PLUMBERS & STEAMFITTERS LOCAL 760 HEALTH & WELFARE has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan PLUMBERS & STEAMFITTERS LOCAL NO. 760 HEALTH & WELFARE TRUST FUND
401k plan membership statisitcs for PLUMBERS & STEAMFITTERS LOCAL NO. 760 HEALTH & WELFARE TRUST FUND
| Measure | Date | Value |
|---|
| 2016: PLUMBERS & STEAMFITTERS LOCAL NO. 760 HEALTH & WELFARE TRUST FUND 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 444 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 500 |
| Total of all active and inactive participants | 2016-01-01 | 500 |
| Total participants | 2016-01-01 | 500 |
| 2015: PLUMBERS & STEAMFITTERS LOCAL NO. 760 HEALTH & WELFARE TRUST FUND 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 444 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 1,372 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
| Total of all active and inactive participants | 2015-01-01 | 1,372 |
| Total participants | 2015-01-01 | 1,372 |
| 2014: PLUMBERS & STEAMFITTERS LOCAL NO. 760 HEALTH & WELFARE TRUST FUND 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 450 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 444 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
| Total of all active and inactive participants | 2014-01-01 | 444 |
| Total participants | 2014-01-01 | 444 |
| 2013: PLUMBERS & STEAMFITTERS LOCAL NO. 760 HEALTH & WELFARE TRUST FUND 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 467 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 450 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 0 |
| Total of all active and inactive participants | 2013-01-01 | 450 |
| Total participants | 2013-01-01 | 450 |
| 2012: PLUMBERS & STEAMFITTERS LOCAL NO. 760 HEALTH & WELFARE TRUST FUND 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 493 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 467 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 0 |
| Total of all active and inactive participants | 2012-01-01 | 467 |
| Total participants | 2012-01-01 | 467 |
| 2011: PLUMBERS & STEAMFITTERS LOCAL NO. 760 HEALTH & WELFARE TRUST FUND 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 505 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 493 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 0 |
| Total of all active and inactive participants | 2011-01-01 | 493 |
| Total participants | 2011-01-01 | 493 |
| 2009: PLUMBERS & STEAMFITTERS LOCAL NO. 760 HEALTH & WELFARE TRUST FUND 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 492 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 492 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 492 |
| Total participants | 2009-01-01 | 492 |
| Measure | Date | Value |
|---|
| 2016 : PLUMBERS & STEAMFITTERS LOCAL NO. 760 HEALTH & WELFARE TRUST FUND 2016 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2016-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $2,155 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $6,244 |
| Total income from all sources (including contributions) | 2016-12-31 | $8,432,430 |
| Total loss/gain on sale of assets | 2016-12-31 | $0 |
| Total of all expenses incurred | 2016-12-31 | $6,519,798 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $6,274,479 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $7,978,097 |
| Value of total assets at end of year | 2016-12-31 | $12,407,661 |
| Value of total assets at beginning of year | 2016-12-31 | $10,499,118 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $245,319 |
| Total interest from all sources | 2016-12-31 | $227,166 |
| Total dividends received (eg from common stock, registered investment company shares) | 2016-12-31 | $227,167 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
| Administrative expenses professional fees incurred | 2016-12-31 | $15,554 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2016-12-31 | $561,822 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2016-12-31 | $645,744 |
| Was this plan covered by a fidelity bond | 2016-12-31 | Yes |
| Value of fidelity bond cover | 2016-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2016-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
| Contributions received from participants | 2016-12-31 | $557,590 |
| Participant contributions at end of year | 2016-12-31 | $83,174 |
| Participant contributions at beginning of year | 2016-12-31 | $44,000 |
| Assets. Other investments not covered elsewhere at end of year | 2016-12-31 | $484,723 |
| Assets. Other investments not covered elsewhere at beginning of year | 2016-12-31 | $374,662 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2016-12-31 | $963,344 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2016-12-31 | $446,189 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-12-31 | $36,490 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-12-31 | $36,890 |
| Administrative expenses (other) incurred | 2016-12-31 | $229,765 |
| Liabilities. Value of operating payables at end of year | 2016-12-31 | $2,155 |
| Liabilities. Value of operating payables at beginning of year | 2016-12-31 | $6,244 |
| Total non interest bearing cash at end of year | 2016-12-31 | $2,435,399 |
| Total non interest bearing cash at beginning of year | 2016-12-31 | $1,718,893 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Value of net income/loss | 2016-12-31 | $1,912,632 |
| Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $12,405,506 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $10,492,874 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2016-12-31 | $4,218,777 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2016-12-31 | $4,088,158 |
| Income. Interest from US Government securities | 2016-12-31 | $227,166 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-12-31 | $2,435,399 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-12-31 | $1,642,648 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-12-31 | $1,642,648 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $5,694,513 |
| Asset value of US Government securities at end of year | 2016-12-31 | $4,218,777 |
| Asset value of US Government securities at beginning of year | 2016-12-31 | $4,088,158 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
| Contributions received in cash from employer | 2016-12-31 | $6,457,163 |
