THUNDER RIDGE TRANSPORT, INC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan THUNDER RIDGE TRANSPORT, INC. HEALTH & WELFARE PLAN
401k plan membership statisitcs for THUNDER RIDGE TRANSPORT, INC. HEALTH & WELFARE PLAN
Measure | Date | Value |
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2020 : THUNDER RIDGE TRANSPORT, INC. HEALTH & WELFARE PLAN 2020 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2020-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $5,043 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $288,033 |
Total income from all sources (including contributions) | 2020-12-31 | $223,841 |
Total loss/gain on sale of assets | 2020-12-31 | $0 |
Total of all expenses incurred | 2020-12-31 | $468,269 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $358,677 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-12-31 | $223,841 |
Value of total assets at end of year | 2020-12-31 | $45,609 |
Value of total assets at beginning of year | 2020-12-31 | $573,027 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $109,592 |
Total interest from all sources | 2020-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2020-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-12-31 | Yes |
Administrative expenses professional fees incurred | 2020-12-31 | $24,413 |
Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
Value of fidelity bond cover | 2020-12-31 | $50,000 |
If this is an individual account plan, was there a blackout period | 2020-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
Income. Received or receivable in cash from other sources (including rollovers) | 2020-12-31 | $1,635 |
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2020-12-31 | $3,190 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-12-31 | $0 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-12-31 | $283 |
Administrative expenses (other) incurred | 2020-12-31 | $5,354 |
Liabilities. Value of operating payables at end of year | 2020-12-31 | $5,043 |
Liabilities. Value of operating payables at beginning of year | 2020-12-31 | $118,115 |
Total non interest bearing cash at end of year | 2020-12-31 | $45,609 |
Total non interest bearing cash at beginning of year | 2020-12-31 | $6,449 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
Value of net income/loss | 2020-12-31 | $-244,428 |
Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $40,566 |
Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $284,994 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
Expenses. Payments to insurance carriers foe the provision of benefits | 2020-12-31 | $355,487 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
Contributions received in cash from employer | 2020-12-31 | $222,206 |
Employer contributions (assets) at end of year | 2020-12-31 | $0 |
Employer contributions (assets) at beginning of year | 2020-12-31 | $566,295 |
Contract administrator fees | 2020-12-31 | $79,825 |
Liabilities. Value of benefit claims payable at end of year | 2020-12-31 | $0 |
Liabilities. Value of benefit claims payable at beginning of year | 2020-12-31 | $169,918 |
Did the plan have assets held for investment | 2020-12-31 | No |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Unqualified |
Accountancy firm name | 2020-12-31 | CLIFTONLARSONALLEN LLP |
Accountancy firm EIN | 2020-12-31 | 410746749 |
2019 : THUNDER RIDGE TRANSPORT, INC. HEALTH & WELFARE PLAN 2019 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2019-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $288,033 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $311,138 |
Total income from all sources (including contributions) | 2019-12-31 | $2,175,395 |
Total loss/gain on sale of assets | 2019-12-31 | $0 |
Total of all expenses incurred | 2019-12-31 | $2,130,261 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $1,741,936 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $2,175,395 |
Value of total assets at end of year | 2019-12-31 | $573,027 |
Value of total assets at beginning of year | 2019-12-31 | $550,998 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $388,325 |
Total interest from all sources | 2019-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2019-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
Administrative expenses professional fees incurred | 2019-12-31 | $16,000 |
Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
Value of fidelity bond cover | 2019-12-31 | $200,000 |
If this is an individual account plan, was there a blackout period | 2019-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
Income. Received or receivable in cash from other sources (including rollovers) | 2019-12-31 | $6,049 |
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2019-12-31 | $12,945 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-12-31 | $283 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $1,661 |
Administrative expenses (other) incurred | 2019-12-31 | $53,613 |
Liabilities. Value of operating payables at end of year | 2019-12-31 | $118,115 |
Liabilities. Value of operating payables at beginning of year | 2019-12-31 | $242,553 |
Total non interest bearing cash at end of year | 2019-12-31 | $6,449 |
Total non interest bearing cash at beginning of year | 2019-12-31 | $110,932 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
Value of net income/loss | 2019-12-31 | $45,134 |
Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $284,994 |
Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $239,860 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $1,728,991 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
Contributions received in cash from employer | 2019-12-31 | $2,169,346 |
Employer contributions (assets) at end of year | 2019-12-31 | $566,295 |
Employer contributions (assets) at beginning of year | 2019-12-31 | $438,405 |
Contract administrator fees | 2019-12-31 | $318,712 |
Liabilities. Value of benefit claims payable at end of year | 2019-12-31 | $169,918 |
Liabilities. Value of benefit claims payable at beginning of year | 2019-12-31 | $68,585 |
Did the plan have assets held for investment | 2019-12-31 | No |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Unqualified |
Accountancy firm name | 2019-12-31 | CLIFTONLARSONALLEN LLP |
Accountancy firm EIN | 2019-12-31 | 410746749 |
2018 : THUNDER RIDGE TRANSPORT, INC. HEALTH & WELFARE PLAN 2018 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2018-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $311,138 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $162,240 |
Total income from all sources (including contributions) | 2018-12-31 | $1,418,417 |
Total loss/gain on sale of assets | 2018-12-31 | $0 |
Total of all expenses incurred | 2018-12-31 | $1,350,861 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $1,098,287 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $1,418,417 |
Value of total assets at end of year | 2018-12-31 | $550,998 |
Value of total assets at beginning of year | 2018-12-31 | $334,544 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $252,574 |
Total interest from all sources | 2018-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2018-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-12-31 | No |
Administrative expenses professional fees incurred | 2018-12-31 | $14,500 |
Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
Value of fidelity bond cover | 2018-12-31 | $200,000 |
If this is an individual account plan, was there a blackout period | 2018-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
Income. Received or receivable in cash from other sources (including rollovers) | 2018-12-31 | $1,139 |
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2018-12-31 | $11,418 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-12-31 | $1,661 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-12-31 | $0 |
Administrative expenses (other) incurred | 2018-12-31 | $70,555 |
Liabilities. Value of operating payables at end of year | 2018-12-31 | $242,553 |
Liabilities. Value of operating payables at beginning of year | 2018-12-31 | $129,165 |
Total non interest bearing cash at end of year | 2018-12-31 | $110,932 |
Total non interest bearing cash at beginning of year | 2018-12-31 | $7,771 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
Value of net income/loss | 2018-12-31 | $67,556 |
Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $239,860 |
Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $172,304 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $1,086,869 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2018-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
Contributions received in cash from employer | 2018-12-31 | $1,417,278 |
Employer contributions (assets) at end of year | 2018-12-31 | $438,405 |
Employer contributions (assets) at beginning of year | 2018-12-31 | $326,773 |
Contract administrator fees | 2018-12-31 | $167,519 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2018-12-31 | No |
Liabilities. Value of benefit claims payable at end of year | 2018-12-31 | $68,585 |
Liabilities. Value of benefit claims payable at beginning of year | 2018-12-31 | $33,075 |
Did the plan have assets held for investment | 2018-12-31 | No |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Unqualified |
Accountancy firm name | 2018-12-31 | CLIFTONLARSONALLEN LLP |
Accountancy firm EIN | 2018-12-31 | 410746749 |
2017 : THUNDER RIDGE TRANSPORT, INC. HEALTH & WELFARE PLAN 2017 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2017-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $162,240 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $136,096 |
Total income from all sources (including contributions) | 2017-12-31 | $1,214,994 |
Total loss/gain on sale of assets | 2017-12-31 | $0 |
Total of all expenses incurred | 2017-12-31 | $1,209,203 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $955,528 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $1,214,994 |
Value of total assets at end of year | 2017-12-31 | $334,544 |
Value of total assets at beginning of year | 2017-12-31 | $302,609 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $253,675 |
Total interest from all sources | 2017-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2017-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-12-31 | No |
Administrative expenses professional fees incurred | 2017-12-31 | $14,125 |
Was this plan covered by a fidelity bond | 2017-12-31 | Yes |
Value of fidelity bond cover | 2017-12-31 | $200,000 |
If this is an individual account plan, was there a blackout period | 2017-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2017-12-31 | $13,821 |
Administrative expenses (other) incurred | 2017-12-31 | $72,659 |
