F. W. OFFENHAUSER & COMPANY, INC. has sponsored the creation of one or more 401k plans.
Additional information about F. W. OFFENHAUSER & COMPANY, INC.
Submission information for form 5500 for 401k plan F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST
401k plan membership statisitcs for F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST
| Measure | Date | Value |
|---|
| 2020: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-06-01 | 35 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-06-01 | 0 |
| Total of all active and inactive participants | 2020-06-01 | 0 |
| 2019: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-06-01 | 38 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-06-01 | 35 |
| Total of all active and inactive participants | 2019-06-01 | 35 |
| 2018: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-06-01 | 40 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-06-01 | 38 |
| Total of all active and inactive participants | 2018-06-01 | 38 |
| 2017: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-06-01 | 44 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-06-01 | 40 |
| Total of all active and inactive participants | 2017-06-01 | 40 |
| 2016: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-06-01 | 46 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-06-01 | 44 |
| Total of all active and inactive participants | 2016-06-01 | 44 |
| 2015: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-06-01 | 40 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-06-01 | 46 |
| Total of all active and inactive participants | 2015-06-01 | 46 |
| 2014: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-06-01 | 43 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-06-01 | 40 |
| Total of all active and inactive participants | 2014-06-01 | 40 |
| 2013: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-06-01 | 46 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-06-01 | 43 |
| Total of all active and inactive participants | 2013-06-01 | 43 |
| 2012: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-06-01 | 45 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-06-01 | 46 |
| Total of all active and inactive participants | 2012-06-01 | 46 |
| 2011: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-06-01 | 49 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-06-01 | 45 |
| Total of all active and inactive participants | 2011-06-01 | 45 |
| 2009: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-06-01 | 58 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-06-01 | 49 |
| Total of all active and inactive participants | 2009-06-01 | 49 |
| Measure | Date | Value |
|---|
| 2021 : F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2021 401k financial data |
|---|
| Expenses. Total of all expenses incurred | 2021-05-31 | $68,367 |
| Benefits paid (including direct rollovers) | 2021-05-31 | $68,367 |
| Total plan assets at end of year | 2021-05-31 | $0 |
| Total plan assets at beginning of year | 2021-05-31 | $68,367 |
| Net income (gross income less expenses) | 2021-05-31 | $-68,367 |
| Net plan assets at end of year (total assets less liabilities) | 2021-05-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-05-31 | $68,367 |
| 2020 : F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2020 401k financial data |
|---|
| Total income from all sources | 2020-05-31 | $114,956 |
| Expenses. Total of all expenses incurred | 2020-05-31 | $61,921 |
| Benefits paid (including direct rollovers) | 2020-05-31 | $42,068 |
| Total plan assets at end of year | 2020-05-31 | $68,367 |
| Total plan assets at beginning of year | 2020-05-31 | $15,332 |
| Expenses. Other expenses not covered elsewhere | 2020-05-31 | $19,853 |
| Other income received | 2020-05-31 | $34,743 |
| Net income (gross income less expenses) | 2020-05-31 | $53,035 |
| Net plan assets at end of year (total assets less liabilities) | 2020-05-31 | $68,367 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-05-31 | $15,332 |
| Total contributions received or receivable from employer(s) | 2020-05-31 | $80,213 |
| 2019 : F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2019 401k financial data |
|---|
| Total income from all sources | 2019-05-31 | $1,105,851 |
| Expenses. Total of all expenses incurred | 2019-05-31 | $1,092,614 |
| Benefits paid (including direct rollovers) | 2019-05-31 | $1,076,334 |
| Total plan assets at end of year | 2019-05-31 | $15,332 |
| Total plan assets at beginning of year | 2019-05-31 | $2,095 |
| Expenses. Other expenses not covered elsewhere | 2019-05-31 | $16,280 |
| Other income received | 2019-05-31 | $358,739 |
| Net income (gross income less expenses) | 2019-05-31 | $13,237 |
| Net plan assets at end of year (total assets less liabilities) | 2019-05-31 | $15,332 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-05-31 | $2,095 |
