SHEET METAL WORKERS FND BD OF TTEES C/O DIMICK HYDE & LEWIS, PC has sponsored the creation of one or more 401k plans.
| Measure | Date | Value |
|---|
| 2023 : LYLE HUGHART WELFARE FUND 2023 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2023-06-30 | $311,964 |
| Total unrealized appreciation/depreciation of assets | 2023-06-30 | $311,964 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-06-30 | $407,845 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-06-30 | $376 |
| Total income from all sources (including contributions) | 2023-06-30 | $5,178,277 |
| Total of all expenses incurred | 2023-06-30 | $4,423,172 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2023-06-30 | $4,304,923 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2023-06-30 | $4,982,429 |
| Value of total assets at end of year | 2023-06-30 | $9,424,378 |
| Value of total assets at beginning of year | 2023-06-30 | $8,261,804 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2023-06-30 | $118,249 |
| Total interest from all sources | 2023-06-30 | $66,658 |
| Total dividends received (eg from common stock, registered investment company shares) | 2023-06-30 | $123,409 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2023-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2023-06-30 | $123,409 |
| Administrative expenses professional fees incurred | 2023-06-30 | $36,388 |
| Was this plan covered by a fidelity bond | 2023-06-30 | Yes |
| Value of fidelity bond cover | 2023-06-30 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2023-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2023-06-30 | No |
| Contributions received from participants | 2023-06-30 | $35,918 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2023-06-30 | $602,648 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2023-06-30 | $953 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2023-06-30 | $407,845 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2023-06-30 | $376 |
| Other income not declared elsewhere | 2023-06-30 | $321 |
| Administrative expenses (other) incurred | 2023-06-30 | $13,053 |
| Total non interest bearing cash at end of year | 2023-06-30 | $291,554 |
| Total non interest bearing cash at beginning of year | 2023-06-30 | $290,903 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-06-30 | No |
| Value of net income/loss | 2023-06-30 | $755,105 |
| Value of net assets at end of year (total assets less liabilities) | 2023-06-30 | $9,016,533 |
| Value of net assets at beginning of year (total assets less liabilities) | 2023-06-30 | $8,261,428 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2023-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2023-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2023-06-30 | No |
| Investment advisory and management fees | 2023-06-30 | $34,644 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2023-06-30 | $5,682,690 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2023-06-30 | $4,438,151 |
| Interest earned on other investments | 2023-06-30 | $26,106 |
| Income. Interest from corporate debt instruments | 2023-06-30 | $13,887 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2023-06-30 | $3,449,149 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2023-06-30 | $3,529,496 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2023-06-30 | $3,529,496 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2023-06-30 | $26,665 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2023-06-30 | $1,039,435 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2023-06-30 | $-306,504 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2023-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2023-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2023-06-30 | No |
| Contributions received in cash from employer | 2023-06-30 | $4,946,511 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2023-06-30 | $2,662,840 |
| Contract administrator fees | 2023-06-30 | $34,164 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2023-06-30 | No |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2023-06-30 | $32 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2023-06-30 | $3,254 |
| Did the plan have assets held for investment | 2023-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2023-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2023-06-30 | Unqualified |
| Accountancy firm name | 2023-06-30 | BRYAN, LITTLE, HALEY & KENT PC |
| Accountancy firm EIN | 2023-06-30 | 730941849 |
| 2022 : LYLE HUGHART WELFARE FUND 2022 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2022-06-30 | $-685,474 |
| Total unrealized appreciation/depreciation of assets | 2022-06-30 | $-685,474 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-06-30 | $376 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-06-30 | $0 |
| Total income from all sources (including contributions) | 2022-06-30 | $3,951,993 |
| Total loss/gain on sale of assets | 2022-06-30 | $0 |
| Total of all expenses incurred | 2022-06-30 | $3,834,059 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-06-30 | $3,725,287 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-06-30 | $4,383,878 |
| Value of total assets at end of year | 2022-06-30 | $8,261,804 |
| Value of total assets at beginning of year | 2022-06-30 | $8,143,494 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-06-30 | $108,772 |
| Total interest from all sources | 2022-06-30 | $59,945 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-06-30 | $99,196 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2022-06-30 | $99,196 |
| Administrative expenses professional fees incurred | 2022-06-30 | $32,197 |
| Was this plan covered by a fidelity bond | 2022-06-30 | Yes |
| Value of fidelity bond cover | 2022-06-30 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2022-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2022-06-30 | No |
| Contributions received from participants | 2022-06-30 | $49,874 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2022-06-30 | $286,773 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-06-30 | $2,956 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2022-06-30 | $376 |
| Other income not declared elsewhere | 2022-06-30 | $6,244 |
| Administrative expenses (other) incurred | 2022-06-30 | $11,348 |
| Total non interest bearing cash at end of year | 2022-06-30 | $290,903 |
| Total non interest bearing cash at beginning of year | 2022-06-30 | $289,741 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-06-30 | No |
| Value of net income/loss | 2022-06-30 | $117,934 |
| Value of net assets at end of year (total assets less liabilities) | 2022-06-30 | $8,261,428 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-06-30 | $8,143,494 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-06-30 | No |
| Investment advisory and management fees | 2022-06-30 | $34,506 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-06-30 | $4,438,151 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-06-30 | $4,919,699 |
| Interest earned on other investments | 2022-06-30 | $39,289 |
| Income. Interest from corporate debt instruments | 2022-06-30 | $11,720 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-06-30 | $3,529,496 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-06-30 | $2,927,669 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-06-30 | $2,927,669 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-06-30 | $8,936 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-06-30 | $945,874 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-06-30 | $88,204 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2022-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-06-30 | No |
| Contributions received in cash from employer | 2022-06-30 | $4,334,004 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-06-30 | $2,492,640 |
| Contract administrator fees | 2022-06-30 | $30,721 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2022-06-30 | $3,254 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2022-06-30 | $3,429 |
| Did the plan have assets held for investment | 2022-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2022-06-30 | Unqualified |
| Accountancy firm name | 2022-06-30 | BRYAN, LITTLE, HALEY & KENT PC |
| Accountancy firm EIN | 2022-06-30 | 730941849 |
