2019-01-01498
2018: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01486
Number of retired or separated participants receiving benefits2018-01-01491
Total of all active and inactive participants2018-01-01491
Total participants2018-01-01491
2017: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01483
Number of retired or separated participants receiving benefits2017-01-01486
Total of all active and inactive participants2017-01-01486
Total participants2017-01-01486
2016: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01480
Number of retired or separated participants receiving benefits2016-01-01482
Total of all active and inactive participants2016-01-01482
Total participants2016-01-01482
2015: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01482
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-01486
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01486
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01486
2014: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01481
Total number of active participants reported on line 7a of the Form 55002014-01-010
Number of retired or separated participants receiving benefits2014-01-01482
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01482
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01482
2013: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01477
Total number of active participants reported on line 7a of the Form 55002013-01-010
Number of retired or separated participants receiving benefits2013-01-01480
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01480
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01480
2012: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01476
Total number of active participants reported on line 7a of the Form 55002012-01-010
Number of retired or separated participants receiving benefits2012-01-01478
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01478
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01478
2011: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01474
Total number of active participants reported on line 7a of the Form 55002011-01-010
Number of retired or separated participants receiving benefits2011-01-01475
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01475
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01475
2009: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01471
Total number of active participants reported on line 7a of the Form 55002009-01-010
Number of retired or separated participants receiving benefits2009-01-01473
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01473
Total participants2009-01-01473
2006: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2006 401k membership
Total participants, beginning-of-year2006-01-01481
Total number of active participants reported on line 7a of the Form 55002006-01-010
Number of retired or separated participants receiving benefits2006-01-01470
Number of other retired or separated participants entitled to future benefits2006-01-010
Total of all active and inactive participants2006-01-01470
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2006-01-010
Total participants2006-01-01470
2005: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2005 401k membership
Total participants, beginning-of-year2005-01-01447
Total number of active participants reported on line 7a of the Form 55002005-01-010
Number of retired or separated participants receiving benefits2005-01-01481
Number of other retired or separated participants entitled to future benefits2005-01-010
Total of all active and inactive participants2005-01-01481
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2005-01-010
Total participants2005-01-01481
2003: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2003 401k membership
Total participants, beginning-of-year2003-09-01337
Total number of active participants reported on line 7a of the Form 55002003-09-010
Number of retired or separated participants receiving benefits2003-09-01397
Number of other retired or separated participants entitled to future benefits2003-09-010
Total of all active and inactive participants2003-09-01397
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2003-09-010
Total participants2003-09-01397

Financial Data on OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN

Measure Date Value
2006 : OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2006 401k financial data
Total income from all sources (including contributions)2006-12-31$94,963
Total of all expenses incurred2006-12-31$5,323,376
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2006-12-31$5,100,277
Value of total assets at end of year2006-12-31$0
Value of total assets at beginning of year2006-12-31$5,228,413
Total of administrative expenses incurred including professional, contract, advisory and management fees2006-12-31$223,099
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2006-12-31No
Administrative expenses professional fees incurred2006-12-31$17,285
Was this plan covered by a fidelity bond2006-12-31Yes
Value of fidelity bond cover2006-12-31$500,000
If this is an individual account plan, was there a blackout period2006-12-31No
Were there any nonexempt tranactions with any party-in-interest2006-12-31No
Administrative expenses (other) incurred2006-12-31$74,251
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2006-12-31No
Value of net income/loss2006-12-31$-5,228,413
Value of net assets at end of year (total assets less liabilities)2006-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2006-12-31$5,228,413
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2006-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2006-12-31No
Were any leases to which the plan was party in default or uncollectible2006-12-31No
Investment advisory and management fees2006-12-31$800
Value of interest in registered invesment companies (eg mutual funds) at end of year2006-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2006-12-31$5,228,413
Expenses. Payments to insurance carriers foe the provision of benefits2006-12-31$76,809
Net investment gain/loss from registered investment companies (e.g. mutual funds)2006-12-31$94,963
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2006-12-31No
Was there a failure to transmit to the plan any participant contributions2006-12-31No
Has the plan failed to provide any benefit when due under the plan2006-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2006-12-31$5,023,468
Contract administrator fees2006-12-31$130,763
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32006-12-31No
Did the plan have assets held for investment2006-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2006-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2006-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2006-12-31Yes