| Employer contributions (assets) at end of year | 2016-12-31 | $870,934 |
| Employer contributions (assets) at beginning of year | 2016-12-31 | $743,898 |
| Income. Dividends from preferred stock | 2016-12-31 | $227,167 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-12-31 | $133,777 |
| Asset. Corporate debt instrument preferred debt at end of year | 2016-12-31 | $3,676,502 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2016-12-31 | $3,657,038 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2016-12-31 | No |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2016-12-31 | $39,840 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2016-12-31 | $53,978 |
| Did the plan have assets held for investment | 2016-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Unqualified |
| Accountancy firm name | 2016-12-31 | ANGIE VICKERY, CPA, PC |
| Accountancy firm EIN | 2016-12-31 | 300358651 |
| 2015 : PLUMBERS & STEAMFITTERS LOCAL NO. 760 HEALTH & WELFARE TRUST FUND 2015 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2015-12-31 | $0 |
| Total transfer of assets to this plan | 2015-12-31 | $194,510 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $6,244 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $3,062 |
| Total income from all sources (including contributions) | 2015-12-31 | $5,482,528 |
| Total loss/gain on sale of assets | 2015-12-31 | $0 |
| Total of all expenses incurred | 2015-12-31 | $5,061,753 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $4,864,807 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-12-31 | $5,467,313 |
| Value of total assets at end of year | 2015-12-31 | $10,499,118 |
| Value of total assets at beginning of year | 2015-12-31 | $9,880,651 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $196,946 |
| Total interest from all sources | 2015-12-31 | $15,215 |
| Total dividends received (eg from common stock, registered investment company shares) | 2015-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-12-31 | No |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2015-12-31 | $645,744 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2015-12-31 | $541,426 |
| Was this plan covered by a fidelity bond | 2015-12-31 | Yes |
| Value of fidelity bond cover | 2015-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2015-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
| Contributions received from participants | 2015-12-31 | $368,941 |
| Participant contributions at end of year | 2015-12-31 | $44,000 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2015-12-31 | $2,141,274 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2015-12-31 | $39,416 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-12-31 | $411,552 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-12-31 | $363,527 |
| Administrative expenses (other) incurred | 2015-12-31 | $196,946 |
| Liabilities. Value of operating payables at end of year | 2015-12-31 | $6,244 |
| Liabilities. Value of operating payables at beginning of year | 2015-12-31 | $3,062 |
| Total non interest bearing cash at end of year | 2015-12-31 | $1,642,648 |
| Total non interest bearing cash at beginning of year | 2015-12-31 | $1,734,061 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Value of net income/loss | 2015-12-31 | $420,775 |
| Value of net assets at end of year (total assets less liabilities) | 2015-12-31 | $10,492,874 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-12-31 | $9,877,589 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2015-12-31 | $4,088,158 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2015-12-31 | $3,379,532 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-12-31 | $15,215 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-12-31 | $4,669,015 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2015-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
| Contributions received in cash from employer | 2015-12-31 | $2,957,098 |
| Employer contributions (assets) at end of year | 2015-12-31 | $743,898 |
| Employer contributions (assets) at beginning of year | 2015-12-31 | $215,364 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-12-31 | $4,825,391 |
| Asset. Corporate debt instrument preferred debt at end of year | 2015-12-31 | $3,657,038 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2015-12-31 | $3,813,851 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2015-12-31 | No |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2015-12-31 | $53,978 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2015-12-31 | $48,254 |
| Did the plan have assets held for investment | 2015-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-12-31 | Unqualified |
| Accountancy firm name | 2015-12-31 | ANGIE VICKERY, CPA, PC |
| Accountancy firm EIN | 2015-12-31 | 300358651 |
| 2016: PLUMBERS & STEAMFITTERS LOCAL NO. 760 HEALTH & WELFARE TRUST FUND 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Multi-employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | Yes |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: PLUMBERS & STEAMFITTERS LOCAL NO. 760 HEALTH & WELFARE TRUST FUND 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Multi-employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | Yes |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: PLUMBERS & STEAMFITTERS LOCAL NO. 760 HEALTH & WELFARE TRUST FUND 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Multi-employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: PLUMBERS & STEAMFITTERS LOCAL NO. 760 HEALTH & WELFARE TRUST FUND 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Multi-employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | Yes |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: PLUMBERS & STEAMFITTERS LOCAL NO. 760 HEALTH & WELFARE TRUST FUND 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Multi-employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | Yes |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: PLUMBERS & STEAMFITTERS LOCAL NO. 760 HEALTH & WELFARE TRUST FUND 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Multi-employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | Yes |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: PLUMBERS & STEAMFITTERS LOCAL NO. 760 HEALTH & WELFARE TRUST FUND 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Multi-employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | Yes |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