Liabilities. Value of operating payables at end of year | 2017-12-31 | $129,165 |
Liabilities. Value of operating payables at beginning of year | 2017-12-31 | $112,477 |
Total non interest bearing cash at end of year | 2017-12-31 | $7,771 |
Total non interest bearing cash at beginning of year | 2017-12-31 | $167,249 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
Value of net income/loss | 2017-12-31 | $5,791 |
Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $172,304 |
Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $166,513 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $941,707 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2017-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
Contributions received in cash from employer | 2017-12-31 | $1,214,994 |
Employer contributions (assets) at end of year | 2017-12-31 | $326,773 |
Employer contributions (assets) at beginning of year | 2017-12-31 | $135,360 |
Contract administrator fees | 2017-12-31 | $166,891 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2017-12-31 | No |
Liabilities. Value of benefit claims payable at end of year | 2017-12-31 | $33,075 |
Liabilities. Value of benefit claims payable at beginning of year | 2017-12-31 | $23,619 |
Did the plan have assets held for investment | 2017-12-31 | No |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Unqualified |
Accountancy firm name | 2017-12-31 | CLIFTONLARSONALLEN LLP |
Accountancy firm EIN | 2017-12-31 | 410746749 |
2016 : THUNDER RIDGE TRANSPORT, INC. HEALTH & WELFARE PLAN 2016 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2016-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $136,096 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $220,905 |
Total income from all sources (including contributions) | 2016-12-31 | $1,036,808 |
Total loss/gain on sale of assets | 2016-12-31 | $0 |
Total of all expenses incurred | 2016-12-31 | $1,032,448 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $816,471 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $1,036,808 |
Value of total assets at end of year | 2016-12-31 | $302,609 |
Value of total assets at beginning of year | 2016-12-31 | $383,058 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $215,977 |
Total interest from all sources | 2016-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2016-12-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
Was this plan covered by a fidelity bond | 2016-12-31 | Yes |
Value of fidelity bond cover | 2016-12-31 | $20,000 |
If this is an individual account plan, was there a blackout period | 2016-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
Income. Received or receivable in cash from other sources (including rollovers) | 2016-12-31 | $685 |
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2016-12-31 | $8,887 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-12-31 | $0 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-12-31 | $83,295 |
Administrative expenses (other) incurred | 2016-12-31 | $57,373 |
Liabilities. Value of operating payables at end of year | 2016-12-31 | $112,477 |
Liabilities. Value of operating payables at beginning of year | 2016-12-31 | $220,336 |
Total non interest bearing cash at end of year | 2016-12-31 | $167,249 |
Total non interest bearing cash at beginning of year | 2016-12-31 | $182,686 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
Value of net income/loss | 2016-12-31 | $4,360 |
Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $166,513 |
Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $162,153 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $807,584 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
Contributions received in cash from employer | 2016-12-31 | $1,036,123 |
Employer contributions (assets) at end of year | 2016-12-31 | $135,360 |
Employer contributions (assets) at beginning of year | 2016-12-31 | $117,077 |
Contract administrator fees | 2016-12-31 | $158,604 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2016-12-31 | No |
Liabilities. Value of benefit claims payable at end of year | 2016-12-31 | $23,619 |
Liabilities. Value of benefit claims payable at beginning of year | 2016-12-31 | $569 |
Did the plan have assets held for investment | 2016-12-31 | No |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Unqualified |
Accountancy firm name | 2016-12-31 | CLIFTONLARSONALLEN LLP |
Accountancy firm EIN | 2016-12-31 | 410746749 |
2009 : THUNDER RIDGE TRANSPORT, INC. HEALTH & WELFARE PLAN 2009 401k financial data |
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Total plan liabilities at end of year | 2009-09-30 | $0 |
Total plan liabilities at beginning of year | 2009-09-30 | $0 |
Total income from all sources | 2009-09-30 | $211,658 |
Expenses. Total of all expenses incurred | 2009-09-30 | $183,367 |
Benefits paid (including direct rollovers) | 2009-09-30 | $124,891 |
Total plan assets at end of year | 2009-09-30 | $28,291 |
Total plan assets at beginning of year | 2009-09-30 | $0 |
Net income (gross income less expenses) | 2009-09-30 | $28,291 |
Net plan assets at end of year (total assets less liabilities) | 2009-09-30 | $28,291 |
Net plan assets at beginning of year (total assets less liabilities) | 2009-09-30 | $0 |
