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AFP GROUP MEDICAL PLAN 401k Plan overview

Plan NameAFP GROUP MEDICAL PLAN
Plan identification number 501

AFP GROUP MEDICAL PLAN Benefits

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

401k Sponsoring company profile

AUSTIN FOAM PLASTICS, INC. has sponsored the creation of one or more 401k plans.

Company Name:AUSTIN FOAM PLASTICS, INC.
Employer identification number (EIN):741962564
NAIC Classification:326100

Additional information about AUSTIN FOAM PLASTICS, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 1978-02-17
Company Identification Number: 0042697800
Legal Registered Office Address: 2415 CASCADE POINTE BLVD

CHARLOTTE
United States of America (USA)
28208

More information about AUSTIN FOAM PLASTICS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AFP GROUP MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012019-01-01KIM RISTOW2020-05-29
5012018-10-01
5012017-10-01
5012016-10-01
5012015-10-01KIMBERLY RISTOW
5012015-10-01KIMBERLY RISTOW
5012014-10-01DEBBIE HALL
5012013-10-01DEBBIE HALL
5012012-10-01HELEN HAYTER
5012011-10-01HELEN HAYTER
5012010-10-01HELEN HAYTER
5012009-10-01 HELEN HAYTER2011-07-15
5012009-10-01DEBRA HALL HELEN HAYTER2011-07-15
5012008-10-01HELEN HAYTER

Plan Statistics for AFP GROUP MEDICAL PLAN

401k plan membership statisitcs for AFP GROUP MEDICAL PLAN

Measure Date Value
2019: AFP GROUP MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01137
Total number of active participants reported on line 7a of the Form 55002019-01-01141
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01141
Number of employers contributing to the scheme2019-01-010
2018: AFP GROUP MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01118
Total number of active participants reported on line 7a of the Form 55002018-10-01137
Number of retired or separated participants receiving benefits2018-10-010
Number of other retired or separated participants entitled to future benefits2018-10-010
Total of all active and inactive participants2018-10-01137
Number of employers contributing to the scheme2018-10-010
2017: AFP GROUP MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01192
Total number of active participants reported on line 7a of the Form 55002017-10-01204
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-010
Total of all active and inactive participants2017-10-01204
Number of employers contributing to the scheme2017-10-010
2016: AFP GROUP MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01155
Total number of active participants reported on line 7a of the Form 55002016-10-01189
Number of retired or separated participants receiving benefits2016-10-013
Number of other retired or separated participants entitled to future benefits2016-10-010
Total of all active and inactive participants2016-10-01192
2015: AFP GROUP MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01178
Total number of active participants reported on line 7a of the Form 55002015-10-01155
Number of retired or separated participants receiving benefits2015-10-016
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-01161
2014: AFP GROUP MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01182
Total number of active participants reported on line 7a of the Form 55002014-10-01178
Number of retired or separated participants receiving benefits2014-10-015
Total of all active and inactive participants2014-10-01183
2013: AFP GROUP MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-01177
Total number of active participants reported on line 7a of the Form 55002013-10-01173
Number of retired or separated participants receiving benefits2013-10-014
Number of other retired or separated participants entitled to future benefits2013-10-010
Total of all active and inactive participants2013-10-01177
2012: AFP GROUP MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-01176
Total number of active participants reported on line 7a of the Form 55002012-10-01164
Number of retired or separated participants receiving benefits2012-10-013
Number of other retired or separated participants entitled to future benefits2012-10-010
Total of all active and inactive participants2012-10-01167
2011: AFP GROUP MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-10-01178
Total number of active participants reported on line 7a of the Form 55002011-10-01174
Number of retired or separated participants receiving benefits2011-10-012
Number of other retired or separated participants entitled to future benefits2011-10-010
Total of all active and inactive participants2011-10-01176
2010: AFP GROUP MEDICAL PLAN 2010 401k membership
Total participants, beginning-of-year2010-10-01207
Total number of active participants reported on line 7a of the Form 55002010-10-01175
Number of retired or separated participants receiving benefits2010-10-013
Number of other retired or separated participants entitled to future benefits2010-10-010
Total of all active and inactive participants2010-10-01178
2009: AFP GROUP MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year2009-10-01224
Total number of active participants reported on line 7a of the Form 55002009-10-01215
Total of all active and inactive participants2009-10-01215
Total participants2009-10-01215
2008: AFP GROUP MEDICAL PLAN 2008 401k membership
Total participants, beginning-of-year2008-10-01271
Total number of active participants reported on line 7a of the Form 55002008-10-01224
Total of all active and inactive participants2008-10-01224
Total participants2008-10-01224