| 2021 : LYLE HUGHART WELFARE FUND 2021 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2021-06-30 | $176,230 |
| Total unrealized appreciation/depreciation of assets | 2021-06-30 | $176,230 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-06-30 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-06-30 | $19 |
| Total income from all sources (including contributions) | 2021-06-30 | $4,625,521 |
| Total loss/gain on sale of assets | 2021-06-30 | $0 |
| Total of all expenses incurred | 2021-06-30 | $4,249,204 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-06-30 | $4,145,533 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-06-30 | $4,198,780 |
| Value of total assets at end of year | 2021-06-30 | $8,143,494 |
| Value of total assets at beginning of year | 2021-06-30 | $7,767,196 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-06-30 | $103,671 |
| Total interest from all sources | 2021-06-30 | $64,877 |
| Total dividends received (eg from common stock, registered investment company shares) | 2021-06-30 | $166,321 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2021-06-30 | $166,321 |
| Administrative expenses professional fees incurred | 2021-06-30 | $28,033 |
| Was this plan covered by a fidelity bond | 2021-06-30 | Yes |
| Value of fidelity bond cover | 2021-06-30 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2021-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2021-06-30 | No |
| Contributions received from participants | 2021-06-30 | $63,187 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2021-06-30 | $364,832 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-06-30 | $2,956 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2021-06-30 | $19 |
| Other income not declared elsewhere | 2021-06-30 | $21,354 |
| Administrative expenses (other) incurred | 2021-06-30 | $10,849 |
| Total non interest bearing cash at end of year | 2021-06-30 | $289,741 |
| Total non interest bearing cash at beginning of year | 2021-06-30 | $270,928 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-06-30 | No |
| Value of net income/loss | 2021-06-30 | $376,317 |
| Value of net assets at end of year (total assets less liabilities) | 2021-06-30 | $8,143,494 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-06-30 | $7,767,177 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-06-30 | No |
| Investment advisory and management fees | 2021-06-30 | $33,253 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-06-30 | $4,919,699 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-06-30 | $4,570,072 |
| Interest earned on other investments | 2021-06-30 | $24,538 |
| Income. Interest from corporate debt instruments | 2021-06-30 | $15,758 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-06-30 | $2,927,669 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-06-30 | $2,922,592 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-06-30 | $2,922,592 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-06-30 | $24,581 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-06-30 | $1,159,980 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2021-06-30 | $-2,041 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2021-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-06-30 | No |
| Contributions received in cash from employer | 2021-06-30 | $4,135,593 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-06-30 | $2,620,721 |
| Contract administrator fees | 2021-06-30 | $31,536 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2021-06-30 | $3,429 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2021-06-30 | $3,604 |
| Did the plan have assets held for investment | 2021-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2021-06-30 | Unqualified |
| Accountancy firm name | 2021-06-30 | BRYAN, LITTLE, HALEY & KENT PC |
| Accountancy firm EIN | 2021-06-30 | 730941849 |
| 2020 : LYLE HUGHART WELFARE FUND 2020 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2020-06-30 | $6,278 |
| Total unrealized appreciation/depreciation of assets | 2020-06-30 | $6,278 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-06-30 | $19 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-06-30 | $0 |
| Total income from all sources (including contributions) | 2020-06-30 | $6,042,913 |
| Total loss/gain on sale of assets | 2020-06-30 | $0 |
| Total of all expenses incurred | 2020-06-30 | $4,788,165 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-06-30 | $4,685,336 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-06-30 | $5,890,320 |
| Value of total assets at end of year | 2020-06-30 | $7,767,196 |
| Value of total assets at beginning of year | 2020-06-30 | $6,512,429 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-06-30 | $102,829 |
| Total interest from all sources | 2020-06-30 | $34,012 |
| Total dividends received (eg from common stock, registered investment company shares) | 2020-06-30 | $112,172 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2020-06-30 | $112,172 |
| Administrative expenses professional fees incurred | 2020-06-30 | $23,985 |
| Was this plan covered by a fidelity bond | 2020-06-30 | Yes |
| Value of fidelity bond cover | 2020-06-30 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2020-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-06-30 | No |
| Contributions received from participants | 2020-06-30 | $52,684 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2020-06-30 | $369,378 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2020-06-30 | $19 |
| Other income not declared elsewhere | 2020-06-30 | $131 |
| Administrative expenses (other) incurred | 2020-06-30 | $15,234 |
| Total non interest bearing cash at end of year | 2020-06-30 | $270,928 |
| Total non interest bearing cash at beginning of year | 2020-06-30 | $2,052,951 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-06-30 | No |
| Value of net income/loss | 2020-06-30 | $1,254,748 |
| Value of net assets at end of year (total assets less liabilities) | 2020-06-30 | $7,767,177 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-06-30 | $6,512,429 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-06-30 | No |
| Investment advisory and management fees | 2020-06-30 | $32,067 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-06-30 | $4,570,072 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-06-30 | $4,452,940 |
| Interest earned on other investments | 2020-06-30 | $12,038 |
| Income. Interest from corporate debt instruments | 2020-06-30 | $18,465 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-06-30 | $2,922,592 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-06-30 | $2,642 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-06-30 | $2,642 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-06-30 | $3,509 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-06-30 | $1,527,295 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2020-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-06-30 | No |
| Contributions received in cash from employer | 2020-06-30 | $5,837,636 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-06-30 | $2,788,663 |
| Contract administrator fees | 2020-06-30 | $31,543 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2020-06-30 | $3,604 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2020-06-30 | $3,896 |
| Did the plan have assets held for investment | 2020-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2020-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2020-06-30 | Unqualified |
| Accountancy firm name | 2020-06-30 | BRYAN, LITTLE, HALEY & KENT PC |
| Accountancy firm EIN | 2020-06-30 | 730941849 |
| 2019 : LYLE HUGHART WELFARE FUND 2019 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-06-30 | $77,738 |
| Total unrealized appreciation/depreciation of assets | 2019-06-30 | $77,738 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-06-30 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-06-30 | $0 |
| Total income from all sources (including contributions) | 2019-06-30 | $5,996,182 |
| Total loss/gain on sale of assets | 2019-06-30 | $0 |
| Total of all expenses incurred | 2019-06-30 | $4,442,857 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-06-30 | $4,338,314 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-06-30 | $5,801,728 |
