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CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 401k Plan overview

Plan NameCITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM
Plan identification number 515

CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Severance pay
  • Other welfare benefit cover
  • Collectively bargained welfare benefit arrangement under Code section 419A(f)(5).

401k Sponsoring company profile

CITGO PETROLEUM CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:CITGO PETROLEUM CORPORATION
Employer identification number (EIN):731173881
NAIC Classification:324110
NAIC Description:Petroleum Refineries

Additional information about CITGO PETROLEUM CORPORATION

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 2005114

More information about CITGO PETROLEUM CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5152023-01-01
5152022-01-01
5152021-01-01
5152020-01-01
5152019-01-01
5152018-01-01
5152017-01-01GLENN HILMAN THERESA MITCHELL2018-10-15
5152017-01-01GLENN HILMAN THERESA MITCHELL2019-02-07
5152016-01-01GLENN HILMAN THERESA MITCHELL2018-01-31
5152015-01-01MARISOL GOMEZ JOHN BUTTS2016-10-13
5152014-01-01MARISOL GOMEZ JOHN BUTTS2015-10-14
5152013-01-01MICHAEL NAJAR JOHN BUTTS2014-10-15
5152012-01-01MICHAEL NAJAR JOHN BUTTS2014-07-23
5152011-01-01MICHAEL NAJAR JOHN BUTTS2012-10-15
5152009-01-01ROBERT CASBURN

Plan Statistics for CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM

401k plan membership statisitcs for CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM

Measure Date Value
2023: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2023 401k membership
Total participants, beginning-of-year2023-01-012,726
Total number of active participants reported on line 7a of the Form 55002023-01-012,287
Number of retired or separated participants receiving benefits2023-01-01505
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-012,792
2022: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2022 401k membership
Total participants, beginning-of-year2022-01-012,703
Total number of active participants reported on line 7a of the Form 55002022-01-012,136
Number of retired or separated participants receiving benefits2022-01-01545
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-012,681
2021: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2021 401k membership
Total participants, beginning-of-year2021-01-012,687
Total number of active participants reported on line 7a of the Form 55002021-01-012,058
Number of retired or separated participants receiving benefits2021-01-01602
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-012,660
2020: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2020 401k membership
Total participants, beginning-of-year2020-01-012,852
Total number of active participants reported on line 7a of the Form 55002020-01-012,095
Number of retired or separated participants receiving benefits2020-01-01620
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-012,715
2019: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2019 401k membership
Total participants, beginning-of-year2019-01-012,912
Total number of active participants reported on line 7a of the Form 55002019-01-012,219
Number of retired or separated participants receiving benefits2019-01-01628
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-012,847
2018: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2018 401k membership
Total participants, beginning-of-year2018-01-012,929
Total number of active participants reported on line 7a of the Form 55002018-01-012,249
Number of retired or separated participants receiving benefits2018-01-01662
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-012,911
2017: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2017 401k membership
Total participants, beginning-of-year2017-01-012,938
Total number of active participants reported on line 7a of the Form 55002017-01-012,231
Number of retired or separated participants receiving benefits2017-01-01692
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-012,923
2016: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2016 401k membership
Total participants, beginning-of-year2016-01-013,037
Total number of active participants reported on line 7a of the Form 55002016-01-012,219
Number of retired or separated participants receiving benefits2016-01-01715
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-012,934
2015: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2015 401k membership
Total participants, beginning-of-year2015-01-012,993
Total number of active participants reported on line 7a of the Form 55002015-01-012,312
Number of retired or separated participants receiving benefits2015-01-01738
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-013,050
2014: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2014 401k membership
Total participants, beginning-of-year2014-01-012,989
Total number of active participants reported on line 7a of the Form 55002014-01-012,245
Number of retired or separated participants receiving benefits2014-01-01745
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-012,990
2013: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2013 401k membership
Total participants, beginning-of-year2013-01-013,111
Total number of active participants reported on line 7a of the Form 55002013-01-012,218
Number of retired or separated participants receiving benefits2013-01-01781
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-012,999
2012: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2012 401k membership
Total participants, beginning-of-year2012-01-014,173
Total number of active participants reported on line 7a of the Form 55002012-01-012,183
Number of retired or separated participants receiving benefits2012-01-011,964
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-014,147
2011: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2011 401k membership
Total participants, beginning-of-year2011-01-014,109
Total number of active participants reported on line 7a of the Form 55002011-01-012,251
Number of retired or separated participants receiving benefits2011-01-011,922
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-014,173
2009: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2009 401k membership
Total participants, beginning-of-year2009-01-014,200
Total number of active participants reported on line 7a of the Form 55002009-01-012,340
Number of retired or separated participants receiving benefits2009-01-011,808
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-014,148

Financial Data on CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM

Measure Date Value
