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HAC EMPLOYEE WELFARE BENEFIT PLAN 401k Plan overview

Plan NameHAC EMPLOYEE WELFARE BENEFIT PLAN
Plan identification number 501

HAC EMPLOYEE WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

HAAS-ANDERSON CONSTRUCTION, LTD has sponsored the creation of one or more 401k plans.

Company Name:HAAS-ANDERSON CONSTRUCTION, LTD
Employer identification number (EIN):742212956
NAIC Classification:238100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HAC EMPLOYEE WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-05-01DARRYL HAAS2022-02-10 DARRYL HAAS2022-02-10
5012019-05-01DARRYL HAAS2021-02-11 DARRYL HAAS2021-02-11
5012018-05-01
5012017-05-01DARRYL HAAS DARRYL HAAS2019-02-05
5012016-05-01DARRYL HAAS DARRYL HAAS2017-12-29
5012015-05-01DARRYL HAAS DARRYL HAAS2017-01-30
5012014-05-01DARRYL HAAS DARRYL HAAS2015-11-17
5012013-05-01DARRYL HAAS DARRYL HAAS2015-02-03
5012012-05-01DARRYL HAAS DARRYL HAAS2014-01-10
5012011-05-01DARRYL HAAS DARRYL HAAS2013-01-17
5012009-05-01DARRYL HAAS DARRYL HAAS2011-01-15

Plan Statistics for HAC EMPLOYEE WELFARE BENEFIT PLAN

401k plan membership statisitcs for HAC EMPLOYEE WELFARE BENEFIT PLAN

Measure Date Value
2020: HAC EMPLOYEE WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-05-0199
Total number of active participants reported on line 7a of the Form 55002020-05-010
Number of retired or separated participants receiving benefits2020-05-010
Number of other retired or separated participants entitled to future benefits2020-05-010
Total of all active and inactive participants2020-05-010
Total participants2020-05-010
2019: HAC EMPLOYEE WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-05-01114
Total number of active participants reported on line 7a of the Form 55002019-05-0199
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-0199
2018: HAC EMPLOYEE WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-05-01126
Total number of active participants reported on line 7a of the Form 55002018-05-01117
Total of all active and inactive participants2018-05-01117
2017: HAC EMPLOYEE WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-05-01144
Total number of active participants reported on line 7a of the Form 55002017-05-01126
Total of all active and inactive participants2017-05-01126
2016: HAC EMPLOYEE WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-05-01140
Total number of active participants reported on line 7a of the Form 55002016-05-01144
Total of all active and inactive participants2016-05-01144
2015: HAC EMPLOYEE WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-05-01128
Total number of active participants reported on line 7a of the Form 55002015-05-01140
Total of all active and inactive participants2015-05-01140
2014: HAC EMPLOYEE WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-05-01110
Total number of active participants reported on line 7a of the Form 55002014-05-01128
Total of all active and inactive participants2014-05-01128
2013: HAC EMPLOYEE WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-05-0199
Total number of active participants reported on line 7a of the Form 55002013-05-01110
Total of all active and inactive participants2013-05-01110
2012: HAC EMPLOYEE WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-05-01109
Total number of active participants reported on line 7a of the Form 55002012-05-0199
Total of all active and inactive participants2012-05-0199
2011: HAC EMPLOYEE WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-05-01118
Total number of active participants reported on line 7a of the Form 55002011-05-01108
Number of retired or separated participants receiving benefits2011-05-011
Total of all active and inactive participants2011-05-01109
2009: HAC EMPLOYEE WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-05-01133
Total number of active participants reported on line 7a of the Form 55002009-05-01122
Number of retired or separated participants receiving benefits2009-05-011
Total of all active and inactive participants2009-05-01123

Financial Data on HAC EMPLOYEE WELFARE BENEFIT PLAN

Measure Date Value
2020 : HAC EMPLOYEE WELFARE BENEFIT PLAN 2020 401k financial data
Total income from all sources (including contributions)2020-04-30$2,021,563
Total of all expenses incurred2020-04-30$2,132,697
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-04-30$2,037,410
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-04-30$1,843,623
Value of total assets at end of year2020-04-30$37,470
Value of total assets at beginning of year2020-04-30$148,604
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-04-30$95,287
Total interest from all sources2020-04-30$43