| Value of total assets at end of year | 2019-06-30 | $6,512,429 |
| Value of total assets at beginning of year | 2019-06-30 | $4,959,104 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-06-30 | $104,543 |
| Total interest from all sources | 2019-06-30 | $21,534 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-06-30 | $84,174 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2019-06-30 | $84,174 |
| Administrative expenses professional fees incurred | 2019-06-30 | $27,961 |
| Was this plan covered by a fidelity bond | 2019-06-30 | Yes |
| Value of fidelity bond cover | 2019-06-30 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2019-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-06-30 | No |
| Contributions received from participants | 2019-06-30 | $47,434 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2019-06-30 | $114,345 |
| Other income not declared elsewhere | 2019-06-30 | $11,008 |
| Administrative expenses (other) incurred | 2019-06-30 | $14,417 |
| Total non interest bearing cash at end of year | 2019-06-30 | $2,052,951 |
| Total non interest bearing cash at beginning of year | 2019-06-30 | $1,201,957 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-06-30 | No |
| Value of net income/loss | 2019-06-30 | $1,553,325 |
| Value of net assets at end of year (total assets less liabilities) | 2019-06-30 | $6,512,429 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-06-30 | $4,959,104 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-06-30 | No |
| Investment advisory and management fees | 2019-06-30 | $30,629 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-06-30 | $4,452,940 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-06-30 | $3,750,154 |
| Interest earned on other investments | 2019-06-30 | $11,149 |
| Income. Interest from corporate debt instruments | 2019-06-30 | $7,669 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-06-30 | $2,642 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-06-30 | $2,611 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-06-30 | $2,611 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-06-30 | $2,716 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-06-30 | $1,314,501 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2019-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-06-30 | No |
| Contributions received in cash from employer | 2019-06-30 | $5,754,294 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-06-30 | $2,909,468 |
| Contract administrator fees | 2019-06-30 | $31,536 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2019-06-30 | $3,896 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2019-06-30 | $4,382 |
| Did the plan have assets held for investment | 2019-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-06-30 | Unqualified |
| Accountancy firm name | 2019-06-30 | BRYAN, LITTLE, HALEY, & KENT PC |
| Accountancy firm EIN | 2019-06-30 | 730941849 |
| 2018 : LYLE HUGHART WELFARE FUND 2018 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2018-06-30 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-06-30 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-06-30 | $0 |
| Total income from all sources (including contributions) | 2018-06-30 | $5,621,796 |
| Total loss/gain on sale of assets | 2018-06-30 | $0 |
| Total of all expenses incurred | 2018-06-30 | $4,364,182 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-06-30 | $4,294,341 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-06-30 | $5,621,623 |
| Value of total assets at end of year | 2018-06-30 | $4,959,104 |
| Value of total assets at beginning of year | 2018-06-30 | $3,701,490 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-06-30 | $69,841 |
| Total interest from all sources | 2018-06-30 | $19 |
| Total dividends received (eg from common stock, registered investment company shares) | 2018-06-30 | $154 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2018-06-30 | $154 |
| Administrative expenses professional fees incurred | 2018-06-30 | $14,183 |
| Was this plan covered by a fidelity bond | 2018-06-30 | Yes |
| Value of fidelity bond cover | 2018-06-30 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2018-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-06-30 | No |
| Contributions received from participants | 2018-06-30 | $58,724 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2018-06-30 | $1 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2018-06-30 | $37,710 |
| Administrative expenses (other) incurred | 2018-06-30 | $20,764 |
| Total non interest bearing cash at end of year | 2018-06-30 | $1,201,957 |
| Total non interest bearing cash at beginning of year | 2018-06-30 | $3,698,882 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-06-30 | No |
| Value of net income/loss | 2018-06-30 | $1,257,614 |
| Value of net assets at end of year (total assets less liabilities) | 2018-06-30 | $4,959,104 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-06-30 | $3,701,490 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-06-30 | No |
| Investment advisory and management fees | 2018-06-30 | $4,200 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2018-06-30 | $3,750,154 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-06-30 | $2,611 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-06-30 | $2,592 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-06-30 | $2,592 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-06-30 | $19 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-06-30 | $1,128,392 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2018-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-06-30 | No |
| Contributions received in cash from employer | 2018-06-30 | $5,562,898 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-06-30 | $3,128,239 |
| Contract administrator fees | 2018-06-30 | $30,694 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2018-06-30 | $4,382 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2018-06-30 | $16 |
| Did the plan have assets held for investment | 2018-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-06-30 | Unqualified |
| Accountancy firm name | 2018-06-30 | BRYAN, LITTLE, HALEY, & KENT PC |
| Accountancy firm EIN | 2018-06-30 | 730941849 |
| 2017 : LYLE HUGHART WELFARE FUND 2017 401k financial data |
|---|
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-06-30 | $1,709 |
| Total income from all sources (including contributions) | 2017-06-30 | $5,645,763 |
| Total of all expenses incurred | 2017-06-30 | $4,637,892 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-06-30 | $4,399,573 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-06-30 | $5,645,751 |
| Value of total assets at end of year | 2017-06-30 | $3,701,490 |
| Value of total assets at beginning of year | 2017-06-30 | $2,695,328 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-06-30 | $57,836 |
| Total interest from all sources | 2017-06-30 | $12 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-06-30 | No |
| Administrative expenses professional fees incurred | 2017-06-30 | $14,696 |
| Was this plan covered by a fidelity bond | 2017-06-30 | Yes |
| Value of fidelity bond cover | 2017-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2017-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-06-30 | No |
| Contributions received from participants | 2017-06-30 | $43,498 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2017-06-30 | $6 |
| Administrative expenses (other) incurred | 2017-06-30 | $13,370 |
| Liabilities. Value of operating payables at beginning of year | 2017-06-30 | $1,709 |
| Total non interest bearing cash at end of year | 2017-06-30 | $3,698,882 |
| Total non interest bearing cash at beginning of year | 2017-06-30 | $2,692,702 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-06-30 | No |
| Value of net income/loss | 2017-06-30 | $1,007,871 |
| Value of net assets at end of year (total assets less liabilities) | 2017-06-30 | $3,701,490 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-06-30 | $2,693,619 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-06-30 | No |
