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NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 401k Plan overview

Plan NameNFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN
Plan identification number 511

NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

KSA INDUSTRIES, INC/TENNESSEE FOOTBALL, INC. has sponsored the creation of one or more 401k plans.

Company Name:KSA INDUSTRIES, INC/TENNESSEE FOOTBALL, INC.
Employer identification number (EIN):760507392
NAIC Classification:711210
NAIC Description: Spectator Sports

Additional information about KSA INDUSTRIES, INC/TENNESSEE FOOTBALL, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2010-03-23
Company Identification Number: 0801247077
Legal Registered Office Address: 17 S BRIAR HOLLOW LN STE 400

HOUSTON
United States of America (USA)
77027

More information about KSA INDUSTRIES, INC/TENNESSEE FOOTBALL, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5112022-04-01
5112021-04-01
5112020-04-01
5112019-04-01
5112018-04-01
5112017-04-01JENNEEN KAUFMAN
5112016-04-01JENNEEN KAUFMAN
5112015-04-01JENNEEN KAUFMAN
5112015-04-01JENNEEN KAUFMAN
5112014-04-01SHANNON MCPETERS
5112014-04-01JENNEEN KAUFMAN
5112013-04-01RICK ABSHIRE
5112012-04-01RICK ABSHIRE
5112011-04-01WILLIAM SCOFIELD
5112009-04-01WILLIAM SCOFIELD WILLIAM SCOFIELD2011-01-13
5112009-04-01 WILLIAM SCOFIELD2011-01-13

Plan Statistics for NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN

401k plan membership statisitcs for NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN

Measure Date Value
2022: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-04-01244
Total number of active participants reported on line 7a of the Form 55002022-04-01246
Number of retired or separated participants receiving benefits2022-04-0114
Number of other retired or separated participants entitled to future benefits2022-04-010
Total of all active and inactive participants2022-04-01260
2021: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-04-01222
Total number of active participants reported on line 7a of the Form 55002021-04-01225
Number of retired or separated participants receiving benefits2021-04-0118
Number of other retired or separated participants entitled to future benefits2021-04-010
Total of all active and inactive participants2021-04-01243
2020: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-04-01215
Total number of active participants reported on line 7a of the Form 55002020-04-01203
Number of retired or separated participants receiving benefits2020-04-0114
Number of other retired or separated participants entitled to future benefits2020-04-010
Total of all active and inactive participants2020-04-01217
2019: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-04-01201
Total number of active participants reported on line 7a of the Form 55002019-04-01197
Number of retired or separated participants receiving benefits2019-04-0116
Number of other retired or separated participants entitled to future benefits2019-04-010
Total of all active and inactive participants2019-04-01213
2018: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-04-01197
Total number of active participants reported on line 7a of the Form 55002018-04-01183
Number of retired or separated participants receiving benefits2018-04-0116
Number of other retired or separated participants entitled to future benefits2018-04-010
Total of all active and inactive participants2018-04-01199
2017: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-04-01179
Total number of active participants reported on line 7a of the Form 55002017-04-01177
Number of retired or separated participants receiving benefits2017-04-0120
Number of other retired or separated participants entitled to future benefits2017-04-010
Total of all active and inactive participants2017-04-01197
2016: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-04-01164
Total number of active participants reported on line 7a of the Form 55002016-04-01163
Number of retired or separated participants receiving benefits2016-04-0118
Number of other retired or separated participants entitled to future benefits2016-04-010
Total of all active and inactive participants2016-04-01181
2015: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-04-01140
Total number of active participants reported on line 7a of the Form 55002015-04-01146
Number of retired or separated participants receiving benefits2015-04-0118
Number of other retired or separated participants entitled to future benefits2015-04-010
Total of all active and inactive participants2015-04-01164
2014: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-04-01138
Total number of active participants reported on line 7a of the Form 55002014-04-01124
Number of retired or separated participants receiving benefits2014-04-0110
Total of all active and inactive participants2014-04-01134
Number of other retired or separated participants entitled to future benefits2014-04-010
2013: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-04-01120
Total number of active participants reported on line 7a of the Form 55002013-04-01126
Number of retired or separated participants receiving benefits2013-04-0113
Total of all active and inactive participants2013-04-01139
2012: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-04-01120
Total number of active participants reported on line 7a of the Form 55002012-04-01112
Number of retired or separated participants receiving benefits2012-04-018
Number of other retired or separated participants entitled to future benefits2012-04-010
Total of all active and inactive participants2012-04-01120
2011: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-04-01126
Total number of active participants reported on line 7a of the Form 55002011-04-01111
Number of retired or separated participants receiving benefits2011-04-015
Number of other retired or separated participants entitled to future benefits2011-04-014
Total of all active and inactive participants2011-04-01120
2009: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year2009-04-01118
Total number of active participants reported on line 7a of the Form 55002009-04-01116
Number of retired or separated participants receiving benefits2009-04-013
Number of other retired or separated participants entitled to future benefits2009-04-012
Total of all active and inactive participants2009-04-01121