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-04-30No
Administrative expenses professional fees incurred2020-04-30$19,000
Was this plan covered by a fidelity bond2020-04-30No
If this is an individual account plan, was there a blackout period2020-04-30No
Were there any nonexempt tranactions with any party-in-interest2020-04-30No
Contributions received from participants2020-04-30$629,101
Other income not declared elsewhere2020-04-30$177,897
Total non interest bearing cash at end of year2020-04-30$36,470
Total non interest bearing cash at beginning of year2020-04-30$98,688
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-04-30No
Value of net income/loss2020-04-30$-111,134
Value of net assets at end of year (total assets less liabilities)2020-04-30$37,470
Value of net assets at beginning of year (total assets less liabilities)2020-04-30$148,604
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-04-30No
Were any leases to which the plan was party in default or uncollectible2020-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-04-30$1,000
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-04-30$49,916
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-04-30$49,916
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-04-30$43
Expenses. Payments to insurance carriers foe the provision of benefits2020-04-30$323,603
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-04-30No
Was there a failure to transmit to the plan any participant contributions2020-04-30No
Has the plan failed to provide any benefit when due under the plan2020-04-30No
Contributions received in cash from employer2020-04-30$1,214,522
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-04-30$1,713,807
Contract administrator fees2020-04-30$76,287
Did the plan have assets held for investment2020-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-04-30No
Opinion of an independent qualified public accountant for this plan2020-04-30Unqualified
Accountancy firm name2020-04-30MICHALAK PC
Accountancy firm EIN2020-04-30834629358
2019 : HAC EMPLOYEE WELFARE BENEFIT PLAN 2019 401k financial data
Total income from all sources (including contributions)2019-04-30$1,550,649
Total of all expenses incurred2019-04-30$1,680,522
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-04-30$1,576,456
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-04-30$1,491,306
Value of total assets at end of year2019-04-30$148,604
Value of total assets at beginning of year2019-04-30$278,477
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-04-30$104,066
Total interest from all sources2019-04-30$219
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-04-30No
Administrative expenses professional fees incurred2019-04-30$17,000
Was this plan covered by a fidelity bond2019-04-30No
If this is an individual account plan, was there a blackout period2019-04-30No
Were there any nonexempt tranactions with any party-in-interest2019-04-30No
Contributions received from participants2019-04-30$621,927
Other income not declared elsewhere2019-04-30$59,124
Administrative expenses (other) incurred2019-04-30$1
Total non interest bearing cash at end of year2019-04-30$98,688
Total non interest bearing cash at beginning of year2019-04-30$81,284
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-04-30No
Value of net income/loss2019-04-30$-129,873
Value of net assets at end of year (total assets less liabilities)2019-04-30$148,604
Value of net assets at beginning of year (total assets less liabilities)2019-04-30$278,477
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2019-04-30No
Were any leases to which the plan was party in default or uncollectible2019-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-04-30$49,916
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-04-30$197,193
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-04-30$197,193
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-04-30$219
Expenses. Payments to insurance carriers foe the provision of benefits2019-04-30$359,549
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-04-30No
Was there a failure to transmit to the plan any participant contributions2019-04-30No
Has the plan failed to provide any benefit when due under the plan2019-04-30No
Contributions received in cash from employer2019-04-30$869,379
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-04-30$1,216,907
Contract administrator fees2019-04-30$87,065
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-04-30No
Did the plan have assets held for investment2019-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-04-30No
Opinion of an independent qualified public accountant for this plan2019-04-30Unqualified
Accountancy firm name2019-04-30BONNES & PULLIN, P.C.