| Value of interest in common/collective trusts at end of year | 2017-06-30 | $0 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-06-30 | $2,592 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-06-30 | $2,580 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-06-30 | $2,580 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-06-30 | $12 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-06-30 | $981,118 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2017-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-06-30 | No |
| Contributions received in cash from employer | 2017-06-30 | $5,602,247 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-06-30 | $3,418,455 |
| Contract administrator fees | 2017-06-30 | $29,770 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2017-06-30 | No |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2017-06-30 | $16 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2017-06-30 | $46 |
| Did the plan have assets held for investment | 2017-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-06-30 | Qualified |
| Accountancy firm name | 2017-06-30 | CASEY J. RUSSELL, CPA, INC. |
| Accountancy firm EIN | 2017-06-30 | 731349920 |
| 2016 : LYLE HUGHART WELFARE FUND 2016 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-06-30 | $1,709 |
| Total income from all sources (including contributions) | 2016-06-30 | $6,502,665 |
| Total of all expenses incurred | 2016-06-30 | $4,524,970 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-06-30 | $4,427,838 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-06-30 | $6,502,652 |
| Value of total assets at end of year | 2016-06-30 | $2,695,328 |
| Value of total assets at beginning of year | 2016-06-30 | $715,924 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-06-30 | $97,132 |
| Total interest from all sources | 2016-06-30 | $13 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-06-30 | No |
| Administrative expenses professional fees incurred | 2016-06-30 | $10,450 |
| Was this plan covered by a fidelity bond | 2016-06-30 | Yes |
| Value of fidelity bond cover | 2016-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2016-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-06-30 | No |
| Contributions received from participants | 2016-06-30 | $32,223 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2016-06-30 | $19,224 |
| Administrative expenses (other) incurred | 2016-06-30 | $57,707 |
| Liabilities. Value of operating payables at end of year | 2016-06-30 | $1,709 |
| Total non interest bearing cash at end of year | 2016-06-30 | $2,692,702 |
| Total non interest bearing cash at beginning of year | 2016-06-30 | $715,835 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-06-30 | No |
| Value of net income/loss | 2016-06-30 | $1,977,695 |
| Value of net assets at end of year (total assets less liabilities) | 2016-06-30 | $2,693,619 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-06-30 | $715,924 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-06-30 | No |
| Value of interest in common/collective trusts at end of year | 2016-06-30 | $0 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-06-30 | $2,580 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-06-30 | $11 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-06-30 | $11 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-06-30 | $13 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-06-30 | $1,116,157 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2016-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-06-30 | No |
| Contributions received in cash from employer | 2016-06-30 | $6,451,205 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-06-30 | $3,311,681 |
| Contract administrator fees | 2016-06-30 | $28,975 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2016-06-30 | $46 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2016-06-30 | $78 |
| Did the plan have assets held for investment | 2016-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-06-30 | Qualified |
| Accountancy firm name | 2016-06-30 | CASEY J. RUSSELL, CPA, INC. |
| Accountancy firm EIN | 2016-06-30 | 731349920 |
| 2015 : LYLE HUGHART WELFARE FUND 2015 401k financial data |
|---|
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-06-30 | $-9 |
| Total income from all sources (including contributions) | 2015-06-30 | $6,052,687 |
| Total of all expenses incurred | 2015-06-30 | $6,830,899 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-06-30 | $6,489,836 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-06-30 | $6,052,637 |
| Value of total assets at end of year | 2015-06-30 | $715,924 |
| Value of total assets at beginning of year | 2015-06-30 | $1,494,127 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-06-30 | $140,129 |
| Total interest from all sources | 2015-06-30 | $50 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-06-30 | No |
| Administrative expenses professional fees incurred | 2015-06-30 | $13,037 |
| Was this plan covered by a fidelity bond | 2015-06-30 | Yes |
| Value of fidelity bond cover | 2015-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2015-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-06-30 | No |
| Contributions received from participants | 2015-06-30 | $97,576 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2015-06-30 | $6,397 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-06-30 | $20,720 |
| Administrative expenses (other) incurred | 2015-06-30 | $99,112 |
| Liabilities. Value of operating payables at beginning of year | 2015-06-30 | $-9 |
| Total non interest bearing cash at end of year | 2015-06-30 | $715,835 |
| Total non interest bearing cash at beginning of year | 2015-06-30 | $451,262 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-06-30 | No |
| Value of net income/loss | 2015-06-30 | $-778,212 |
| Value of net assets at end of year (total assets less liabilities) | 2015-06-30 | $715,924 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-06-30 | $1,494,136 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-06-30 | No |
| Value of interest in common/collective trusts at end of year | 2015-06-30 | $0 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-06-30 | $11 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-06-30 | $1,022,016 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-06-30 | $1,022,016 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-06-30 | $50 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-06-30 | $847,212 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2015-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-06-30 | No |
| Contributions received in cash from employer | 2015-06-30 | $5,948,664 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-06-30 | $5,642,624 |
| Contract administrator fees | 2015-06-30 | $27,980 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2015-06-30 | $78 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2015-06-30 | $129 |
| Did the plan have assets held for investment | 2015-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-06-30 | Qualified |
| Accountancy firm name | 2015-06-30 | CASEY J. RUSSELL, CPA, INC. |
| Accountancy firm EIN | 2015-06-30 | 731349920 |
| 2014 : LYLE HUGHART WELFARE FUND 2014 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2014-06-30 | $-70,248 |
| Total unrealized appreciation/depreciation of assets | 2014-06-30 | $-70,248 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-06-30 | $-9 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-06-30 | $138,853 |
| Total income from all sources (including contributions) | 2014-06-30 | $5,402,047 |
| Total loss/gain on sale of assets | 2014-06-30 | $147,340 |
| Total of all expenses incurred | 2014-06-30 | $6,789,351 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-06-30 | $6,743,099 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-06-30 | $5,296,477 |
| Value of total assets at end of year | 2014-06-30 | $1,494,127 |
| Value of total assets at beginning of year | 2014-06-30 | $3,020,293 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-06-30 | $46,252 |
| Total interest from all sources | 2014-06-30 | $28,478 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-06-30 | No |
| Administrative expenses professional fees incurred | 2014-06-30 | $8,207 |
| Was this plan covered by a fidelity bond | 2014-06-30 | Yes |