Total contributions received or receivable from employer(s) | 2009-09-30 | $211,658 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2009-09-30 | $58,476 |
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 743756 |
Policy instance | 5 |
Insurance contract or identification number | 743756 | Number of Individuals Covered | 0 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $6,143 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $197,178 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,143 | Insurance broker organization code? | 3 |
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EYE MED VISION CARE (National Association of Insurance Commissioners NAIC id number: 98512 ) |
Policy contract number | CL VIS TRT 2 |
Policy instance | 4 |
Insurance contract or identification number | CL VIS TRT 2 | Number of Individuals Covered | 22 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $122 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $4,890 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $122 | Insurance broker organization code? | 3 |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | VAR 681675 |
Policy instance | 3 |
Insurance contract or identification number | VAR 681675 | Number of Individuals Covered | 251 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $147 | Total amount of fees paid to insurance company | USD $223 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,471 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $147 | Amount paid for insurance broker fees | 223 | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER SERVICE RELATED CONTRACT FEES | Insurance broker organization code? | 3 |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | GL 681427 |
Policy instance | 2 |
Insurance contract or identification number | GL 681427 | Number of Individuals Covered | 253 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $891 | Total amount of fees paid to insurance company | USD $1,354 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $8,909 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $891 | Amount paid for insurance broker fees | 1354 | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER SERVICE RELATED CONTRACT FEES | Insurance broker organization code? | 3 |
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COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | CLLMBTRT9 |
Policy instance | 1 |
Insurance contract or identification number | CLLMBTRT9 | Number of Individuals Covered | 32 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $3,454 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $41,817 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,454 | Insurance broker organization code? | 3 |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 11273-79 |
Policy instance | 7 |
Insurance contract or identification number | 11273-79 | Number of Individuals Covered | 80 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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UNITED BEHAVIORAL HEALTH DBA OPTUM (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 1395871 |
Policy instance | 6 |
Insurance contract or identification number | 1395871 | Number of Individuals Covered | 249 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $4,114 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 743756 |
Policy instance | 5 |
Insurance contract or identification number | 743756 | Number of Individuals Covered | 176 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $47,547 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,515,113 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $47,547 | Insurance broker organization code? | 5 |
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EYE MED VISION CARE (National Association of Insurance Commissioners NAIC id number: 98512 ) |
Policy contract number | CL VIS TRP 1 |
Policy instance | 4 |
Insurance contract or identification number | CL VIS TRP 1 | Number of Individuals Covered | 615 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $533 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $21,301 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $533 | Insurance broker organization code? | 3 |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | VAR 681675 |
Policy instance | 3 |
Insurance contract or identification number | VAR 681675 | Number of Individuals Covered | 247 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $308 | Total amount of fees paid to insurance company | USD $371 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $3,077 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $308 | Amount paid for insurance broker fees | 371 | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER SERVICE RELATED CONTRACT FEES | Insurance broker organization code? | 3 |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | GL 681427 |
Policy instance | 2 |
Insurance contract or identification number | GL 681427 | Number of Individuals Covered | 247 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $1,870 | Total amount of fees paid to insurance company | USD $2,253 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $18,704 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,870 | Amount paid for insurance broker fees | 2253 | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER SERVICE RELATED CONTRACT FEES | Insurance broker organization code? | 3 |