Accountancy firm EIN2019-04-30461224180
2018 : HAC EMPLOYEE WELFARE BENEFIT PLAN 2018 401k financial data
Total income from all sources (including contributions)2018-04-30$1,784,988
Total of all expenses incurred2018-04-30$1,615,655
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-04-30$1,508,884
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-04-30$1,556,004
Value of total assets at end of year2018-04-30$278,477
Value of total assets at beginning of year2018-04-30$109,144
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-04-30$106,771
Total interest from all sources2018-04-30$136
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-04-30No
Administrative expenses professional fees incurred2018-04-30$16,500
Was this plan covered by a fidelity bond2018-04-30No
If this is an individual account plan, was there a blackout period2018-04-30No
Were there any nonexempt tranactions with any party-in-interest2018-04-30No
Contributions received from participants2018-04-30$647,647
Other income not declared elsewhere2018-04-30$228,848
Administrative expenses (other) incurred2018-04-30$16
Total non interest bearing cash at end of year2018-04-30$81,284
Total non interest bearing cash at beginning of year2018-04-30$32,621
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-04-30No
Value of net income/loss2018-04-30$169,333
Value of net assets at end of year (total assets less liabilities)2018-04-30$278,477
Value of net assets at beginning of year (total assets less liabilities)2018-04-30$109,144
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2018-04-30No
Were any leases to which the plan was party in default or uncollectible2018-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-04-30$197,193
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-04-30$76,523
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-04-30$76,523
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-04-30$136
Expenses. Payments to insurance carriers foe the provision of benefits2018-04-30$368,621
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-04-30Yes
Was there a failure to transmit to the plan any participant contributions2018-04-30No
Has the plan failed to provide any benefit when due under the plan2018-04-30No
Contributions received in cash from employer2018-04-30$908,357
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-04-30$1,140,263
Contract administrator fees2018-04-30$90,255
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-04-30No
Did the plan have assets held for investment2018-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-04-30No
Opinion of an independent qualified public accountant for this plan2018-04-30Unqualified
Accountancy firm name2018-04-30BONNES & PULLIN, P.C.
Accountancy firm EIN2018-04-30461224180
2017 : HAC EMPLOYEE WELFARE BENEFIT PLAN 2017 401k financial data
Total income from all sources (including contributions)2017-04-30$1,683,384
Total of all expenses incurred2017-04-30$1,715,021
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-04-30$1,596,340
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-04-30$1,662,977
Value of total assets at end of year2017-04-30$109,144
Value of total assets at beginning of year2017-04-30$140,781
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-04-30$118,681
Total interest from all sources2017-04-30$116
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-04-30No
Administrative expenses professional fees incurred2017-04-30$16,000
Was this plan covered by a fidelity bond2017-04-30No
If this is an individual account plan, was there a blackout period2017-04-30No
Were there any nonexempt tranactions with any party-in-interest2017-04-30No
Contributions received from participants2017-04-30$690,981
Other income not declared elsewhere2017-04-30$20,291
Administrative expenses (other) incurred2017-04-30$5,927
Total non interest bearing cash at end of year2017-04-30$32,621
Total non interest bearing cash at beginning of year2017-04-30$89,711
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-04-30No
Value of net income/loss2017-04-30$-31,637
Value of net assets at end of year (total assets less liabilities)2017-04-30$109,144
Value of net assets at beginning of year (total assets less liabilities)2017-04-30$140,781
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2017-04-30No
Were any leases to which the plan was party in default or uncollectible2017-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-04-30$76,523
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-04-30$51,070
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-04-30$51,070
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-04-30$116
Expenses. Payments to insurance carriers foe the provision of benefits2017-04-30$423,915
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-04-30Yes
Was there a failure to transmit to the plan any participant contributions2017-04-30No
Has the plan failed to provide any benefit when due under the plan2017-04-30No
Contributions received in cash from employer2017-04-30$971,996
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-04-30$1,172,425
Contract administrator fees2017-04-30$96,754
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-04-30No
Did the plan have assets held for investment2017-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-04-30No
Opinion of an independent qualified public accountant for this plan2017-04-30Unqualified
Accountancy firm name2017-04-30BONNES & PULLIN, P.C.