| Policy contract number | 24603 |
| Policy instance | 1 |
| Insurance contract or identification number | 24603 | | Number of Individuals Covered | 1372 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | EXPANDED PSYCHIATRIC SERVICES BABY YOURSELF AIR MEDICAL SERVICES | | 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 Carrier | USD $60,654 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F017826 |
| Policy instance | 2 |
| Insurance contract or identification number | F017826 | | Number of Individuals Covered | 759 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $32,922 | | Total amount of fees paid to insurance company | USD $198 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $140,590 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $23,359 | | Amount paid for insurance broker fees | 137 | | Additional information about fees paid to insurance broker | PREFERRED BROKER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | JOHN M CRUICKSHANK |
|
| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
| Policy contract number | 24603 |
| Policy instance | 1 |
| Insurance contract or identification number | 24603 | | Number of Individuals Covered | 444 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | EXPANDED PSYCHIATRIC SERVICES BABY YOURSELF AIR MEDICAL SERVICES | | 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 Carrier | USD $50,456 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F017826 |
| Policy instance | 2 |
| Insurance contract or identification number | F017826 | | Number of Individuals Covered | 593 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $26,458 | | Total amount of fees paid to insurance company | USD $88 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $110,241 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,141 | | Amount paid for insurance broker fees | 44 | | Additional information about fees paid to insurance broker | PREFERRED BROKER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | WILLIAM E MOORE AND ASSOCIATES |
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| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
| Policy contract number | 24603 |
| Policy instance | 1 |
| Insurance contract or identification number | 24603 | | Number of Individuals Covered | 1196 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | EXPANDED PSYCHIATRIC SERVICES BABY YOURSELF AIR MEDICAL SERVICES | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No |
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| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F017826 |
| Policy instance | 2 |
| Insurance contract or identification number | F017826 | | Number of Individuals Covered | 583 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $29,224 | | Total amount of fees paid to insurance company | USD $102 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $113,823 | | Commission paid to Insurance Broker | USD $20,232 | | Amount paid for insurance broker fees | 71 | | Additional information about fees paid to insurance broker | PREFERRED BROKER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | JOHN M CRUICKSHANK |
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| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
| Policy contract number | 24603 |
| Policy instance | 1 |
| Insurance contract or identification number | 24603 | | Number of Individuals Covered | 1217 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | EPS BABY YOURSELF (AIRMED) |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F017826 |
| Policy instance | 2 |
| Insurance contract or identification number | F017826 | | Number of Individuals Covered | 588 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $30,738 | | Total amount of fees paid to insurance company | USD $163 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD & D | | Welfare Benefit Premiums Paid to Carrier | USD $127,127 | | Commission paid to Insurance Broker | USD $9,508 | | Additional information about fees paid to insurance broker | PREFERRED BROKER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | WILLIAM E MOORE & ASSOC INSURANCE |
|
| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
| Policy contract number | 24603 |
| Policy instance | 1 |
| Insurance contract or identification number | 24603 | | Number of Individuals Covered | 1284 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | EPS BABY YOURSELF AIRMED |
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| UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
| Policy contract number | 146177 |
| Policy instance | 2 |
| Insurance contract or identification number | 146177 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $2,171 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD & D |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F017826 |
| Policy instance | 3 |
| Insurance contract or identification number | F017826 | | Number of Individuals Covered | 602 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $31,625 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD & D | | Welfare Benefit Premiums Paid to Carrier | USD $121,725 |
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| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
| Policy contract number | 24603 |
| Policy instance | 1 |
| Insurance contract or identification number | 24603 | | Number of Individuals Covered | 1324 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | EPS |
|
| UNICARE HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80314 ) |
| Policy contract number | 146177 |
| Policy instance | 2 |
| Insurance contract or identification number | 146177 | | Number of Individuals Covered | 601 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $28,038 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD & D | | Welfare Benefit Premiums Paid to Carrier | USD $129,893 | | Commission paid to Insurance Broker | USD $23,695 | | Additional information about fees paid to insurance broker | PREFERRED BROKER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | JOHN M CRUICKSHANK |
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