| Value of fidelity bond cover | 2014-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2014-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-06-30 | No |
| Income. Received or receivable in cash from other sources (including rollovers) | 2014-06-30 | $11,036 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-06-30 | $20,720 |
| Administrative expenses (other) incurred | 2014-06-30 | $3,740 |
| Liabilities. Value of operating payables at end of year | 2014-06-30 | $-9 |
| Liabilities. Value of operating payables at beginning of year | 2014-06-30 | $138,853 |
| Total non interest bearing cash at end of year | 2014-06-30 | $451,262 |
| Total non interest bearing cash at beginning of year | 2014-06-30 | $764,817 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-06-30 | No |
| Value of net income/loss | 2014-06-30 | $-1,387,304 |
| Value of net assets at end of year (total assets less liabilities) | 2014-06-30 | $1,494,136 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-06-30 | $2,881,440 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-06-30 | No |
| Investment advisory and management fees | 2014-06-30 | $7,365 |
| Value of interest in common/collective trusts at end of year | 2014-06-30 | $0 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-06-30 | $1,022,016 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-06-30 | $1,522,579 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-06-30 | $1,522,579 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-06-30 | $28,478 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-06-30 | $904,908 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2014-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-06-30 | No |
| Contributions received in cash from employer | 2014-06-30 | $5,285,441 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-06-30 | $5,838,191 |
| Contract administrator fees | 2014-06-30 | $26,940 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2014-06-30 | $732,682 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2014-06-30 | $129 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2014-06-30 | $215 |
| Did the plan have assets held for investment | 2014-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-06-30 | No |
| Aggregate proceeds on sale of assets | 2014-06-30 | $2,321,367 |
| Aggregate carrying amount (costs) on sale of assets | 2014-06-30 | $2,174,027 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-06-30 | Qualified |
| Accountancy firm name | 2014-06-30 | CASEY J. RUSSELL, CPA, INC. |
| Accountancy firm EIN | 2014-06-30 | 731349920 |
| 2013 : LYLE HUGHART WELFARE FUND 2013 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2013-06-30 | $50,922 |
| Total unrealized appreciation/depreciation of assets | 2013-06-30 | $50,922 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-06-30 | $138,853 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-06-30 | $138,625 |
| Total income from all sources (including contributions) | 2013-06-30 | $5,854,100 |
| Total loss/gain on sale of assets | 2013-06-30 | $57,226 |
| Total of all expenses incurred | 2013-06-30 | $6,520,988 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-06-30 | $6,432,980 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-06-30 | $5,695,455 |
| Value of total assets at end of year | 2013-06-30 | $3,020,293 |
| Value of total assets at beginning of year | 2013-06-30 | $3,686,953 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-06-30 | $88,008 |
| Total interest from all sources | 2013-06-30 | $50,420 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-06-30 | No |
| Administrative expenses professional fees incurred | 2013-06-30 | $26,123 |
| Was this plan covered by a fidelity bond | 2013-06-30 | Yes |
| Value of fidelity bond cover | 2013-06-30 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2013-06-30 | No |
| Contributions received from participants | 2013-06-30 | $441,182 |
| Other income not declared elsewhere | 2013-06-30 | $77 |
| Administrative expenses (other) incurred | 2013-06-30 | $25,222 |
| Liabilities. Value of operating payables at end of year | 2013-06-30 | $138,853 |
| Liabilities. Value of operating payables at beginning of year | 2013-06-30 | $138,625 |
| Total non interest bearing cash at end of year | 2013-06-30 | $764,817 |
| Total non interest bearing cash at beginning of year | 2013-06-30 | $349,332 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-06-30 | No |
| Value of net income/loss | 2013-06-30 | $-666,888 |
| Value of net assets at end of year (total assets less liabilities) | 2013-06-30 | $2,881,440 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-06-30 | $3,548,328 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-06-30 | No |
| Investment advisory and management fees | 2013-06-30 | $10,535 |
| Value of interest in common/collective trusts at end of year | 2013-06-30 | $0 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-06-30 | $1,522,579 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-06-30 | $1,847,512 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-06-30 | $1,847,512 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-06-30 | $50,420 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-06-30 | $1,012,201 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2013-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-06-30 | No |
| Contributions received in cash from employer | 2013-06-30 | $5,254,273 |
| Employer contributions (assets) at beginning of year | 2013-06-30 | $14,759 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-06-30 | $5,420,779 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2013-06-30 | $277,361 |
| Contract administrator fees | 2013-06-30 | $26,128 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2013-06-30 | $732,682 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2013-06-30 | $1,197,989 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2013-06-30 | $215 |
| Did the plan have assets held for investment | 2013-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-06-30 | No |
| Aggregate proceeds on sale of assets | 2013-06-30 | $1,447,771 |
| Aggregate carrying amount (costs) on sale of assets | 2013-06-30 | $1,390,545 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-06-30 | Qualified |
| Accountancy firm name | 2013-06-30 | CASEY J. RUSSELL, CPA, INC. |
| Accountancy firm EIN | 2013-06-30 | 731349920 |
| 2012 : LYLE HUGHART WELFARE FUND 2012 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2012-06-30 | $-19,867 |
| Total unrealized appreciation/depreciation of assets | 2012-06-30 | $-19,867 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-06-30 | $138,625 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-06-30 | $138,606 |
| Total income from all sources (including contributions) | 2012-06-30 | $6,076,398 |
| Total loss/gain on sale of assets | 2012-06-30 | $-7,666 |
| Total of all expenses incurred | 2012-06-30 | $6,113,996 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-06-30 | $6,020,895 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-06-30 | $6,052,896 |
| Value of total assets at end of year | 2012-06-30 | $3,686,953 |
| Value of total assets at beginning of year | 2012-06-30 | $3,724,532 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-06-30 | $93,101 |
| Total interest from all sources | 2012-06-30 | $48,015 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-06-30 | No |
| Administrative expenses professional fees incurred | 2012-06-30 | $20,306 |
| Was this plan covered by a fidelity bond | 2012-06-30 | Yes |
| Value of fidelity bond cover | 2012-06-30 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2012-06-30 | No |
| Contributions received from participants | 2012-06-30 | $395,634 |
| Other income not declared elsewhere | 2012-06-30 | $3,020 |
| Administrative expenses (other) incurred | 2012-06-30 | $32,937 |
| Liabilities. Value of operating payables at end of year | 2012-06-30 | $138,625 |
| Liabilities. Value of operating payables at beginning of year | 2012-06-30 | $138,606 |
| Total non interest bearing cash at end of year | 2012-06-30 | $349,332 |
| Total non interest bearing cash at beginning of year | 2012-06-30 | $31,628 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-06-30 | No |
| Value of net income/loss | 2012-06-30 | $-37,598 |
