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DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 401k Plan overview

Plan NameDEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION
Plan identification number 501

DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION Benefits

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

401k Sponsoring company profile

DEALERS ELECTRICAL SUPPLY CO. has sponsored the creation of one or more 401k plans.

Company Name:DEALERS ELECTRICAL SUPPLY CO.
Employer identification number (EIN):741972120
NAIC Classification:423600

Additional information about DEALERS ELECTRICAL SUPPLY CO.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 1978-04-27
Company Identification Number: 0043402700
Legal Registered Office Address: PO BOX 2676 ATTN:DAVID BRYANT

WACO
United States of America (USA)
76702

More information about DEALERS ELECTRICAL SUPPLY CO.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012024-01-01GREG CHUDEJ
5012023-01-01
5012023-01-01GREG CHUDEJ
5012022-01-01
5012022-01-01GREG CHUDEJ
5012021-01-01
5012021-01-01GREG CHUDEJ
5012020-01-01
5012019-01-01
5012018-01-01GREG CHUDEJ
5012017-01-01GREG CHUDEJ
5012016-01-01GREG CHUDEJ
5012015-01-01GREG CHUDEJ
5012014-01-01GREG CHUDEJ
5012013-01-01GREG CHUDEJ
5012012-01-01GREG CHUDEJ GREG CHUDEJ2013-09-18
5012011-01-01GREG CHUDEJ
5012009-01-01GREG CHUDEJ

Plan Statistics for DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION

401k plan membership statisitcs for DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION

Measure Date Value
2023: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2023 401k membership
Total participants, beginning-of-year2023-01-01566
Total number of active participants reported on line 7a of the Form 55002023-01-01649
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01649
2022: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2022 401k membership
Total participants, beginning-of-year2022-01-01570
Total number of active participants reported on line 7a of the Form 55002022-01-01566
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01566
2021: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2021 401k membership
Total participants, beginning-of-year2021-01-01608
Total number of active participants reported on line 7a of the Form 55002021-01-01570
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01570
2020: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2020 401k membership
Total participants, beginning-of-year2020-01-01636
Total number of active participants reported on line 7a of the Form 55002020-01-01608
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01608
2019: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2019 401k membership
Total participants, beginning-of-year2019-01-01631
Total number of active participants reported on line 7a of the Form 55002019-01-01636
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 participants2019-01-01636
2018: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2018 401k membership
Total participants, beginning-of-year2018-01-01645
Total number of active participants reported on line 7a of the Form 55002018-01-01631
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01631
2017: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2017 401k membership
Total participants, beginning-of-year2017-01-01645
Total number of active participants reported on line 7a of the Form 55002017-01-01645
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01645
2016: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2016 401k membership
Total participants, beginning-of-year2016-01-01668
Total number of active participants reported on line 7a of the Form 55002016-01-01630
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01630
2015: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2015 401k membership
Total participants, beginning-of-year2015-01-01665
Total number of active participants reported on line 7a of the Form 55002015-01-01668
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01668
2014: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2014 401k membership
Total participants, beginning-of-year2014-01-01643
Total number of active participants reported on line 7a of the Form 55002014-01-01665
Total of all active and inactive participants2014-01-01665
2013: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2013 401k membership
Total participants, beginning-of-year2013-01-01647
Total number of active participants reported on line 7a of the Form 55002013-01-01643
Total of all active and inactive participants2013-01-01643
2012: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2012 401k membership
Total participants, beginning-of-year2012-01-01634
Total number of active participants reported on line 7a of the Form 55002012-01-01647
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01647
2011: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2011 401k membership
Total participants, beginning-of-year2011-01-01644
Total number of active participants reported on line 7a of the Form 55002011-01-01634
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01634
2009: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2009 401k membership
Total participants, beginning-of-year2009-01-01668
Total number of active participants reported on line 7a of the Form 55002009-01-01666
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01666

Form 5500 Responses for DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION

2023: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: DEALERS ELECTRICAL SUPPLY CO. GROUP MEDICAL AND HOSPITALIZATION 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number66020-5
Policy instance 3
Insurance contract or identification number66020-5
Number of Individuals Covered649
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $7,974
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D, PERSONAL ACCIDENT
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 $110,843
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number66020-05
Policy instance 2
Insurance contract or identification number66020-05
Number of Individuals Covered1134
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $20,606
Total amount of fees paid to insurance companyUSD $40,916
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $818,313
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCCLOT40428
Policy instance 1
Insurance contract or identification numberHCCLOT40428
Number of Individuals Covered508
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $9,616
Total amount of fees paid to insurance companyUSD $3,178
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedTRANSPLANT
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 $96,147
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 numberERL122101574003
Policy instance 3
Insurance contract or identification numberERL122101574003
Number of Individuals Covered522
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare 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 $784,027
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number66020-05
Policy instance 2
Insurance contract or identification number66020-05
Number of Individuals Covered566
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $8,727
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D, PERSONAL ACCIDENT
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 $108,722
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCCLOT40428
Policy instance 1
Insurance contract or identification numberHCCLOT40428
Number of Individuals Covered522
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $9,902
Total amount of fees paid to insurance companyUSD $3,564
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedTRANSPLANT
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 $99,036
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCCLOT40428
Policy instance 1
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number66020-05
Policy instance 2
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )
Policy contract numberERL12010157001
Policy instance 3
BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )
Policy contract numberERL12010157001
Policy instance 3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number66020-05
Policy instance 2
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCCLOT40428
Policy instance 1
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number406729A
Policy instance 3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number66020-05
Policy instance 2
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCCLOT40428
Policy instance 1
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number406729A
Policy instance 3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number660205
Policy instance 2
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number947-4362
Policy instance 1
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number660205
Policy instance 2
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number947-4362
Policy instance 1
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number947-0787
Policy instance 1
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number660205
Policy instance 2
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number949-7592
Policy instance 1
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number660205
Policy instance 2
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number949-3838
Policy instance 1
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number660205
Policy instance 2
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number660205
Policy instance 2
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number949-0872
Policy instance 1
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number280-8150
Policy instance 2
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number660205
Policy instance 1
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number660205
Policy instance 1
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number280-8150
Policy instance 2

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