2023 : CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$4,578,687
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$3,770,759
Total income from all sources (including contributions)2023-12-31$59,547,487
Total loss/gain on sale of assets2023-12-31$0
Total of all expenses incurred2023-12-31$61,954,584
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$58,525,380
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-12-31$51,867,402
Value of total assets at end of year2023-12-31$16,061,753
Value of total assets at beginning of year2023-12-31$17,660,922
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$3,429,204
Total interest from all sources2023-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2023-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-12-31No
Was this plan covered by a fidelity bond2023-12-31Yes
Value of fidelity bond cover2023-12-31$40,000,000
Were there any nonexempt tranactions with any party-in-interest2023-12-31No
Contributions received from participants2023-12-31$8,533,688
Value of other receiveables (less allowance for doubtful accounts) at end of year2023-12-31$3,566,073
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2023-12-31$2,565,724
Other income not declared elsewhere2023-12-31$6,885,797
Administrative expenses (other) incurred2023-12-31$109,768
Liabilities. Value of operating payables at end of year2023-12-31$228,732
Liabilities. Value of operating payables at beginning of year2023-12-31$302,844
Total non interest bearing cash at end of year2023-12-31$400,026
Total non interest bearing cash at beginning of year2023-12-31$374,535
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Value of net income/loss2023-12-31$-2,407,097
Value of net assets at end of year (total assets less liabilities)2023-12-31$11,483,066
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$13,890,163
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-12-31No
Were any leases to which the plan was party in default or uncollectible2023-12-31No
Value of interest in master investment trust accounts at end of year2023-12-31$12,095,654
Value of interest in master investment trust accounts at beginning of year2023-12-31$14,720,663
Expenses. Payments to insurance carriers foe the provision of benefits2023-12-31$5,198,296
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-12-31No
Was there a failure to transmit to the plan any participant contributions2023-12-31No
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Contributions received in cash from employer2023-12-31$43,333,714
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-12-31$53,327,084
Contract administrator fees2023-12-31$2,969,148
Liabilities. Value of benefit claims payable at end of year2023-12-31$4,349,955
Liabilities. Value of benefit claims payable at beginning of year2023-12-31$3,467,915
Did the plan have assets held for investment2023-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-12-31No
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31KPMG LLP
Accountancy firm EIN2023-12-31135565207
2022 : CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$3,770,759
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$6,537,689
Total income from all sources (including contributions)2022-12-31$64,689,964
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$56,288,885
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$52,969,352
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$59,480,884
Value of total assets at end of year2022-12-31$17,660,922
Value of total assets at beginning of year2022-12-31$12,026,773
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$3,319,533
Total interest from all sources2022-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$40,000,000
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$8,693,408
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$2,565,724
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$2,075,678
Other income not declared elsewhere2022-12-31$5,044,500
Administrative expenses (other) incurred2022-12-31$5,634
Liabilities. Value of operating payables at end of year2022-12-31$302,844
Liabilities. Value of operating payables at beginning of year2022-12-31$138,442
Total non interest bearing cash at end of year2022-12-31$374,535
Total non interest bearing cash at beginning of year2022-12-31$350,146
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$8,401,079
Value of net assets at end of year (total assets less liabilities)2022-12-31$13,890,163
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$5,489,084
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in master investment trust accounts at end of year2022-12-31$14,720,663
Value of interest in master investment trust accounts at beginning of year2022-12-31$9,600,949
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$4,949,222
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$50,787,476
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$48,020,130
Contract administrator fees2022-12-31$3,313,899
Liabilities. Value of benefit claims payable at end of year2022-12-31$3,467,915
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$6,399,247
Did the plan have assets held for investment2022-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31KPMG LLP
Accountancy firm EIN2022-12-31135565207
2021 : CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$6,537,689
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$4,710,533
Total income from all sources (including contributions)2021-12-31$61,876,684
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$57,653,919
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$54,392,949
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$57,676,023
Value of total assets at end of year2021-12-31$12,026,773
Value of total assets at beginning of year2021-12-31$5,976,852
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$3,260,970
Total interest from all sources2021-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Administrative expenses professional fees incurred2021-12-31$262,237
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$40,000,000
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$8,920,982
Participant contributions at end of year2021-12-31$0
Participant contributions at beginning of year2021-12-31$23,707
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$2,075,678
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$2,053,785
Other income not declared elsewhere2021-12-31$4,199,898
Administrative expenses (other) incurred2021-12-31$127,959
Liabilities. Value of operating payables at end of year2021-12-31$138,442
Liabilities. Value of operating payables at beginning of year2021-12-31$125,852
Total non interest bearing cash at end of year2021-12-31$350,146