Accountancy firm EIN2017-04-30461224180
2016 : HAC EMPLOYEE WELFARE BENEFIT PLAN 2016 401k financial data
Total income from all sources (including contributions)2016-04-30$2,246,555
Total of all expenses incurred2016-04-30$2,295,971
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-04-30$2,172,695
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-04-30$1,394,870
Value of total assets at end of year2016-04-30$140,781
Value of total assets at beginning of year2016-04-30$190,197
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-04-30$123,276
Total interest from all sources2016-04-30$92
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-04-30No
Administrative expenses professional fees incurred2016-04-30$15,500
Was this plan covered by a fidelity bond2016-04-30No
If this is an individual account plan, was there a blackout period2016-04-30No
Were there any nonexempt tranactions with any party-in-interest2016-04-30No
Contributions received from participants2016-04-30$583,141
Other income not declared elsewhere2016-04-30$851,593
Administrative expenses (other) incurred2016-04-30$17,549
Total non interest bearing cash at end of year2016-04-30$89,711
Total non interest bearing cash at beginning of year2016-04-30$137,759
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-04-30No
Value of net income/loss2016-04-30$-49,416
Value of net assets at end of year (total assets less liabilities)2016-04-30$140,781
Value of net assets at beginning of year (total assets less liabilities)2016-04-30$190,197
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-04-30No
Were any leases to which the plan was party in default or uncollectible2016-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-04-30$51,070
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-04-30$52,438
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-04-30$52,438
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-04-30$92
Expenses. Payments to insurance carriers foe the provision of benefits2016-04-30$356,373
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-04-30Yes
Was there a failure to transmit to the plan any participant contributions2016-04-30No
Has the plan failed to provide any benefit when due under the plan2016-04-30No
Contributions received in cash from employer2016-04-30$811,729
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-04-30$1,816,322
Contract administrator fees2016-04-30$90,227
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-04-30No
Did the plan have assets held for investment2016-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-04-30No
Opinion of an independent qualified public accountant for this plan2016-04-30Unqualified
Accountancy firm name2016-04-30BONNES & PULLIN, P.C.
Accountancy firm EIN2016-04-30461224180
2015 : HAC EMPLOYEE WELFARE BENEFIT PLAN 2015 401k financial data
Total income from all sources (including contributions)2015-04-30$2,021,158
Total of all expenses incurred2015-04-30$2,170,899
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-04-30$2,055,235
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-04-30$1,224,177
Value of total assets at end of year2015-04-30$190,197
Value of total assets at beginning of year2015-04-30$339,938
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-04-30$115,664
Total interest from all sources2015-04-30$420
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-04-30No
Administrative expenses professional fees incurred2015-04-30$15,000
Was this plan covered by a fidelity bond2015-04-30No
If this is an individual account plan, was there a blackout period2015-04-30No
Were there any nonexempt tranactions with any party-in-interest2015-04-30No
Contributions received from participants2015-04-30$508,875
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-04-30$7,049
Other income not declared elsewhere2015-04-30$796,561
Administrative expenses (other) incurred2015-04-30$14,238
Total non interest bearing cash at end of year2015-04-30$137,759
Total non interest bearing cash at beginning of year2015-04-30$50,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-04-30No
Value of net income/loss2015-04-30$-149,741
Value of net assets at end of year (total assets less liabilities)2015-04-30$190,197
Value of net assets at beginning of year (total assets less liabilities)2015-04-30$339,938
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-04-30No
Were any leases to which the plan was party in default or uncollectible2015-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-04-30$52,438
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-04-30$282,889
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-04-30$282,889
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-04-30$420
Expenses. Payments to insurance carriers foe the provision of benefits2015-04-30$308,087
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-04-30Yes
Was there a failure to transmit to the plan any participant contributions2015-04-30No
Has the plan failed to provide any benefit when due under the plan2015-04-30No
Contributions received in cash from employer2015-04-30$715,302
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-04-30$1,747,148
Contract administrator fees2015-04-30$86,426
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-04-30No
Did the plan have assets held for investment2015-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-04-30No
Opinion of an independent qualified public accountant for this plan2015-04-30Unqualified
Accountancy firm name2015-04-30BONNES & PULLIN, P.C.