Form 5500 Responses for AFP GROUP MEDICAL PLAN

2019: AFP GROUP MEDICAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: AFP GROUP MEDICAL PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01This return/report is a short plan year return/report (less than 12 months)Yes
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan funding arrangement – General assets of the sponsorYes
2018-10-01Plan benefit arrangement – InsuranceYes
2018-10-01Plan benefit arrangement – General assets of the sponsorYes
2017: AFP GROUP MEDICAL PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan funding arrangement – General assets of the sponsorYes
2017-10-01Plan benefit arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – General assets of the sponsorYes
2016: AFP GROUP MEDICAL PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan funding arrangement – General assets of the sponsorYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – General assets of the sponsorYes
2015: AFP GROUP MEDICAL PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingNo
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan funding arrangement – General assets of the sponsorYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – General assets of the sponsorYes
2014: AFP GROUP MEDICAL PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Submission has been amendedNo
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planNo
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan funding arrangement – General assets of the sponsorYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – General assets of the sponsorYes
2013: AFP GROUP MEDICAL PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Submission has been amendedNo
2013-10-01This submission is the final filingNo
2013-10-01This return/report is a short plan year return/report (less than 12 months)No
2013-10-01Plan is a collectively bargained planNo
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan funding arrangement – General assets of the sponsorYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-10-01Plan benefit arrangement – General assets of the sponsorYes
2012: AFP GROUP MEDICAL PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Submission has been amendedNo
2012-10-01This submission is the final filingNo
2012-10-01This return/report is a short plan year return/report (less than 12 months)No
2012-10-01Plan is a collectively bargained planNo
2012-10-01Plan funding arrangement – General assets of the sponsorYes
2012-10-01Plan benefit arrangement – General assets of the sponsorYes
2011: AFP GROUP MEDICAL PLAN 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Submission has been amendedNo
2011-10-01This submission is the final filingNo
2011-10-01This return/report is a short plan year return/report (less than 12 months)No
2011-10-01Plan is a collectively bargained planNo
2011-10-01Plan funding arrangement – General assets of the sponsorYes
2011-10-01Plan benefit arrangement – General assets of the sponsorYes
2010: AFP GROUP MEDICAL PLAN 2010 form 5500 responses
2010-10-01Type of plan entitySingle employer plan
2010-10-01Submission has been amendedNo
2010-10-01This submission is the final filingNo
2010-10-01This return/report is a short plan year return/report (less than 12 months)No
2010-10-01Plan is a collectively bargained planNo
2010-10-01Plan funding arrangement – InsuranceYes
2010-10-01Plan funding arrangement – General assets of the sponsorYes
2010-10-01Plan benefit arrangement – InsuranceYes
2010-10-01Plan benefit arrangement – General assets of the sponsorYes
2009: AFP GROUP MEDICAL PLAN 2009 form 5500 responses
2009-10-01Type of plan entitySingle employer plan
2009-10-01Submission has been amendedNo
2009-10-01This submission is the final filingNo
2009-10-01This return/report is a short plan year return/report (less than 12 months)No
2009-10-01Plan is a collectively bargained planNo
2009-10-01Plan funding arrangement – InsuranceYes
2009-10-01Plan benefit arrangement – InsuranceYes
2008: AFP GROUP MEDICAL PLAN 2008 form 5500 responses
2008-10-01Type of plan entitySingle employer plan
2008-10-01Submission has been amendedNo
2008-10-01This submission is the final filingNo
2008-10-01This return/report is a short plan year return/report (less than 12 months)No
2008-10-01Plan is a collectively bargained planNo
2008-10-01Plan funding arrangement – InsuranceYes
2008-10-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HUMANA HEALTH PLAN OF TEXAS, INC. (National Association of Insurance Commissioners NAIC id number: 95024 )
Policy contract number747153
Policy instance 2
Insurance contract or identification number747153
Number of Individuals Covered195
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $52,623
Total amount of fees paid to insurance companyUSD $1,953
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,403,884
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,623
Amount paid for insurance broker fees1953
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number747153
