JOHN MADONNA CONSTRUCTION COMPANY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM
| Measure | Date | Value |
|---|
| 2023 : JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2023 401k financial data |
|---|
| Total plan liabilities at end of year | 2023-12-31 | $0 |
| Total plan liabilities at beginning of year | 2023-12-31 | $0 |
| Total income from all sources | 2023-12-31 | $191,362 |
| Expenses. Total of all expenses incurred | 2023-12-31 | $239,500 |
| Benefits paid (including direct rollovers) | 2023-12-31 | $197,461 |
| Total plan assets at end of year | 2023-12-31 | $522,615 |
| Total plan assets at beginning of year | 2023-12-31 | $570,753 |
| Net income (gross income less expenses) | 2023-12-31 | $-48,138 |
| Net plan assets at end of year (total assets less liabilities) | 2023-12-31 | $522,615 |
| Net plan assets at beginning of year (total assets less liabilities) | 2023-12-31 | $570,753 |
| Total contributions received or receivable from employer(s) | 2023-12-31 | $191,362 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2023-12-31 | $42,039 |
| 2022 : JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2022 401k financial data |
|---|
| Total income from all sources | 2022-12-31 | $168,749 |
| Expenses. Total of all expenses incurred | 2022-12-31 | $242,881 |
| Benefits paid (including direct rollovers) | 2022-12-31 | $223,763 |
| Total plan assets at end of year | 2022-12-31 | $570,753 |
| Total plan assets at beginning of year | 2022-12-31 | $644,885 |
| Net income (gross income less expenses) | 2022-12-31 | $-74,132 |
| Net plan assets at end of year (total assets less liabilities) | 2022-12-31 | $570,753 |
| Net plan assets at beginning of year (total assets less liabilities) | 2022-12-31 | $644,885 |
| Total contributions received or receivable from employer(s) | 2022-12-31 | $168,749 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2022-12-31 | $19,118 |
| 2021 : JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2021 401k financial data |
|---|
| Total income from all sources | 2021-12-31 | $215,070 |
| Expenses. Total of all expenses incurred | 2021-12-31 | $227,293 |
| Benefits paid (including direct rollovers) | 2021-12-31 | $217,212 |
| Total plan assets at end of year | 2021-12-31 | $644,885 |
| Total plan assets at beginning of year | 2021-12-31 | $657,108 |
| Net income (gross income less expenses) | 2021-12-31 | $-12,223 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-31 | $644,885 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-31 | $657,108 |
| Total contributions received or receivable from employer(s) | 2021-12-31 | $215,070 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2021-12-31 | $10,081 |
| 2020 : JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2020 401k financial data |
|---|
| Total income from all sources | 2020-12-31 | $297,471 |
| Expenses. Total of all expenses incurred | 2020-12-31 | $328,458 |
| Benefits paid (including direct rollovers) | 2020-12-31 | $308,070 |
| Total plan assets at end of year | 2020-12-31 | $657,108 |
| Total plan assets at beginning of year | 2020-12-31 | $688,095 |
| Net income (gross income less expenses) | 2020-12-31 | $-30,987 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $657,108 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-31 | $688,095 |
| Total contributions received or receivable from employer(s) | 2020-12-31 | $297,471 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-12-31 | $20,388 |
| 2019 : JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2019 401k financial data |
|---|
| Total income from all sources | 2019-12-31 | $464,508 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $331,674 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $314,071 |
| Total plan assets at end of year | 2019-12-31 | $688,095 |
| Total plan assets at beginning of year | 2019-12-31 | $555,261 |
| Net income (gross income less expenses) | 2019-12-31 | $132,834 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $688,095 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $555,261 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $464,508 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $17,603 |
| 2018 : JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2018 401k financial data |
|---|
| Total income from all sources | 2018-12-31 | $494,641 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $220,376 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $202,979 |
| Total plan assets at end of year | 2018-12-31 | $555,261 |
| Total plan assets at beginning of year | 2018-12-31 | $280,996 |
| Net income (gross income less expenses) | 2018-12-31 | $274,265 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $555,261 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $280,996 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $494,641 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $17,397 |
| 2017 : JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2017 401k financial data |
|---|
| Total income from all sources | 2017-12-31 | $366,065 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $114,149 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $108,035 |
| Total plan assets at end of year | 2017-12-31 | $280,996 |
| Total plan assets at beginning of year | 2017-12-31 | $29,080 |
| Net income (gross income less expenses) | 2017-12-31 | $251,916 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $280,996 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $29,080 |
| Total contributions received or receivable from employer(s) | 2017-12-31 | $366,065 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $6,114 |
| 2016 : JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2016 401k financial data |
|---|
| Total income from all sources | 2016-12-31 | $92,296 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $87,479 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $85,764 |
| Total plan assets at end of year | 2016-12-31 | $29,080 |
| Total plan assets at beginning of year | 2016-12-31 | $24,263 |
| Net income (gross income less expenses) | 2016-12-31 | $4,817 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $29,080 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $24,263 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $92,296 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $1,715 |
| 2015 : JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2015 401k financial data |
|---|
| Total income from all sources | 2015-12-31 | $89,019 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $79,881 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $83,371 |
| Total plan assets at end of year | 2015-12-31 | $24,263 |
| Total plan assets at beginning of year | 2015-12-31 | $15,125 |
| Net income (gross income less expenses) | 2015-12-31 | $9,138 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $24,263 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $15,125 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $89,019 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $-3,490 |
| 2014 : JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2014 401k financial data |
|---|
| Total income from all sources | 2014-12-31 | $93,543 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $105,973 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $93,121 |
| Total plan assets at end of year | 2014-12-31 | $15,125 |
| Total plan assets at beginning of year | 2014-12-31 | $27,555 |
| Value of fidelity bond covering the plan | 2014-12-31 | $3,000 |
| Net income (gross income less expenses) | 2014-12-31 | $-12,430 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $15,125 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $27,555 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $93,543 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-12-31 | $12,852 |
| 2013 : JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2013 401k financial data |
|---|
| Total income from all sources | 2013-12-31 | $103,716 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $99,060 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $96,822 |
| Total plan assets at end of year | 2013-12-31 | $27,555 |
| Total plan assets at beginning of year | 2013-12-31 | $22,899 |
| Value of fidelity bond covering the plan | 2013-12-31 | $125,000 |
| Net income (gross income less expenses) | 2013-12-31 | $4,656 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $27,555 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $22,899 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $103,716 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-12-31 | $2,238 |