Accountancy firm EIN2015-04-30461224180
2014 : HAC EMPLOYEE WELFARE BENEFIT PLAN 2014 401k financial data
Total income from all sources (including contributions)2014-04-30$1,114,434
Total of all expenses incurred2014-04-30$980,309
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-04-30$881,571
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-04-30$1,109,828
Value of total assets at end of year2014-04-30$339,938
Value of total assets at beginning of year2014-04-30$205,813
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-04-30$98,738
Total interest from all sources2014-04-30$420
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-04-30No
Administrative expenses professional fees incurred2014-04-30$15,000
Was this plan covered by a fidelity bond2014-04-30No
If this is an individual account plan, was there a blackout period2014-04-30No
Were there any nonexempt tranactions with any party-in-interest2014-04-30No
Contributions received from participants2014-04-30$428,034
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-04-30$7,049
Other income not declared elsewhere2014-04-30$4,186
Administrative expenses (other) incurred2014-04-30$12
Total non interest bearing cash at end of year2014-04-30$50,000
Total non interest bearing cash at beginning of year2014-04-30$50,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-04-30No
Value of net income/loss2014-04-30$134,125
Value of net assets at end of year (total assets less liabilities)2014-04-30$339,938
Value of net assets at beginning of year (total assets less liabilities)2014-04-30$205,813
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-04-30No
Were any leases to which the plan was party in default or uncollectible2014-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-04-30$282,889
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-04-30$155,813
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-04-30$155,813
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-04-30$420
Expenses. Payments to insurance carriers foe the provision of benefits2014-04-30$225,423
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-04-30Yes
Was there a failure to transmit to the plan any participant contributions2014-04-30No
Has the plan failed to provide any benefit when due under the plan2014-04-30No
Contributions received in cash from employer2014-04-30$681,794
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-04-30$656,148
Contract administrator fees2014-04-30$83,726
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-04-30No
Did the plan have assets held for investment2014-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-04-30No
Opinion of an independent qualified public accountant for this plan2014-04-30Unqualified
Accountancy firm name2014-04-30BONNES & PULLIN, P.C.
Accountancy firm EIN2014-04-30461224180
2013 : HAC EMPLOYEE WELFARE BENEFIT PLAN 2013 401k financial data
Total income from all sources (including contributions)2013-04-30$1,005,094
Total of all expenses incurred2013-04-30$903,134
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-04-30$795,755
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-04-30$990,826
Value of total assets at end of year2013-04-30$205,813
Value of total assets at beginning of year2013-04-30$103,853
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-04-30$107,379
Total interest from all sources2013-04-30$209
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-04-30No
Administrative expenses professional fees incurred2013-04-30$15,000
Was this plan covered by a fidelity bond2013-04-30No
If this is an individual account plan, was there a blackout period2013-04-30No
Were there any nonexempt tranactions with any party-in-interest2013-04-30No
Contributions received from participants2013-04-30$370,044
Other income not declared elsewhere2013-04-30$14,059
Administrative expenses (other) incurred2013-04-30$85
Total non interest bearing cash at end of year2013-04-30$50,000
Total non interest bearing cash at beginning of year2013-04-30$15,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-04-30No
Value of net income/loss2013-04-30$101,960
Value of net assets at end of year (total assets less liabilities)2013-04-30$205,813
Value of net assets at beginning of year (total assets less liabilities)2013-04-30$103,853
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-04-30No
Were any leases to which the plan was party in default or uncollectible2013-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-04-30$155,813
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-04-30$88,853
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-04-30$88,853
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-04-30$209
Expenses. Payments to insurance carriers foe the provision of benefits2013-04-30$168,380
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-04-30Yes
Was there a failure to transmit to the plan any participant contributions2013-04-30No
Has the plan failed to provide any benefit when due under the plan2013-04-30No
Contributions received in cash from employer2013-04-30$620,782
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-04-30$627,375
Contract administrator fees2013-04-30$92,294
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-04-30No
Did the plan have assets held for investment2013-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-04-30No
Opinion of an independent qualified public accountant for this plan2013-04-30Unqualified
Accountancy firm name2013-04-30BONNES & PULLIN, P.C.