Financial Data on NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN

Measure Date Value
2023 : NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-03-31$320,303
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-03-31$87,637
Total income from all sources (including contributions)2023-03-31$3,625,545
Total loss/gain on sale of assets2023-03-31$0
Total of all expenses incurred2023-03-31$3,392,524
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-03-31$3,258,070
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-03-31$3,622,654
Value of total assets at end of year2023-03-31$643,680
Value of total assets at beginning of year2023-03-31$177,993
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-03-31$134,454
Total interest from all sources2023-03-31$2,891
Total dividends received (eg from common stock, registered investment company shares)2023-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-03-31No
Administrative expenses professional fees incurred2023-03-31$75,022
Was this plan covered by a fidelity bond2023-03-31Yes
Value of fidelity bond cover2023-03-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2023-03-31No
Contributions received from participants2023-03-31$824,298
Liabilities. Value of operating payables at end of year2023-03-31$320,303
Liabilities. Value of operating payables at beginning of year2023-03-31$87,637
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-03-31No
Value of net income/loss2023-03-31$233,021
Value of net assets at end of year (total assets less liabilities)2023-03-31$323,377
Value of net assets at beginning of year (total assets less liabilities)2023-03-31$90,356
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-03-31No
Were any leases to which the plan was party in default or uncollectible2023-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2023-03-31$323,377
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2023-03-31$90,356
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2023-03-31$2,891
Expenses. Payments to insurance carriers foe the provision of benefits2023-03-31$1,023,502
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-03-31Yes
Was there a failure to transmit to the plan any participant contributions2023-03-31No
Has the plan failed to provide any benefit when due under the plan2023-03-31No
Contributions received in cash from employer2023-03-31$2,798,356
Employer contributions (assets) at end of year2023-03-31$320,303
Employer contributions (assets) at beginning of year2023-03-31$87,637
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-03-31$2,234,568
Contract administrator fees2023-03-31$59,432
Did the plan have assets held for investment2023-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-03-31No
Opinion of an independent qualified public accountant for this plan2023-03-31Unqualified
Accountancy firm name2023-03-31ABRAMS FOSTER NOLE & WILLIAMS PA
Accountancy firm EIN2023-03-31521854049
2022 : NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-03-31$87,637
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-03-31$11,225
Total income from all sources (including contributions)2022-03-31$3,063,844
Total loss/gain on sale of assets2022-03-31$0
Total of all expenses incurred2022-03-31$2,987,385
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-03-31$2,862,648
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-03-31$3,063,822
Value of total assets at end of year2022-03-31$177,993
Value of total assets at beginning of year2022-03-31$25,122
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-03-31$124,737
Total interest from all sources2022-03-31$22
Total dividends received (eg from common stock, registered investment company shares)2022-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-03-31No
Administrative expenses professional fees incurred2022-03-31$71,670
Was this plan covered by a fidelity bond2022-03-31Yes
Value of fidelity bond cover2022-03-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2022-03-31No
Contributions received from participants2022-03-31$778,159
Liabilities. Value of operating payables at end of year2022-03-31$87,637
Liabilities. Value of operating payables at beginning of year2022-03-31$11,225
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-03-31No
Value of net income/loss2022-03-31$76,459
Value of net assets at end of year (total assets less liabilities)2022-03-31$90,356
Value of net assets at beginning of year (total assets less liabilities)2022-03-31$13,897
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-03-31No
Were any leases to which the plan was party in default or uncollectible2022-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-03-31$90,356
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-03-31$13,897
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-03-31$22
Expenses. Payments to insurance carriers foe the provision of benefits2022-03-31$819,973
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-03-31Yes
Was there a failure to transmit to the plan any participant contributions2022-03-31No
Has the plan failed to provide any benefit when due under the plan2022-03-31No
Contributions received in cash from employer2022-03-31$2,285,663
Employer contributions (assets) at end of year2022-03-31$87,637
Employer contributions (assets) at beginning of year2022-03-31$11,225
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-03-31$2,042,675
Contract administrator fees2022-03-31$53,067
Did the plan have assets held for investment2022-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-03-31No
Opinion of an independent qualified public accountant for this plan2022-03-31Unqualified
Accountancy firm name2022-03-31ABRAMS FOSTER NOLE & WILLIAMS PA
Accountancy firm EIN2022-03-31521854049