Policy instance 1
Insurance contract or identification number747153
Number of Individuals Covered141
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,937
Total amount of fees paid to insurance companyUSD $264
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,937
Amount paid for insurance broker fees264
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HUMANA HEALTH PLAN OF TEXAS, INC. (National Association of Insurance Commissioners NAIC id number: 95024 )
Policy contract number747153
Policy instance 2
Insurance contract or identification number747153
Number of Individuals Covered206
Insurance policy start date2018-10-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $13,636
Total amount of fees paid to insurance companyUSD $13
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $526,711
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,636
Amount paid for insurance broker fees13
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number747153
Policy instance 1
Insurance contract or identification number747153
Number of Individuals Covered147
Insurance policy start date2018-10-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $485
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,615
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $485
Amount paid for insurance broker fees0
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number747153
Policy instance 2
Insurance contract or identification number747153
Number of Individuals Covered137
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $1,814
Total amount of fees paid to insurance companyUSD $132
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,236
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA HEALTH PLAN OF TEXAS, INC. (National Association of Insurance Commissioners NAIC id number: 95024 )
Policy contract number747153
Policy instance 1
Insurance contract or identification number747153
Number of Individuals Covered204
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $50,934
Total amount of fees paid to insurance companyUSD $2,587
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,466,176
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number747153
Policy instance 2
Insurance contract or identification number747153
Number of Individuals Covered93
Insurance policy start date2015-10-01
Insurance policy end date2016-09-30
Total amount of commissions paid to insurance brokerUSD $1,335
Total amount of fees paid to insurance companyUSD $1
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $14,510
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $737
Insurance broker organization code?3
Amount paid for insurance broker fees1
Additional information about fees paid to insurance brokerBONUS
Insurance broker nameUSI INSURANCE SERVICES, LLC
HUMANA HEALTH PLAN OF TEXAS, INC. (National Association of Insurance Commissioners NAIC id number: 95024 )
Policy contract number747153
Policy instance 1
Insurance contract or identification number747153
Number of Individuals Covered164
Insurance policy start date2015-10-01
Insurance policy end date2016-09-30
Total amount of commissions paid to insurance brokerUSD $48,217
Total amount of fees paid to insurance companyUSD $1,117
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,519,981
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,165
Amount paid for insurance broker fees1117
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameUSI INSURANCE SERVICES, LLC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number847675
Policy instance 1
Insurance contract or identification number847675
Number of Individuals Covered311
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $47,242
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,308,158
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees31779
Additional information about fees paid to insurance brokerDIRECT COMPENSATION
Insurance broker organization code?3
Insurance broker nameSUMMIT GLOBAL PARTNERS OF TX, INC.
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number647675
Policy instance 1
Insurance contract or identification number647675
Number of Individuals Covered315
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $46,071
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,254,728
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees46071
Additional information about fees paid to insurance brokerDIRECT COMPENSATION 4Q WEST SUPER BONUS
Insurance broker organization code?3
Insurance broker nameSUMMIT GLOBAL PARTNERS OF TX, INC.
HUMANA HEALTH PLAN OF TEXAS, INC. (National Association of Insurance Commissioners NAIC id number: 95024 )
Policy contract number567788
Policy instance 1
Insurance contract or identification number567788
Number of Individuals Covered175
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $49,911
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,090,545
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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