| Value of net assets at end of year (total assets less liabilities) | 2012-06-30 | $3,548,328 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-06-30 | $3,585,926 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-06-30 | No |
| Investment advisory and management fees | 2012-06-30 | $13,218 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-06-30 | $1,847,512 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-06-30 | $3,574,306 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-06-30 | $3,574,306 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-06-30 | $48,015 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-06-30 | $1,023,078 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2012-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-06-30 | No |
| Contributions received in cash from employer | 2012-06-30 | $5,657,262 |
| Employer contributions (assets) at end of year | 2012-06-30 | $14,759 |
| Employer contributions (assets) at beginning of year | 2012-06-30 | $15,024 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-06-30 | $4,997,817 |
| Asset. Corporate debt instrument debt (other) at end of year | 2012-06-30 | $277,361 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2012-06-30 | $103,574 |
| Contract administrator fees | 2012-06-30 | $26,640 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2012-06-30 | $1,197,989 |
| Did the plan have assets held for investment | 2012-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-06-30 | No |
| Aggregate proceeds on sale of assets | 2012-06-30 | $513,971 |
| Aggregate carrying amount (costs) on sale of assets | 2012-06-30 | $521,637 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-06-30 | Qualified |
| Accountancy firm name | 2012-06-30 | CASEY J. RUSSELL, CPA, INC. |
| Accountancy firm EIN | 2012-06-30 | 731349920 |
| 2011 : LYLE HUGHART WELFARE FUND 2011 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2011-06-30 | $78,725 |
| Total unrealized appreciation/depreciation of assets | 2011-06-30 | $78,725 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-06-30 | $138,606 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-06-30 | $135,572 |
| Total income from all sources (including contributions) | 2011-06-30 | $5,715,622 |
| Total loss/gain on sale of assets | 2011-06-30 | $98,709 |
| Total of all expenses incurred | 2011-06-30 | $6,377,899 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-06-30 | $6,318,254 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-06-30 | $5,486,824 |
| Value of total assets at end of year | 2011-06-30 | $3,724,532 |
| Value of total assets at beginning of year | 2011-06-30 | $4,383,775 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-06-30 | $59,645 |
| Total interest from all sources | 2011-06-30 | $48,163 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-06-30 | No |
| Administrative expenses professional fees incurred | 2011-06-30 | $3,500 |
| Was this plan covered by a fidelity bond | 2011-06-30 | Yes |
| Value of fidelity bond cover | 2011-06-30 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2011-06-30 | No |
| Contributions received from participants | 2011-06-30 | $368,536 |
| Other income not declared elsewhere | 2011-06-30 | $3,201 |
| Administrative expenses (other) incurred | 2011-06-30 | $19,945 |
| Liabilities. Value of operating payables at end of year | 2011-06-30 | $138,606 |
| Liabilities. Value of operating payables at beginning of year | 2011-06-30 | $135,572 |
| Total non interest bearing cash at end of year | 2011-06-30 | $31,628 |
| Total non interest bearing cash at beginning of year | 2011-06-30 | $639,466 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-06-30 | No |
| Value of net income/loss | 2011-06-30 | $-662,277 |
| Value of net assets at end of year (total assets less liabilities) | 2011-06-30 | $3,585,926 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-06-30 | $4,248,203 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-06-30 | No |
| Investment advisory and management fees | 2011-06-30 | $10,160 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-06-30 | $3,574,306 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-06-30 | $3,047,773 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-06-30 | $3,047,773 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-06-30 | $48,163 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-06-30 | $939,882 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2011-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-06-30 | No |
| Contributions received in cash from employer | 2011-06-30 | $5,118,288 |
| Employer contributions (assets) at end of year | 2011-06-30 | $15,024 |
| Employer contributions (assets) at beginning of year | 2011-06-30 | $157 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-06-30 | $5,378,372 |
| Asset. Corporate debt instrument debt (other) at end of year | 2011-06-30 | $103,574 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2011-06-30 | $207,046 |
| Contract administrator fees | 2011-06-30 | $26,040 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2011-06-30 | $489,270 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2011-06-30 | $63 |
| Did the plan have assets held for investment | 2011-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-06-30 | No |
| Aggregate proceeds on sale of assets | 2011-06-30 | $904,711 |
| Aggregate carrying amount (costs) on sale of assets | 2011-06-30 | $806,002 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-06-30 | Qualified |
| Accountancy firm name | 2011-06-30 | CASEY J. RUSSELL, CPA, INC. |
| Accountancy firm EIN | 2011-06-30 | 731349920 |
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 417002415612 |
| Policy instance | 5 |
| Insurance contract or identification number | 417002415612 | | Number of Individuals Covered | 596 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $430,832 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 237827 |
| Policy instance | 4 |
| Insurance contract or identification number | 237827 | | Number of Individuals Covered | 289 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $7,245 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $82,335 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,896 | | Insurance broker organization code? | 3 |
|
| RXBENEFITS (National Association of Insurance Commissioners NAIC id number: 52429 ) |
| Policy contract number | |
| Policy instance | 3 |
| Number of Individuals Covered | 302 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 number | TS05348814 |
| Policy instance | 2 |
| Insurance contract or identification number | TS05348814 | | Number of Individuals Covered | 725 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $2,101 | | Total amount of fees paid to insurance company | USD $2,801 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $86,641 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,101 | | Amount paid for insurance broker fees | 2801 | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 228930 |
| Policy instance | 1 |
| Insurance contract or identification number | 228930 | | Number of Individuals Covered | 299 | | 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 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30085078 |
| Policy instance | 6 |
| Insurance contract or identification number | 30085078 | | Number of Individuals Covered | 304 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $1,072 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $46,200 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,072 | | Insurance broker organization code? | 5 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TS05348814 |
| Policy instance | 2 |
| Insurance contract or identification number | TS05348814 | | Number of Individuals Covered | 717 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $5,081 | | Total amount of fees paid to insurance company | USD $3,792 | | 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 | 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 $210,075 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,081 | | Amount paid for insurance broker fees | 3792 | | Additional information about fees paid to insurance broker | OTHER INSURANCE RELATED FEES | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 228930 |
| Policy instance | 1 |