| Total contributions received or receivable from employer(s) | 2019-05-31 | $747,112 |
| 2018 : F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2018 401k financial data |
|---|
| Total income from all sources | 2018-05-31 | $501,343 |
| Expenses. Total of all expenses incurred | 2018-05-31 | $560,210 |
| Benefits paid (including direct rollovers) | 2018-05-31 | $543,234 |
| Total plan assets at end of year | 2018-05-31 | $2,095 |
| Total plan assets at beginning of year | 2018-05-31 | $60,962 |
| Expenses. Other expenses not covered elsewhere | 2018-05-31 | $16,976 |
| Other income received | 2018-05-31 | $27,138 |
| Net income (gross income less expenses) | 2018-05-31 | $-58,867 |
| Net plan assets at end of year (total assets less liabilities) | 2018-05-31 | $2,095 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-05-31 | $60,962 |
| Total contributions received or receivable from employer(s) | 2018-05-31 | $474,205 |
| 2017 : F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2017 401k financial data |
|---|
| Total income from all sources | 2017-05-31 | $682,596 |
| Expenses. Total of all expenses incurred | 2017-05-31 | $622,372 |
| Benefits paid (including direct rollovers) | 2017-05-31 | $601,636 |
| Total plan assets at end of year | 2017-05-31 | $60,962 |
| Total plan assets at beginning of year | 2017-05-31 | $738 |
| Expenses. Other expenses not covered elsewhere | 2017-05-31 | $20,736 |
| Other income received | 2017-05-31 | $126,924 |
| Net income (gross income less expenses) | 2017-05-31 | $60,224 |
| Net plan assets at end of year (total assets less liabilities) | 2017-05-31 | $60,962 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-05-31 | $738 |
| Total contributions received or receivable from employer(s) | 2017-05-31 | $555,672 |
| 2016 : F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2016 401k financial data |
|---|
| Total income from all sources | 2016-05-31 | $891,308 |
| Expenses. Total of all expenses incurred | 2016-05-31 | $896,557 |
| Benefits paid (including direct rollovers) | 2016-05-31 | $875,868 |
| Total plan assets at end of year | 2016-05-31 | $738 |
| Total plan assets at beginning of year | 2016-05-31 | $5,987 |
| Expenses. Other expenses not covered elsewhere | 2016-05-31 | $20,689 |
| Other income received | 2016-05-31 | $201,263 |
| Net income (gross income less expenses) | 2016-05-31 | $-5,249 |
| Net plan assets at end of year (total assets less liabilities) | 2016-05-31 | $738 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-05-31 | $5,987 |
| Total contributions received or receivable from employer(s) | 2016-05-31 | $690,045 |
| 2015 : F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2015 401k financial data |
|---|
| Total income from all sources | 2015-05-31 | $560,221 |
| Expenses. Total of all expenses incurred | 2015-05-31 | $612,597 |
| Benefits paid (including direct rollovers) | 2015-05-31 | $591,471 |
| Total plan assets at end of year | 2015-05-31 | $5,987 |
| Total plan assets at beginning of year | 2015-05-31 | $58,363 |
| Expenses. Other expenses not covered elsewhere | 2015-05-31 | $21,126 |
| Other income received | 2015-05-31 | $10,960 |
| Net income (gross income less expenses) | 2015-05-31 | $-52,376 |
| Net plan assets at end of year (total assets less liabilities) | 2015-05-31 | $5,987 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-05-31 | $58,363 |
| Total contributions received or receivable from employer(s) | 2015-05-31 | $549,261 |
| 2014 : F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2014 401k financial data |
|---|
| Total income from all sources | 2014-05-31 | $658,543 |
| Expenses. Total of all expenses incurred | 2014-05-31 | $629,388 |
| Benefits paid (including direct rollovers) | 2014-05-31 | $598,661 |
| Total plan assets at end of year | 2014-05-31 | $58,363 |
| Total plan assets at beginning of year | 2014-05-31 | $29,208 |
| Expenses. Other expenses not covered elsewhere | 2014-05-31 | $30,727 |
| Other income received | 2014-05-31 | $165,447 |
| Net income (gross income less expenses) | 2014-05-31 | $29,155 |
| Net plan assets at end of year (total assets less liabilities) | 2014-05-31 | $58,363 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-05-31 | $29,208 |
| Total contributions received or receivable from employer(s) | 2014-05-31 | $493,096 |
| 2013 : F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2013 401k financial data |
|---|
| Total income from all sources | 2013-05-31 | $923,543 |
| Expenses. Total of all expenses incurred | 2013-05-31 | $919,180 |
| Benefits paid (including direct rollovers) | 2013-05-31 | $890,712 |
| Total plan assets at end of year | 2013-05-31 | $29,208 |
| Total plan assets at beginning of year | 2013-05-31 | $24,845 |
| Expenses. Other expenses not covered elsewhere | 2013-05-31 | $28,468 |