Total non interest bearing cash at beginning of year2021-12-31$346,779
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$4,222,765
Value of net assets at end of year (total assets less liabilities)2021-12-31$5,489,084
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$1,266,319
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in master investment trust accounts at end of year2021-12-31$9,600,949
Value of interest in master investment trust accounts at beginning of year2021-12-31$3,552,581
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$5,491,275
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$48,755,041
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$48,901,674
Contract administrator fees2021-12-31$2,870,774
Liabilities. Value of benefit claims payable at end of year2021-12-31$6,399,247
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$4,584,681
Did the plan have assets held for investment2021-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31KPMG LLP
Accountancy firm EIN2021-12-31135565207
2020 : CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$4,710,533
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$5,178,031
Total income from all sources (including contributions)2020-12-31$34,866,180
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$57,735,251
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$54,176,964
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$30,847,990
Value of total assets at end of year2020-12-31$5,976,852
Value of total assets at beginning of year2020-12-31$29,313,421
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$3,558,287
Total interest from all sources2020-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$40,000,000
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$9,653,105
Participant contributions at end of year2020-12-31$23,707
Participant contributions at beginning of year2020-12-31$6,091
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$2,053,785
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$1,732,636
Other income not declared elsewhere2020-12-31$3,973,911
Administrative expenses (other) incurred2020-12-31$6,246
Liabilities. Value of operating payables at end of year2020-12-31$125,852
Liabilities. Value of operating payables at beginning of year2020-12-31$201,961
Total non interest bearing cash at end of year2020-12-31$346,779
Total non interest bearing cash at beginning of year2020-12-31$330,312
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$-22,869,071
Value of net assets at end of year (total assets less liabilities)2020-12-31$1,266,319
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$24,135,390
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in master investment trust accounts at end of year2020-12-31$3,552,581
Value of interest in master investment trust accounts at beginning of year2020-12-31$27,244,382
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$6,129,102
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$21,194,885
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$48,047,862
Contract administrator fees2020-12-31$3,552,041
Liabilities. Value of benefit claims payable at end of year2020-12-31$4,584,681
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$4,976,070
Did the plan have assets held for investment2020-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31KPMG LLP
Accountancy firm EIN2020-12-31135565207
2019 : CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$5,178,031
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$4,156,118
Total income from all sources (including contributions)2019-12-31$83,606,972
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$60,429,551
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$57,130,609
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$80,314,337
Value of total assets at end of year2019-12-31$29,313,421
Value of total assets at beginning of year2019-12-31$5,114,087
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$3,298,942
Total interest from all sources2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$40,000,000
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$9,571,164
Participant contributions at end of year2019-12-31$6,091
Participant contributions at beginning of year2019-12-31$2,176
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$1,732,636
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$1,487,153
Other income not declared elsewhere2019-12-31$2,804,070
Administrative expenses (other) incurred2019-12-31$6,327
Liabilities. Value of operating payables at end of year2019-12-31$201,961
Liabilities. Value of operating payables at beginning of year2019-12-31$185,042
Total non interest bearing cash at end of year2019-12-31$330,312
Total non interest bearing cash at beginning of year2019-12-31$296,102
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$23,177,421
Value of net assets at end of year (total assets less liabilities)2019-12-31$24,135,390
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$957,969
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in master investment trust accounts at end of year2019-12-31$27,244,382
Value of interest in master investment trust accounts at beginning of year2019-12-31$3,328,656
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$4,699,693
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$70,743,173
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$52,430,916
Contract administrator fees2019-12-31$3,292,615
Liabilities. Value of benefit claims payable at end of year2019-12-31$4,976,070
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$3,971,076
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31KPMG LLP
Accountancy firm EIN2019-12-31135565207
2018 : CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$4,156,118
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$4,785,661
Total income from all sources (including contributions)2018-12-31$57,899,055
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$56,360,614
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$53,134,450
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$55,619,906
Value of total assets at end of year2018-12-31$5,114,087
Value of total assets at beginning of year2018-12-31$4,205,189
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$3,226,164
Total interest from all sources2018-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$30,000,000
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$9,979,309
Participant contributions at end of year2018-12-31$2,176
Participant contributions at beginning of year2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$1,487,153