| Insurance contract or identification number | 228930 | | Number of Individuals Covered | 280 | | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RXBENEFITS (National Association of Insurance Commissioners NAIC id number: 52429 ) |
| Policy contract number | |
| Policy instance | 3 |
| Number of Individuals Covered | 280 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | 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 | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 237827 |
| Policy instance | 4 |
| Insurance contract or identification number | 237827 | | Number of Individuals Covered | 286 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $1,849 | | 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 $77,413 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,849 | | Insurance broker organization code? | 3 |
|
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 910742147 |
| Policy instance | 5 |
| Insurance contract or identification number | 910742147 | | Number of Individuals Covered | 277 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $16,082 | | 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 | 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 $601,679 | | Amount paid for insurance broker fees | 16082 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30085078 |
| Policy instance | 6 |
| Insurance contract or identification number | 30085078 | | Number of Individuals Covered | 273 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $1,139 | | 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 | Yes | | 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 $37,873 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,139 | | Insurance broker organization code? | 3 |
|
| BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 ) |
| Policy contract number | ERL L18101250 |
| Policy instance | 1 |
| Insurance contract or identification number | ERL L18101250 | | Number of Individuals Covered | 254 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $14,876 | | 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 | 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 $495,880 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,876 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TS05348814 |
| Policy instance | 2 |
| Insurance contract or identification number | TS05348814 | | Number of Individuals Covered | 693 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $5,520 | | 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 | 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 $216,552 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,520 | | Insurance broker organization code? | 3 |
|
| RXBENEFITS (National Association of Insurance Commissioners NAIC id number: 52429 ) |
| Policy contract number | |
| Policy instance | 3 |
| Number of Individuals Covered | 275 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | 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 | 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 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 237827 |
| Policy instance | 4 |
| Insurance contract or identification number | 237827 | | Number of Individuals Covered | 337 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $6,714 | | 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 $93,508 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,714 | | Insurance broker organization code? | 3 |
|
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 910742147 |
| Policy instance | 5 |
| Insurance contract or identification number | 910742147 | | Number of Individuals Covered | 280 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $2,931 | | 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 $318,418 | | Commission paid to Insurance Broker | USD $2,931 | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30085078 |
| Policy instance | 6 |
| Insurance contract or identification number | 30085078 | | Number of Individuals Covered | 263 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $1,155 | | 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 | Yes | | 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 $38,595 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,155 | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 30085078 |
| Policy instance | 5 |
| Insurance contract or identification number | 30085078 | | Number of Individuals Covered | 319 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $996 | | 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 | Yes | | 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 $44,157 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $996 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 237827 |
| Policy instance | 4 |
| Insurance contract or identification number | 237827 | | Number of Individuals Covered | 317 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $2,589 | | 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 $68,309 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,589 | | Insurance broker organization code? | 3 |
|
| RXBENEFITS (National Association of Insurance Commissioners NAIC id number: 52429 ) |
| Policy contract number | |
| Policy instance | 3 |
| Number of Individuals Covered | 344 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | 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 | 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 | | 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 number | TS05348814 |
| Policy instance | 2 |
| Insurance contract or identification number | TS05348814 | | Number of Individuals Covered | 1493 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $6,462 | | 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 | 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 $278,071 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,462 | | Insurance broker organization code? | 3 |
|
| BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 ) |
| Policy contract number | ERL L18101250 |
| Policy instance | 1 |
| Insurance contract or identification number | ERL L18101250 | | Number of Individuals Covered | 325 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $26,847 | | 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 | 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 $982,232 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $26,847 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 237827 |
| Policy instance | 3 |
| Insurance contract or identification number | 237827 | | Number of Individuals Covered | 323 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $1,768 | | 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 $24,627 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,768 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TS05348814 |
| Policy instance | 2 |
| Insurance contract or identification number | TS05348814 | | Number of Individuals Covered | 1571 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $5,905 | | Total amount of fees paid to insurance company | USD $1,094 | | 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 | 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 $245,110 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,905 | | Amount paid for insurance broker fees | 1094 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 ) |
| Policy contract number | ERL L18101250 |
| Policy instance | 1 |
| Insurance contract or identification number | ERL L18101250 | | Number of Individuals Covered | 316 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $26,199 | | 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 | 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 $873,303 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $26,199 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 237827 |
| Policy instance | 3 |
| Insurance contract or identification number | 237827 | | Number of Individuals Covered | 343 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $1,790 | | Total amount of fees paid to insurance company | USD $514 | | 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 $22,334 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 ) |
| Policy contract number | ERL L18101250 |
| Policy instance | 1 |