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COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | CLLMBTRP1 |
Policy instance | 1 |
Insurance contract or identification number | CLLMBTRP1 | Number of Individuals Covered | 615 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $183,388 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 743756 |
Policy instance | 5 |
Insurance contract or identification number | 743756 | Number of Individuals Covered | 27 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $27,041 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $915,000 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $27,041 | Insurance broker organization code? | 5 |
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EYE MED VISION CARE (National Association of Insurance Commissioners NAIC id number: 98512 ) |
Policy contract number | CLLMBTRT7 |
Policy instance | 4 |
Insurance contract or identification number | CLLMBTRT7 | Number of Individuals Covered | 252 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $355 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $14,213 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $355 | Insurance broker organization code? | 3 |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | VAR 681675 |
Policy instance | 3 |
Insurance contract or identification number | VAR 681675 | Number of Individuals Covered | 186 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $162 | Total amount of fees paid to insurance company | USD $221 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,622 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $162 | Amount paid for insurance broker fees | 221 | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER SERVICE RELATED CONTRACT FEES | Insurance broker organization code? | 3 |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | GL 681427 |
Policy instance | 2 |
Insurance contract or identification number | GL 681427 | Number of Individuals Covered | 186 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $978 | Total amount of fees paid to insurance company | USD $1,328 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $9,775 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $978 | Amount paid for insurance broker fees | 1328 | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER SERVICE RELATED CONTRACT FEES | Insurance broker organization code? | 3 |
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COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | CLL MBT RT7 |
Policy instance | 1 |
Insurance contract or identification number | CLL MBT RT7 | Number of Individuals Covered | 252 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $503 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $121,531 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $503 | Insurance broker organization code? | 3 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 743756 |
Policy instance | 5 |
Insurance contract or identification number | 743756 | Number of Individuals Covered | 150 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $22,923 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $764,092 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $22,923 | Insurance broker organization code? | 5 | Insurance broker name | FCE BENEFIT ADMINISTRATORS, INC. |
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MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: N/A ) |
Policy contract number | FCE0-001 |
Policy instance | 4 |
Insurance contract or identification number | FCE0-001 | Number of Individuals Covered | 185 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $2,230 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | VAR 681675 |
Policy instance | 3 |
Insurance contract or identification number | VAR 681675 | Number of Individuals Covered | 168 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $210 | Total amount of fees paid to insurance company | USD $267 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $2,105 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $210 | Amount paid for insurance broker fees | 267 | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER SERVICE RELATED CONTRACT FEES | Insurance broker organization code? | 3 | Insurance broker name | FCE BENEFIT ADMINISTRATORS INC |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | GL 681427 |
Policy instance | 2 |
Insurance contract or identification number | GL 681427 | Number of Individuals Covered | 168 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,263 | Total amount of fees paid to insurance company | USD $1,613 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $12,628 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,263 | Amount paid for insurance broker fees | 1613 | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER SERVICE RELATED CONTRACT FEES | Insurance broker organization code? | 3 | Insurance broker name | FCE BENEFIT ADMINISTRATORS INC |
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COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | CLL MBT RT3 |
Policy instance | 1 |
Insurance contract or identification number | CLL MBT RT3 | Number of Individuals Covered | 82 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $157,274 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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