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$717,123
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$422
Other income not declared elsewhere2018-12-31$2,246,933
Administrative expenses (other) incurred2018-12-31$6,228
Liabilities. Value of operating payables at end of year2018-12-31$185,042
Liabilities. Value of operating payables at beginning of year2018-12-31$49,180
Total non interest bearing cash at end of year2018-12-31$296,102
Total non interest bearing cash at beginning of year2018-12-31$294,009
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$1,538,441
Value of net assets at end of year (total assets less liabilities)2018-12-31$957,969
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$-580,472
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in master investment trust accounts at end of year2018-12-31$3,328,656
Value of interest in master investment trust accounts at beginning of year2018-12-31$3,194,057
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$4,635,640
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$45,640,597
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$48,498,810
Contract administrator fees2018-12-31$3,219,936
Liabilities. Value of benefit claims payable at end of year2018-12-31$3,971,076
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$4,736,059
Did the plan have assets held for investment2018-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31KPMG LLP
Accountancy firm EIN2018-12-31135565207
2017 : CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$4,785,661
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$5,078,678
Total income from all sources (including contributions)2017-12-31$57,922,079
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$56,120,938
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$53,270,948
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$56,726,970
Value of total assets at end of year2017-12-31$4,205,189
Value of total assets at beginning of year2017-12-31$2,697,065
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$2,849,990
Total interest from all sources2017-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Administrative expenses professional fees incurred2017-12-31$130,560
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$30,000,000
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$10,383,261
Participant contributions at end of year2017-12-31$0
Participant contributions at beginning of year2017-12-31$2,040
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$717,123
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$584,898
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$422
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$0
Other income not declared elsewhere2017-12-31$1,186,643
Administrative expenses (other) incurred2017-12-31$29,344
Liabilities. Value of operating payables at end of year2017-12-31$49,180
Liabilities. Value of operating payables at beginning of year2017-12-31$142,030
Total non interest bearing cash at end of year2017-12-31$294,009
Total non interest bearing cash at beginning of year2017-12-31$276,280
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$1,801,141
Value of net assets at end of year (total assets less liabilities)2017-12-31$-580,472
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$-2,381,613
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in master investment trust accounts at end of year2017-12-31$3,194,057
Value of interest in master investment trust accounts at beginning of year2017-12-31$1,833,847
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$4,537,746
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$46,343,709
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$48,733,202
Contract administrator fees2017-12-31$2,690,086
Liabilities. Value of benefit claims payable at end of year2017-12-31$4,736,059
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$4,936,648
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31KPMG LLP
Accountancy firm EIN2017-12-31135565207
2016 : CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$5,078,678
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$3,147,699
Total income from all sources (including contributions)2016-12-31$54,353,291
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$56,369,589
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$53,942,993
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$53,096,374
Value of total assets at end of year2016-12-31$2,697,065
Value of total assets at beginning of year2016-12-31$2,782,384
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$2,426,596
Total interest from all sources2016-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$133,246
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$30,000,000
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$10,316,256
Participant contributions at end of year2016-12-31$2,040
Participant contributions at beginning of year2016-12-31$4,348
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$584,898
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$1,131,719
Other income not declared elsewhere2016-12-31$1,256,246
Administrative expenses (other) incurred2016-12-31$173,152
Liabilities. Value of operating payables at end of year2016-12-31$142,030
Liabilities. Value of operating payables at beginning of year2016-12-31$53,949
Total non interest bearing cash at end of year2016-12-31$276,280
Total non interest bearing cash at beginning of year2016-12-31$260,362
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-2,016,298
Value of net assets at end of year (total assets less liabilities)2016-12-31$-2,381,613
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$-365,315
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in master investment trust accounts at end of year2016-12-31$1,833,847
Value of interest in master investment trust accounts at beginning of year2016-12-31$1,385,955
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$3,734,762
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$42,780,118
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$50,208,231
Contract administrator fees2016-12-31$2,120,198
Liabilities. Value of benefit claims payable at end of year2016-12-31$4,936,648
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$3,093,750
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31KPMG LLP
Accountancy firm EIN2016-12-31135565207
2015 : CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$3,147,699
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$4,496,581
Total income from all sources (including contributions)2015-12-31$46,424,158
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$48,024,016