| Insurance contract or identification number | ERL L18101250 | | Number of Individuals Covered | 323 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $21,067 | | 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 | 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 $702,228 | | 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 number | TS05348814 |
| Policy instance | 2 |
| Insurance contract or identification number | TS05348814 | | Number of Individuals Covered | 1536 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $5,978 | | Total amount of fees paid to insurance company | USD $2,756 | | 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 | 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 $247,899 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 237860 |
| Policy instance | 1 |
| Insurance contract or identification number | 237860 | | Number of Individuals Covered | 347 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of fees paid to insurance company | USD $9,767 | | Welfare Benefit Premiums Paid to Carrier | USD $765,441 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 9767 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 | | Insurance broker name | GROUP & PENSION ADMINISTRATORS, INC |
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| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TS05348814 |
| Policy instance | 3 |
| Insurance contract or identification number | TS05348814 | | Number of Individuals Covered | 1598 | | Insurance policy start date | 2016-01-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $3,727 | | Total amount of fees paid to insurance company | USD $1,131 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $75,912 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,780 | | Amount paid for insurance broker fees | 1131 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | ASSUREX AGENCY INC |
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| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | AM1242 |
| Policy instance | 4 |
| Insurance contract or identification number | AM1242 | | Number of Individuals Covered | 944 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $10,453 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $38,426 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $6,744 | | Insurance broker organization code? | 3 | | Insurance broker name | FRINGE INSURANCE BENEFITS |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 237827 |
| Policy instance | 2 |
| Insurance contract or identification number | 237827 | | Number of Individuals Covered | 361 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $2,242 | | Total amount of fees paid to insurance company | USD $389 | | Welfare Benefit Premiums Paid to Carrier | USD $27,876 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,242 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 389 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker name | IMA, INC - LIFE INS - KS |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 237827 |
| Policy instance | 2 |
| Insurance contract or identification number | 237827 | | Number of Individuals Covered | 379 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $1,547 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,303 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,547 | | Insurance broker name | IMA, INC LIFE INS |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | T286 |
| Policy instance | 1 |
| Insurance contract or identification number | T286 | | Number of Individuals Covered | 372 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2014-08-31 | | Total amount of commissions paid to insurance broker | USD $13,114 | | Welfare Benefit Premiums Paid to Carrier | USD $96,171 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,114 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 5 | | Insurance broker name | HEALTHCARE SOLUTIONS GROUP STP LS |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | T286 |
| Policy instance | 3 |
| Insurance contract or identification number | T286 | | Number of Individuals Covered | 364 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2014-08-31 | | Total amount of commissions paid to insurance broker | USD $840 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,359 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $840 | | Insurance broker name | HEALTHCARE SOLUTIONS GROUP LIFE |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 237860 |
| Policy instance | 4 |
| Insurance contract or identification number | 237860 | | Number of Individuals Covered | 298 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-06-30 | | Welfare Benefit Premiums Paid to Carrier | USD $594,802 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | AM1242 |
| Policy instance | 5 |
| Insurance contract or identification number | AM1242 | | Number of Individuals Covered | 284 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $11,514 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $87,731 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,514 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. NATIONWIDE |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | T286 |
| Policy instance | 2 |
| Insurance contract or identification number | T286 | | Number of Individuals Covered | 356 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $5,581 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,326 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,581 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 5 | | Insurance broker name | HEALTHCARE SOLUTIONS GROUP |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | T286 |
| Policy instance | 1 |
| Insurance contract or identification number | T286 | | Number of Individuals Covered | 427 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $86,640 | | Welfare Benefit Premiums Paid to Carrier | USD $635,352 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $86,640 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 5 | | Insurance broker name | HEALTHCARE SOLUTIONS GROUP |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | T286 |
| Policy instance | 1 |
| Insurance contract or identification number | T286 | | Number of Individuals Covered | 411 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $6,456 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $25,826 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,456 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 5 | | Insurance broker name | HEALTHCARE SOLUTIONS GROUP |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | T286 |
| Policy instance | 2 |
| Insurance contract or identification number | T286 | | Number of Individuals Covered | 476 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $94,844 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $695,389 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $94,844 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE | | Insurance broker organization code? | 5 | | Insurance broker name | HEALTHCARE SOLUTIONS GROUP |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | T286 |
| Policy instance | 2 |
| Insurance contract or identification number | T286 | | Number of Individuals Covered | 480 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $109,390 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $676,694 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | T286 |
| Policy instance | 1 |
| Insurance contract or identification number | T286 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $7,193 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $28,776 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | T286 |
| Policy instance | 2 |
| Insurance contract or identification number | T286 | | Number of Individuals Covered | 557 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $85,713 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $485,330 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | T286 |
| Policy instance | 1 |
| Insurance contract or identification number | T286 | | Number of Individuals Covered | 476 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $6,321 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $25,286 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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