Opinion of an independent qualified public accountant for this plan2006-12-31Disclaimer
Accountancy firm name2006-12-31CARR, RIGGS & INGRAM LLC
Accountancy firm EIN2006-12-31721396621
2005 : OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2005 401k financial data
Total income from all sources (including contributions)2005-12-31$230,724
Total of all expenses incurred2005-12-31$5,910,366
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2005-12-31$5,597,833
Value of total assets at end of year2005-12-31$5,228,413
Value of total assets at beginning of year2005-12-31$10,908,055
Total of administrative expenses incurred including professional, contract, advisory and management fees2005-12-31$312,533
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2005-12-31No
Administrative expenses professional fees incurred2005-12-31$36,734
Was this plan covered by a fidelity bond2005-12-31Yes
Value of fidelity bond cover2005-12-31$500,000
If this is an individual account plan, was there a blackout period2005-12-31No
Were there any nonexempt tranactions with any party-in-interest2005-12-31No
Administrative expenses (other) incurred2005-12-31$97,597
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2005-12-31No
Value of net income/loss2005-12-31$-5,679,642
Value of net assets at end of year (total assets less liabilities)2005-12-31$5,228,413
Value of net assets at beginning of year (total assets less liabilities)2005-12-31$10,908,055
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2005-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2005-12-31No
Were any leases to which the plan was party in default or uncollectible2005-12-31No
Investment advisory and management fees2005-12-31$2,000
Value of interest in registered invesment companies (eg mutual funds) at end of year2005-12-31$5,228,413
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2005-12-31$10,908,055
Expenses. Payments to insurance carriers foe the provision of benefits2005-12-31$85,154
Net investment gain/loss from registered investment companies (e.g. mutual funds)2005-12-31$230,724
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2005-12-31No
Was there a failure to transmit to the plan any participant contributions2005-12-31No
Has the plan failed to provide any benefit when due under the plan2005-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2005-12-31$5,512,679
Contract administrator fees2005-12-31$176,202
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32005-12-31No
Did the plan have assets held for investment2005-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2005-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2005-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2005-12-31Yes
Opinion of an independent qualified public accountant for this plan2005-12-31Disclaimer
Accountancy firm name2005-12-31BRIDGES & DUNN-RANKIN LLP
Accountancy firm EIN2005-12-31582085823
2003 : OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2003 401k financial data
Total transfer of assets to this plan2003-12-31$17,087,918
Total income from all sources (including contributions)2003-12-31$49,332
Total of all expenses incurred2003-12-31$1,167,175
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2003-12-31$1,086,808
Value of total assets at end of year2003-12-31$15,970,075
Total of administrative expenses incurred including professional, contract, advisory and management fees2003-12-31$80,367
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2003-12-31No
Administrative expenses professional fees incurred2003-12-31$15,485
Was this plan covered by a fidelity bond2003-12-31Yes
Value of fidelity bond cover2003-12-31$500,000
If this is an individual account plan, was there a blackout period2003-12-31No
Were there any nonexempt tranactions with any party-in-interest2003-12-31No
Administrative expenses (other) incurred2003-12-31$24,146
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2003-12-31No
Value of net income/loss2003-12-31$-1,117,843
Value of net assets at end of year (total assets less liabilities)2003-12-31$15,970,075
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2003-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2003-12-31No
Were any leases to which the plan was party in default or uncollectible2003-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2003-12-31$15,970,075
Expenses. Payments to insurance carriers foe the provision of benefits2003-12-31$21,589
Net investment gain/loss from registered investment companies (e.g. mutual funds)2003-12-31$49,332
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2003-12-31No
Was there a failure to transmit to the plan any participant contributions2003-12-31No
Has the plan failed to provide any benefit when due under the plan2003-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2003-12-31$1,065,219
Contract administrator fees2003-12-31$40,736
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32003-12-31No
Did the plan have assets held for investment2003-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2003-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2003-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2003-12-31Yes
Opinion of an independent qualified public accountant for this plan2003-12-31Disclaimer
Accountancy firm name2003-12-31BRIDGES & DUNN RANKIN LLP
Accountancy firm EIN2003-12-31582085823

Form 5500 Responses for OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN

2022: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle 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 planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
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 planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle 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 planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle 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 planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle 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 planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle 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 planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle 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 planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle 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 planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle 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 planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle 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 planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle 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 planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle 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 planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle 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 planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes
2006: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2006 form 5500 responses
2006-01-01Type of plan entitySingle employer plan
2006-01-01Submission has been amendedYes
2006-01-01This submission is the final filingNo
2006-01-01This return/report is a short plan year return/report (less than 12 months)No
2006-01-01Plan is a collectively bargained planNo
2006-01-01Plan funding arrangement – InsuranceYes
2006-01-01Plan funding arrangement – TrustYes
2006-01-01Plan benefit arrangement – InsuranceYes
2006-01-01Plan benefit arrangement - TrustYes
2005: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2005 form 5500 responses
2005-01-01Type of plan entitySingle employer plan
2005-01-01Submission has been amendedYes
2005-01-01This submission is the final filingNo
2005-01-01This return/report is a short plan year return/report (less than 12 months)No
2005-01-01Plan is a collectively bargained planNo
2005-01-01Plan funding arrangement – InsuranceYes
2005-01-01Plan funding arrangement – TrustYes
2005-01-01Plan benefit arrangement – InsuranceYes
2005-01-01Plan benefit arrangement - TrustYes
2003: OFS REPRESENTED RETIREE MEDICAL AND DENTAL PLAN 2003 form 5500 responses
2003-09-01Type of plan entitySingle employer plan
2003-09-01First time form 5500 has been submittedYes
2003-09-01Submission has been amendedNo
2003-09-01This submission is the final filingNo
2003-09-01This return/report is a short plan year return/report (less than 12 months)Yes
2003-09-01Plan is a collectively bargained planNo
2003-09-01Plan funding arrangement – InsuranceYes
2003-09-01Plan funding arrangement – TrustYes
2003-09-01Plan benefit arrangement – InsuranceYes
2003-09-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number804052G
Policy instance 1
Insurance contract or identification number804052G
Number of Individuals Covered496
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 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 $282,105
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number804052G
Policy instance 1
Insurance contract or identification number804052G
Number of Individuals Covered507
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 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 $243,951
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number804052
Policy instance 1
Insurance contract or identification number804052
Number of Individuals Covered498
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 $11,290
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
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 $283,643
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees11290
Additional information about fees paid to insurance brokerBONUS
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0705618
Policy instance 1
Insurance contract or identification number0705618
Number of Individuals Covered498
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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 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 $135,196
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0705618
Policy instance 1
Insurance contract or identification number0705618
Number of Individuals Covered491
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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 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 $278,572
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0705618
Policy instance 1
Insurance contract or identification number0705618
Number of Individuals Covered486
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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 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 $409,857
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0705618
Policy instance 1
Insurance contract or identification number0705618
Number of Individuals Covered486
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 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 $401,651
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0705618
Policy instance 1
Insurance contract or identification number0705618
Number of Individuals Covered482
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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 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 $291,704
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0705618
Policy instance 1
Insurance contract or identification number0705618
Number of Individuals Covered480
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
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 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 $343,355
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number705618
Policy instance 1
Insurance contract or identification number705618
Number of Individuals Covered478
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $305,581
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number705618
Policy instance 1
Insurance contract or identification number705618
Number of Individuals Covered475
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $267,177
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number705618
Policy instance 1
Insurance contract or identification number705618
Number of Individuals Covered474
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $244,340
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number134105
Policy instance 1
Insurance contract or identification number134105
Number of Individuals Covered470
Insurance policy start date2006-01-01
Insurance policy end date2006-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $76,809
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number134105
Policy instance 1
Insurance contract or identification number134105
Number of Individuals Covered481
Insurance policy start date2005-01-01
Insurance policy end date2005-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $85,154
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number134105
Policy instance 1
Insurance contract or identification number134105
Number of Individuals Covered447
Insurance policy start date2004-01-01
Insurance policy end date2004-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $75,814
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number134105
Policy instance 1
Insurance contract or identification number134105
Number of Individuals Covered373
Insurance policy start date2003-09-01
Insurance policy end date2003-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,589
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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