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$45,359,797
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$44,534,794
Value of total assets at end of year2015-12-31$2,782,384
Value of total assets at beginning of year2015-12-31$5,731,124
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$2,664,219
Total interest from all sources2015-12-31$0
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 year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$199,153
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$30,000,000
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$10,159,914
Participant contributions at end of year2015-12-31$4,348
Participant contributions at beginning of year2015-12-31$10,347
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$1,131,719
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$696,401
Other income not declared elsewhere2015-12-31$1,888,717
Administrative expenses (other) incurred2015-12-31$266,264
Liabilities. Value of operating payables at end of year2015-12-31$53,949
Liabilities. Value of operating payables at beginning of year2015-12-31$457,136
Total non interest bearing cash at end of year2015-12-31$260,362
Total non interest bearing cash at beginning of year2015-12-31$228,858
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-1,599,858
Value of net assets at end of year (total assets less liabilities)2015-12-31$-365,315
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$1,234,543
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in master investment trust accounts at end of year2015-12-31$1,385,955
Value of interest in master investment trust accounts at beginning of year2015-12-31$4,795,518
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$3,588,776
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$34,374,880
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$41,771,021
Contract administrator fees2015-12-31$2,198,802
Liabilities. Value of benefit claims payable at end of year2015-12-31$3,093,750
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$4,039,445
Did the plan have assets held for investment2015-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31KPMG LLP
Accountancy firm EIN2015-12-31135565207
2014 : CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$4,496,581
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$3,353,459
Total income from all sources (including contributions)2014-12-31$44,811,169
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$44,651,678
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$41,908,975
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$43,768,068
Value of total assets at end of year2014-12-31$5,731,124
Value of total assets at beginning of year2014-12-31$4,428,511
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$2,742,703
Total interest from all sources2014-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Administrative expenses professional fees incurred2014-12-31$117,016
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$20,000,000
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$10,100,901
Participant contributions at end of year2014-12-31$10,347
Participant contributions at beginning of year2014-12-31$27,561
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$696,401
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$680,098
Other income not declared elsewhere2014-12-31$1,042,569
Administrative expenses (other) incurred2014-12-31$360,930
Liabilities. Value of operating payables at end of year2014-12-31$457,136
Liabilities. Value of operating payables at beginning of year2014-12-31$51,507
Total non interest bearing cash at end of year2014-12-31$228,858
Total non interest bearing cash at beginning of year2014-12-31$239,008
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$159,491
Value of net assets at end of year (total assets less liabilities)2014-12-31$1,234,543
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$1,075,052
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in master investment trust accounts at end of year2014-12-31$4,795,518
Value of interest in master investment trust accounts at beginning of year2014-12-31$3,481,844
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$3,377,980
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$33,667,167
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$38,530,995
Contract administrator fees2014-12-31$2,264,757
Liabilities. Value of benefit claims payable at end of year2014-12-31$4,039,445
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$3,301,952
Did the plan have assets held for investment2014-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31KPMG LLP
Accountancy firm EIN2014-12-31135565207
2013 : CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$3,353,459
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$3,749,507
Total income from all sources (including contributions)2013-12-31$44,113,554
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$42,443,496
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$39,982,826
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$43,245,037
Value of total assets at end of year2013-12-31$4,428,511
Value of total assets at beginning of year2013-12-31$3,154,501
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$2,460,670
Total interest from all sources2013-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Administrative expenses professional fees incurred2013-12-31$183,937
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$20,000,000
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$9,541,518
Participant contributions at end of year2013-12-31$27,561
Participant contributions at beginning of year2013-12-31$9,012
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$680,098
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$1,016,561
Other income not declared elsewhere2013-12-31$868,263
Administrative expenses (other) incurred2013-12-31$27,384
Liabilities. Value of operating payables at end of year2013-12-31$51,507
Liabilities. Value of operating payables at beginning of year2013-12-31$67,728
Total non interest bearing cash at end of year2013-12-31$239,008
Total non interest bearing cash at beginning of year2013-12-31$257,933
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$1,670,058
Value of net assets at end of year (total assets less liabilities)2013-12-31$1,075,052
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$-595,006
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in master investment trust accounts at end of year2013-12-31$3,481,844
Value of interest in master investment trust accounts at beginning of year2013-12-31$1,870,995
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$3,271,072