| 2012 : JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2012 401k financial data |
|---|
| Total income from all sources | 2012-12-31 | $122,532 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $127,137 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $126,214 |
| Total plan assets at end of year | 2012-12-31 | $22,899 |
| Total plan assets at beginning of year | 2012-12-31 | $27,504 |
| Value of fidelity bond covering the plan | 2012-12-31 | $125,000 |
| Net income (gross income less expenses) | 2012-12-31 | $-4,605 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $22,899 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $27,504 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $122,532 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2012-12-31 | $923 |
| 2011 : JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2011 401k financial data |
|---|
| Total income from all sources | 2011-12-31 | $148,192 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $133,734 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $122,618 |
| Total plan assets at end of year | 2011-12-31 | $27,504 |
| Total plan assets at beginning of year | 2011-12-31 | $13,046 |
| Value of fidelity bond covering the plan | 2011-12-31 | $125,000 |
| Net income (gross income less expenses) | 2011-12-31 | $14,458 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $27,504 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $13,046 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $148,192 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-12-31 | $11,116 |
| 2010 : JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2010 401k financial data |
|---|
| Total income from all sources | 2010-12-31 | $96,455 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $103,912 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $101,800 |
| Total plan assets at end of year | 2010-12-31 | $13,046 |
| Total plan assets at beginning of year | 2010-12-31 | $20,503 |
| Net income (gross income less expenses) | 2010-12-31 | $-7,457 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $13,046 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $20,503 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $96,455 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2010-12-31 | $2,112 |
| 2023: JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2023 form 5500 responses |
|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Submission has been amended | No |
| 2023-01-01 | This submission is the final filing | No |
| 2023-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2023-01-01 | Plan is a collectively bargained plan | No |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan funding arrangement – Trust | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement - Trust | Yes |
| 2022: JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – Trust | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement - Trust | Yes |
| 2021: JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – Trust | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement - Trust | Yes |
| 2020: JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – Trust | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement - Trust | Yes |
| 2019: JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – Trust | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement - Trust | Yes |
| 2018: JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – Trust | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement - Trust | Yes |
| 2017: JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – Trust | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement - Trust | Yes |
| 2016: JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015: JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – Trust | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
| 2014: JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – Trust | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement - Trust | Yes |
| 2013: JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – Trust | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement - Trust | Yes |
| 2012: JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement - Trust | Yes |
| 2011: JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – Trust | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement - Trust | Yes |
| 2010: JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Submission has been amended | No |
| 2010-01-01 | This submission is the final filing | No |
| 2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-01-01 | Plan is a collectively bargained plan | No |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – Trust | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement - Trust | Yes |
| 2009: JOHN MADONNA CONSTRUCTION COMPANY, INC. INSURANCE PROGRAM 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement - Trust | Yes |
| PRINCIPAL FINANCIAL GROUP, INC (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1165527-1001 |
| Policy instance | 4 |
| Insurance contract or identification number | 1165527-1001 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $5,252 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 5398541 |
| Policy instance | 3 |
| Insurance contract or identification number | 5398541 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,694 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| TDC - HUMANA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 8 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $9,153 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| BLUE SHIELD OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 688603-000 |
| Policy instance | 1 |
| Insurance contract or identification number | 688603-000 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $134,928 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| BLUE SHIELD OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 688603-000 |
| Policy instance | 1 |
| Insurance contract or identification number | 688603-000 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $129,241 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| TDC - HUMANA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 10 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $13,520 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 5398541 |
| Policy instance | 3 |
| Insurance contract or identification number | 5398541 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $226 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| PRINCIPAL FINANCIAL GROUP, INC (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1165527-1001 |
| Policy instance | 4 |
| Insurance contract or identification number | 1165527-1001 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $715 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| THE HARTFORD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | GLT 886352 |
| Policy instance | 5 |
| Insurance contract or identification number | GLT 886352 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,129 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| THE HARTFORD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | GLT 886352 |
| Policy instance | 3 |
| TDC - HUMANA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | |
| Policy instance | 2 |
| BLUE SHIELD OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 688603-000 |
| Policy instance | 1 |
| THE HARTFORD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | GLT 886352 |
| Policy instance | 3 |
| TDC - HUMANA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | |
| Policy instance | 2 |
| BLUE SHIELD OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 688603-000 |
| Policy instance | 1 |
| BLUE SHIELD OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 688603-000 |
| Policy instance | 1 |
| TDC - HUMANA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | |
| Policy instance | 2 |
| THE HARTFORD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | GLT 886352 |
| Policy instance | 3 |
| THE HARTFORD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | GLT 886352 |
| Policy instance | 3 |
| TDC - HUMANA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | |
| Policy instance | 2 |
| BLUE SHIELD OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 688603-000 |
| Policy instance | 1 |
| TDC - HUMANA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | |
| Policy instance | 2 |
| BLUE SHIELD OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 688603-000 |
| Policy instance | 1 |