| Other income received | 2013-05-31 | $318,680 |
| Net income (gross income less expenses) | 2013-05-31 | $4,363 |
| Net plan assets at end of year (total assets less liabilities) | 2013-05-31 | $29,208 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-05-31 | $24,845 |
| Total contributions received or receivable from employer(s) | 2013-05-31 | $604,863 |
| 2012 : F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2012 401k financial data |
|---|
| Total income from all sources | 2012-05-31 | $601,239 |
| Expenses. Total of all expenses incurred | 2012-05-31 | $625,906 |
| Benefits paid (including direct rollovers) | 2012-05-31 | $596,842 |
| Total plan assets at end of year | 2012-05-31 | $24,845 |
| Total plan assets at beginning of year | 2012-05-31 | $49,512 |
| Other income received | 2012-05-31 | $57,385 |
| Net income (gross income less expenses) | 2012-05-31 | $-24,667 |
| Net plan assets at end of year (total assets less liabilities) | 2012-05-31 | $24,845 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-05-31 | $49,512 |
| Total contributions received or receivable from employer(s) | 2012-05-31 | $543,854 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2012-05-31 | $29,064 |
| 2011 : F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2011 401k financial data |
|---|
| Total plan liabilities at beginning of year | 2011-05-31 | $793 |
| Total income from all sources | 2011-05-31 | $490,943 |
| Expenses. Total of all expenses incurred | 2011-05-31 | $441,431 |
| Benefits paid (including direct rollovers) | 2011-05-31 | $413,112 |
| Total plan assets at end of year | 2011-05-31 | $49,512 |
| Total plan assets at beginning of year | 2011-05-31 | $793 |
| Other income received | 2011-05-31 | $7,662 |
| Net income (gross income less expenses) | 2011-05-31 | $49,512 |
| Net plan assets at end of year (total assets less liabilities) | 2011-05-31 | $49,512 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-05-31 | $0 |
| Total contributions received or receivable from employer(s) | 2011-05-31 | $483,281 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-05-31 | $28,319 |
| 2020: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2020 form 5500 responses |
|---|
| 2020-06-01 | Type of plan entity | Single employer plan |
| 2020-06-01 | This submission is the final filing | Yes |
| 2020-06-01 | Plan funding arrangement – Trust | Yes |
| 2020-06-01 | Plan benefit arrangement - Trust | Yes |
| 2019: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2019 form 5500 responses |
|---|
| 2019-06-01 | Type of plan entity | Single employer plan |
| 2019-06-01 | Plan funding arrangement – Insurance | Yes |
| 2019-06-01 | Plan funding arrangement – Trust | Yes |
| 2019-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-06-01 | Plan benefit arrangement - Trust | Yes |
| 2018: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2018 form 5500 responses |
|---|
| 2018-06-01 | Type of plan entity | Single employer plan |
| 2018-06-01 | Plan funding arrangement – Insurance | Yes |
| 2018-06-01 | Plan funding arrangement – Trust | Yes |
| 2018-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-06-01 | Plan benefit arrangement - Trust | Yes |
| 2017: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2017 form 5500 responses |
|---|
| 2017-06-01 | Type of plan entity | Single employer plan |
| 2017-06-01 | Plan funding arrangement – Insurance | Yes |
| 2017-06-01 | Plan funding arrangement – Trust | Yes |
| 2017-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-06-01 | Plan benefit arrangement - Trust | Yes |
| 2016: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2016 form 5500 responses |
|---|
| 2016-06-01 | Type of plan entity | Single employer plan |
| 2016-06-01 | Plan funding arrangement – Insurance | Yes |
| 2016-06-01 | Plan funding arrangement – Trust | Yes |
| 2016-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-06-01 | Plan benefit arrangement - Trust | Yes |
| 2015: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2015 form 5500 responses |
|---|
| 2015-06-01 | Type of plan entity | Single employer plan |
| 2015-06-01 | Plan funding arrangement – Insurance | Yes |
| 2015-06-01 | Plan funding arrangement – Trust | Yes |
| 2015-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-06-01 | Plan benefit arrangement - Trust | Yes |
| 2014: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2014 form 5500 responses |
|---|
| 2014-06-01 | Type of plan entity | Single employer plan |
| 2014-06-01 | Plan funding arrangement – Insurance | Yes |
| 2014-06-01 | Plan funding arrangement – Trust | Yes |
| 2014-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-06-01 | Plan benefit arrangement - Trust | Yes |
| 2013: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2013 form 5500 responses |