Accountancy firm EIN2013-04-30461224180
2012 : HAC EMPLOYEE WELFARE BENEFIT PLAN 2012 401k financial data
Total income from all sources (including contributions)2012-04-30$1,179,022
Total of all expenses incurred2012-04-30$1,304,561
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-04-30$1,186,596
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-04-30$994,703
Value of total assets at end of year2012-04-30$103,853
Value of total assets at beginning of year2012-04-30$229,392
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-04-30$117,965
Total interest from all sources2012-04-30$360
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-04-30No
Administrative expenses professional fees incurred2012-04-30$15,000
Was this plan covered by a fidelity bond2012-04-30No
If this is an individual account plan, was there a blackout period2012-04-30No
Were there any nonexempt tranactions with any party-in-interest2012-04-30No
Contributions received from participants2012-04-30$377,141
Other income not declared elsewhere2012-04-30$183,959
Administrative expenses (other) incurred2012-04-30$421
Total non interest bearing cash at end of year2012-04-30$15,000
Total non interest bearing cash at beginning of year2012-04-30$18,026
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-04-30No
Value of net income/loss2012-04-30$-125,539
Value of net assets at end of year (total assets less liabilities)2012-04-30$103,853
Value of net assets at beginning of year (total assets less liabilities)2012-04-30$229,392
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-04-30No
Were any leases to which the plan was party in default or uncollectible2012-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-04-30$88,853
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-04-30$211,366
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-04-30$211,366
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-04-30$360
Expenses. Payments to insurance carriers foe the provision of benefits2012-04-30$178,853
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-04-30Yes
Was there a failure to transmit to the plan any participant contributions2012-04-30No
Has the plan failed to provide any benefit when due under the plan2012-04-30No
Contributions received in cash from employer2012-04-30$617,562
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-04-30$1,007,743
Contract administrator fees2012-04-30$102,544
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-04-30No
Did the plan have assets held for investment2012-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-04-30No
Opinion of an independent qualified public accountant for this plan2012-04-30Unqualified
Accountancy firm name2012-04-30BONNES & PULLIN, P.C.
Accountancy firm EIN2012-04-30461224180
2011 : HAC EMPLOYEE WELFARE BENEFIT PLAN 2011 401k financial data
Total income from all sources (including contributions)2011-04-30$1,030,050
Total of all expenses incurred2011-04-30$1,015,743
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-04-30$881,383
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-04-30$1,021,466
Value of total assets at end of year2011-04-30$229,392
Value of total assets at beginning of year2011-04-30$215,085
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-04-30$134,360
Total interest from all sources2011-04-30$1,070
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-04-30No
Administrative expenses professional fees incurred2011-04-30$15,000
Was this plan covered by a fidelity bond2011-04-30No
If this is an individual account plan, was there a blackout period2011-04-30No
Were there any nonexempt tranactions with any party-in-interest2011-04-30No
Contributions received from participants2011-04-30$377,703
Other income not declared elsewhere2011-04-30$7,514
Administrative expenses (other) incurred2011-04-30$585
Total non interest bearing cash at end of year2011-04-30$18,026
Total non interest bearing cash at beginning of year2011-04-30$15,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-04-30No
Value of net income/loss2011-04-30$14,307
Value of net assets at end of year (total assets less liabilities)2011-04-30$229,392
Value of net assets at beginning of year (total assets less liabilities)2011-04-30$215,085
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-04-30No
Were any leases to which the plan was party in default or uncollectible2011-04-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-04-30$211,366
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-04-30$200,085
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-04-30$200,085
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-04-30$1,070
Expenses. Payments to insurance carriers foe the provision of benefits2011-04-30$119,585
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-04-30Yes
Was there a failure to transmit to the plan any participant contributions2011-04-30No
Has the plan failed to provide any benefit when due under the plan2011-04-30No
Contributions received in cash from employer2011-04-30$643,763
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-04-30$761,798
Contract administrator fees2011-04-30$118,775
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-04-30No
Did the plan have assets held for investment2011-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-04-30No
Opinion of an independent qualified public accountant for this plan2011-04-30Unqualified
Accountancy firm name2011-04-30FITE & WHEELER, P.C.