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$33,703,519
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$36,711,754
Contract administrator fees2013-12-31$2,249,349
Liabilities. Value of benefit claims payable at end of year2013-12-31$3,301,952
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$3,681,779
Did the plan have assets held for investment2013-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31KPMG LLP
Accountancy firm EIN2013-12-31135565207
2012 : CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$3,749,507
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$4,700,731
Total income from all sources (including contributions)2012-12-31$49,808,315
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$48,320,887
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$45,609,949
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$48,443,027
Value of total assets at end of year2012-12-31$3,154,501
Value of total assets at beginning of year2012-12-31$2,618,297
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$2,710,938
Total interest from all sources2012-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Administrative expenses professional fees incurred2012-12-31$135,900
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$20,000,000
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$11,182,419
Participant contributions at end of year2012-12-31$9,012
Participant contributions at beginning of year2012-12-31$23,507
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$1,016,561
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$1,061,860
Other income not declared elsewhere2012-12-31$1,365,104
Administrative expenses (other) incurred2012-12-31$47,334
Liabilities. Value of operating payables at end of year2012-12-31$67,728
Liabilities. Value of operating payables at beginning of year2012-12-31$25,814
Total non interest bearing cash at end of year2012-12-31$257,933
Total non interest bearing cash at beginning of year2012-12-31$243,088
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$1,487,428
Value of net assets at end of year (total assets less liabilities)2012-12-31$-595,006
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$-2,082,434
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in master investment trust accounts at end of year2012-12-31$1,870,995
Value of interest in master investment trust accounts at beginning of year2012-12-31$1,289,842
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$3,217,146
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$37,260,608
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$42,392,803
Contract administrator fees2012-12-31$2,527,704
Liabilities. Value of benefit claims payable at end of year2012-12-31$3,681,779
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$4,674,917
Did the plan have assets held for investment2012-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31KPMG LLP
Accountancy firm EIN2012-12-31135565207
2011 : CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$4,700,731
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$4,041,149
Total income from all sources (including contributions)2011-12-31$49,518,273
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$49,801,030
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$47,828,052
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$48,143,557
Value of total assets at end of year2011-12-31$2,618,297
Value of total assets at beginning of year2011-12-31$2,241,472
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$1,972,978
Total interest from all sources2011-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Administrative expenses professional fees incurred2011-12-31$120,743
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$5,000,000
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$11,516,127
Participant contributions at end of year2011-12-31$23,507
Participant contributions at beginning of year2011-12-31$6,408
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$2,224,971
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$1,061,860
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$975,924
Other income not declared elsewhere2011-12-31$1,374,604
Administrative expenses (other) incurred2011-12-31$38,498
Liabilities. Value of operating payables at end of year2011-12-31$25,814
Liabilities. Value of operating payables at beginning of year2011-12-31$75,075
Total non interest bearing cash at end of year2011-12-31$243,088
Total non interest bearing cash at beginning of year2011-12-31$368,768
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-282,757
Value of net assets at end of year (total assets less liabilities)2011-12-31$-2,082,434
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$-1,799,677
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in master investment trust accounts at end of year2011-12-31$1,289,842
Value of interest in master investment trust accounts at beginning of year2011-12-31$890,372
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$2,673,396
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$34,402,459
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$45,154,656
Contract administrator fees2011-12-31$1,813,737
Liabilities. Value of benefit claims payable at end of year2011-12-31$4,674,917
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$3,966,074
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31KPMG LLP
Accountancy firm EIN2011-12-31135565207
2010 : CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$4,041,149
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$4,573,381
Total income from all sources (including contributions)2010-12-31$46,949,289
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$45,680,998
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$43,736,182
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$45,615,237
Value of total assets at end of year2010-12-31$2,241,472
Value of total assets at beginning of year2010-12-31$1,505,413
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$1,944,816
Total interest from all sources2010-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$5,000,000
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$11,009,101
Participant contributions at end of year2010-12-31$6,408
Participant contributions at beginning of year2010-12-31$7,055
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$975,924
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$1,026,162
Other income not declared elsewhere2010-12-31$1,333,781
Administrative expenses (other) incurred2010-12-31$5,874
Liabilities. Value of operating payables at end of year2010-12-31$75,075