|---|
| 2013-06-01 | Type of plan entity | Single employer plan |
| 2013-06-01 | Plan funding arrangement – Insurance | Yes |
| 2013-06-01 | Plan funding arrangement – Trust | Yes |
| 2013-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-06-01 | Plan benefit arrangement - Trust | Yes |
| 2012: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2012 form 5500 responses |
|---|
| 2012-06-01 | Type of plan entity | Single employer plan |
| 2012-06-01 | Plan funding arrangement – Insurance | Yes |
| 2012-06-01 | Plan funding arrangement – Trust | Yes |
| 2012-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-06-01 | Plan benefit arrangement - Trust | Yes |
| 2011: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2011 form 5500 responses |
|---|
| 2011-06-01 | Type of plan entity | Single employer plan |
| 2011-06-01 | Plan funding arrangement – Insurance | Yes |
| 2011-06-01 | Plan funding arrangement – Trust | Yes |
| 2011-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-06-01 | Plan benefit arrangement - Trust | Yes |
| 2009: F. W. OFFENHAUSER & COMPANY, INC. EMPLOYEES BENEFIT PLAN & TRUST 2009 form 5500 responses |
|---|
| 2009-06-01 | Type of plan entity | Single employer plan |
| 2009-06-01 | This submission is the final filing | No |
| 2009-06-01 | Plan funding arrangement – Insurance | Yes |
| 2009-06-01 | Plan funding arrangement – Trust | Yes |
| 2009-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-06-01 | Plan benefit arrangement - Trust | Yes |
| AMERICAN HEALTH HOLDINGS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 1 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 38 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | Total amount of commissions paid to insurance broker | USD $688 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | PRECERTIFICATION | | Welfare Benefit Premiums Paid to Carrier | USD $1,855 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $688 | | Insurance broker organization code? | 5 |
|
| PPO PLUS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 2 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 38 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | Total amount of commissions paid to insurance broker | USD $447 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $3,129 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $447 | | Insurance broker organization code? | 5 |
|
| BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 3 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 38 | | Insurance policy start date | 2018-06-01 | | Insurance policy end date | 2019-05-31 | | Total amount of commissions paid to insurance broker | USD $28,295 | | Total amount of fees paid to insurance company | USD $13,479 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | COMPLIANCE | | Welfare Benefit Premiums Paid to Carrier | USD $186,782 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $28,295 | | Amount paid for insurance broker fees | 13479 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMIN FEES | | Insurance broker organization code? | 5 |
|
| AMERICAN HEALTH HOLDINGS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 1 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 40 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-05-31 | | Total amount of commissions paid to insurance broker | USD $643 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | PRECERTIFICATION | | Welfare Benefit Premiums Paid to Carrier | USD $1,857 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $643 | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
| PPO PLUS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 2 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 40 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-05-31 | | Total amount of commissions paid to insurance broker | USD $476 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $3,332 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $476 | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
| BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 ) |
| Policy contract number | NOT AVAILABLE |
| Policy instance | 3 |
| Insurance contract or identification number | NOT AVAILABLE | | Number of Individuals Covered | 40 | | Insurance policy start date | 2017-06-01 | | Insurance policy end date | 2018-05-31 | | Total amount of commissions paid to insurance broker | USD $28,767 | | Total amount of fees paid to insurance company | USD $14,176 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | COMPLIANCE | | Welfare Benefit Premiums Paid to Carrier | USD $188,610 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $28,767 | | Amount paid for insurance broker fees | 14176 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMIN FEES | | Insurance broker organization code? | 5 | | Insurance broker name | IMA, INC. |
|