Accountancy firm EIN2011-04-30742518603

Form 5500 Responses for HAC EMPLOYEE WELFARE BENEFIT PLAN

2020: HAC EMPLOYEE WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Submission has been amendedNo
2020-05-01This submission is the final filingYes
2020-05-01This return/report is a short plan year return/report (less than 12 months)No
2020-05-01Plan is a collectively bargained planNo
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan benefit arrangement – InsuranceYes
2019: HAC EMPLOYEE WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan funding arrangement – TrustYes
2019-05-01Plan benefit arrangement – InsuranceYes
2019-05-01Plan benefit arrangement - TrustYes
2018: HAC EMPLOYEE WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan funding arrangement – TrustYes
2018-05-01Plan benefit arrangement – InsuranceYes
2018-05-01Plan benefit arrangement - TrustYes
2017: HAC EMPLOYEE WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan funding arrangement – TrustYes
2017-05-01Plan benefit arrangement – InsuranceYes
2017-05-01Plan benefit arrangement - TrustYes
2016: HAC EMPLOYEE WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan funding arrangement – TrustYes
2016-05-01Plan benefit arrangement – InsuranceYes
2016-05-01Plan benefit arrangement - TrustYes
2015: HAC EMPLOYEE WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan funding arrangement – TrustYes
2015-05-01Plan benefit arrangement – InsuranceYes
2015-05-01Plan benefit arrangement - TrustYes
2014: HAC EMPLOYEE WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-05-01Type of plan entitySingle employer plan
2014-05-01Plan funding arrangement – InsuranceYes
2014-05-01Plan funding arrangement – TrustYes
2014-05-01Plan benefit arrangement – InsuranceYes
2014-05-01Plan benefit arrangement - TrustYes
2013: HAC EMPLOYEE WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan funding arrangement – TrustYes
2013-05-01Plan benefit arrangement – InsuranceYes
2013-05-01Plan benefit arrangement - TrustYes
2012: HAC EMPLOYEE WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan funding arrangement – TrustYes
2012-05-01Plan benefit arrangement – InsuranceYes
2012-05-01Plan benefit arrangement - TrustYes
2011: HAC EMPLOYEE WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan funding arrangement – TrustYes
2011-05-01Plan benefit arrangement – InsuranceYes
2011-05-01Plan benefit arrangement - TrustYes
2009: HAC EMPLOYEE WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-05-01Type of plan entitySingle employer plan
2009-05-01This submission is the final filingNo
2009-05-01Plan funding arrangement – InsuranceYes
2009-05-01Plan funding arrangement – TrustYes
2009-05-01Plan benefit arrangement – InsuranceYes
2009-05-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0849648
Policy instance 1
Insurance contract or identification number0849648
Number of Individuals Covered0
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0849648
Policy instance 1
Insurance contract or identification number0849648
Number of Individuals Covered99
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $26,881
Total amount of fees paid to insurance companyUSD $49,407
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $323,603
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,881
Amount paid for insurance broker fees49407
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0849648
Policy instance 1
Insurance contract or identification number0849648
Number of Individuals Covered117
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $31,332
Total amount of fees paid to insurance companyUSD $55,733
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $359,549
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,332
Amount paid for insurance broker fees55733
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0849648
Policy instance 1
Insurance contract or identification number0849648
Number of Individuals Covered127
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $33,185
Total amount of fees paid to insurance companyUSD $57,070
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $368,891
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0849648
Policy instance 1
Insurance contract or identification number0849648
Number of Individuals Covered196
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $35,528
Total amount of fees paid to insurance companyUSD $54,698
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $358,385
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,528
Amount paid for insurance broker fees54698
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0849648
Policy instance 1
Insurance contract or identification number0849648
Number of Individuals Covered204
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $33,654
Total amount of fees paid to insurance companyUSD $52,772
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $308,567
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,654
Amount paid for insurance broker fees52772
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0849648
Policy instance 1
Insurance contract or identification number0849648
Number of Individuals Covered204
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $27,179
Total amount of fees paid to insurance companyUSD $56,547
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $225,423
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,179
Amount paid for insurance broker fees56547
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number25230
Policy instance 1
Insurance contract or identification number25230
Number of Individuals Covered193
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $25,305
Total amount of fees paid to insurance companyUSD $67,074
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $168,380
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,305
Amount paid for insurance broker fees67074
Additional information about fees paid to insurance brokerADMINISTRATIVE FEES
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number25230
Policy instance 1
Insurance contract or identification number25230
Number of Individuals Covered200
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $27,903
Total amount of fees paid to insurance companyUSD $75,051
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $178,853
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number25230
Policy instance 1
Insurance contract or identification number25230
Number of Individuals Covered230
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $41,261
Total amount of fees paid to insurance companyUSD $78,087
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $119,585
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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