Liabilities. Value of operating payables at beginning of year2010-12-31$163,981
Total non interest bearing cash at end of year2010-12-31$368,768
Total non interest bearing cash at beginning of year2010-12-31$196,120
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$1,268,291
Value of net assets at end of year (total assets less liabilities)2010-12-31$-1,799,677
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$-3,067,968
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in master investment trust accounts at end of year2010-12-31$890,372
Value of interest in master investment trust accounts at beginning of year2010-12-31$276,076
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$2,647,345
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$34,606,136
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$41,088,837
Contract administrator fees2010-12-31$1,938,942
Liabilities. Value of benefit claims payable at end of year2010-12-31$3,966,074
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$4,409,400
Did the plan have assets held for investment2010-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31KPMG LLP
Accountancy firm EIN2010-12-31135565207

Form 5500 Responses for CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM

2023: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 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 – TrustYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 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 – TrustYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 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 – TrustYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 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 – TrustYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 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 – TrustYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 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 – TrustYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 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 – TrustYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 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 – TrustYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 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 – TrustYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 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 – TrustYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedYes
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 – TrustYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 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 – TrustYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: CITGO PETROLEUM CORPORATION SALARIED EMPLOYEES' MEDICAL, DENTAL AND LIFE INSURANCE PROGRAM 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 – TrustYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0155587
Policy instance 4
Insurance contract or identification number0155587
Number of Individuals Covered1035
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
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 BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $362,515
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 )
Policy contract number70561
Policy instance 3
Insurance contract or identification number70561
Number of Individuals Covered1891
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $4,354
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $193,390
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 )
Policy contract number70560
Policy instance 2
Insurance contract or identification number70560
Number of Individuals Covered7057
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $98,224
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 $4,314,117
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number229556
Policy instance 1
Insurance contract or identification number229556
Number of Individuals Covered2144
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $653,586
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number229556
Policy instance 1
Insurance contract or identification number229556
Number of Individuals Covered2172
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $637,860
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 )
Policy contract number70560
Policy instance 2
Insurance contract or identification number70560
Number of Individuals Covered5353
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 $75,383
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 $4,093,642
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees75383
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
Insurance broker organization code?3
SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 )
Policy contract number70561
Policy instance 3
Insurance contract or identification number70561
Number of Individuals Covered1271
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 $2,950
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $131,641
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2950
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number229556
Policy instance 3
Insurance contract or identification number229556
Number of Individuals Covered2074
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $620,433
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0114243
Policy instance 2
Insurance contract or identification number0114243
Number of Individuals Covered3127
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $199,044
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0096386
Policy instance 1
Insurance contract or identification number0096386
Number of Individuals Covered4249
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 $4,659,323
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0096386
Policy instance 1
Insurance contract or identification number0096386
Number of Individuals Covered4370
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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 $5,394,749
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0114243
Policy instance 2
Insurance contract or identification number0114243
Number of Individuals Covered3218
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $210,671
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number229556
Policy instance 3
Insurance contract or identification number229556
Number of Individuals Covered2114
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $510,970
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number229556
Policy instance 3
Insurance contract or identification number229556
Number of Individuals Covered2165
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 BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $501,095
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0114243
Policy instance 2
Insurance contract or identification number0114243
Number of Individuals Covered3435
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $215,254
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0096386
Policy instance 1
Insurance contract or identification number0096386
Number of Individuals Covered4731
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 $3,971,341
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number229556
Policy instance 3
Insurance contract or identification number229556
Number of Individuals Covered2168
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 BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $498,317
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0114243
Policy instance 2
Insurance contract or identification number0114243
Number of Individuals Covered3528
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $218,354
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0096386
Policy instance 1
Insurance contract or identification number0096386
Number of Individuals Covered4920
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 $3,907,031
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number229556
Policy instance 3
Insurance contract or identification number229556
Number of Individuals Covered2110
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 BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $458,896
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0114243
Policy instance 2
Insurance contract or identification number0114243
Number of Individuals Covered3565
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $218,120
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0096386
Policy instance 1
Insurance contract or identification number0096386
Number of Individuals Covered4997
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 $3,848,731
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0096386
Policy instance 1
Insurance contract or identification number0096386
Number of Individuals Covered5239
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 $2,972,280
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number114243
Policy instance 2
Insurance contract or identification number114243
Number of Individuals Covered3750
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $186,959
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number229556
Policy instance 3
Insurance contract or identification number229556
Number of Individuals Covered2095
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 BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $429,537
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number114243
Policy instance 2
Insurance contract or identification number114243
Number of Individuals Covered3699
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $180,923
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number229556
Policy instance 3
Insurance contract or identification number229556
Number of Individuals Covered2023
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 BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $405,816
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0096386
Policy instance 1
Insurance contract or identification number0096386
Number of Individuals Covered5259
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 $2,791,241
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0096386
Policy instance 1
Insurance contract or identification number0096386
Number of Individuals Covered5363
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 $2,713,225
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number114243
Policy instance 2
Insurance contract or identification number114243
Number of Individuals Covered3736
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $179,578
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number229556
Policy instance 3
Insurance contract or identification number229556
Number of Individuals Covered1988
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 BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $378,269
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number114243
Policy instance 2
Insurance contract or identification number114243
Number of Individuals Covered3754
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $179,960
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number229556
Policy instance 3
Insurance contract or identification number229556
Number of Individuals Covered2127
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $394,471
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0096386
Policy instance 1
Insurance contract or identification number0096386
Number of Individuals Covered5442
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare 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 $2,642,715
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0096386
Policy instance 3
Insurance contract or identification number0096386
Number of Individuals Covered5683
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare 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 $2,190,326
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number229556
Policy instance 2
Insurance contract or identification number229556
Number of Individuals Covered2012
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $304,022
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number114243
Policy instance 1
Insurance contract or identification number114243
Number of Individuals Covered3903
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $179,048
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number114243
Policy instance 1
Insurance contract or identification number114243
Number of Individuals Covered3989
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare 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 providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $181,762
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number229556
Policy instance 2
Insurance contract or identification number229556
Number of Individuals Covered1968
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $295,763
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0096386
Policy instance 3
Insurance contract or identification number0096386
Number of Individuals Covered5714
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare 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 $2,169,820
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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