2021 : NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-03-31$11,225
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-03-31$64,638
Total income from all sources (including contributions)2021-03-31$2,826,871
Total loss/gain on sale of assets2021-03-31$0
Total of all expenses incurred2021-03-31$2,879,446
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-03-31$2,763,241
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-03-31$2,826,824
Value of total assets at end of year2021-03-31$25,122
Value of total assets at beginning of year2021-03-31$131,110
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-03-31$116,205
Total interest from all sources2021-03-31$47
Total dividends received (eg from common stock, registered investment company shares)2021-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-03-31No
Was this plan covered by a fidelity bond2021-03-31Yes
Value of fidelity bond cover2021-03-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2021-03-31No
Contributions received from participants2021-03-31$568,085
Administrative expenses (other) incurred2021-03-31$116,205
Liabilities. Value of operating payables at end of year2021-03-31$11,225
Liabilities. Value of operating payables at beginning of year2021-03-31$64,638
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-03-31No
Value of net income/loss2021-03-31$-52,575
Value of net assets at end of year (total assets less liabilities)2021-03-31$13,897
Value of net assets at beginning of year (total assets less liabilities)2021-03-31$66,472
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-03-31No
Were any leases to which the plan was party in default or uncollectible2021-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-03-31$13,897
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-03-31$66,472
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-03-31$47
Expenses. Payments to insurance carriers foe the provision of benefits2021-03-31$867,396
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-03-31Yes
Was there a failure to transmit to the plan any participant contributions2021-03-31No
Has the plan failed to provide any benefit when due under the plan2021-03-31No
Contributions received in cash from employer2021-03-31$2,258,739
Employer contributions (assets) at end of year2021-03-31$11,225
Employer contributions (assets) at beginning of year2021-03-31$64,638
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-03-31$1,895,845
Did the plan have assets held for investment2021-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-03-31No
Opinion of an independent qualified public accountant for this plan2021-03-31Unqualified
Accountancy firm name2021-03-31ABRAMS FOSTER NOLE & WILLIAMS PA
Accountancy firm EIN2021-03-31521854049
2020 : NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-03-31$0
Total unrealized appreciation/depreciation of assets2020-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-03-31$64,638
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-03-31$64,638
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-03-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-03-31$0
Total income from all sources (including contributions)2020-03-31$2,827,841
Total income from all sources (including contributions)2020-03-31$2,827,841
Total loss/gain on sale of assets2020-03-31$0
Total loss/gain on sale of assets2020-03-31$0
Total of all expenses incurred2020-03-31$2,762,397
Total of all expenses incurred2020-03-31$2,762,397
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-03-31$2,651,354
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-03-31$2,651,354
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-03-31$2,827,035
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-03-31$2,827,035
Value of total assets at end of year2020-03-31$131,110
Value of total assets at end of year2020-03-31$131,110
Value of total assets at beginning of year2020-03-31$1,028
Value of total assets at beginning of year2020-03-31$1,028
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-03-31$111,043
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-03-31$111,043
Total interest from all sources2020-03-31$806
Total interest from all sources2020-03-31$806
Total dividends received (eg from common stock, registered investment company shares)2020-03-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-03-31No
Was this plan covered by a fidelity bond2020-03-31Yes
Was this plan covered by a fidelity bond2020-03-31Yes
Value of fidelity bond cover2020-03-31$1,000,000
Value of fidelity bond cover2020-03-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2020-03-31No
Were there any nonexempt tranactions with any party-in-interest2020-03-31No
Contributions received from participants2020-03-31$517,028
Contributions received from participants2020-03-31$517,028
Administrative expenses (other) incurred2020-03-31$111,043
Administrative expenses (other) incurred2020-03-31$111,043
Liabilities. Value of operating payables at end of year2020-03-31$64,638
Liabilities. Value of operating payables at end of year2020-03-31$64,638
Liabilities. Value of operating payables at beginning of year2020-03-31$0
Liabilities. Value of operating payables at beginning of year2020-03-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-03-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-03-31No
Value of net income/loss2020-03-31$65,444
Value of net income/loss2020-03-31$65,444
Value of net assets at end of year (total assets less liabilities)2020-03-31$66,472
Value of net assets at end of year (total assets less liabilities)2020-03-31$66,472
Value of net assets at beginning of year (total assets less liabilities)2020-03-31$1,028
Value of net assets at beginning of year (total assets less liabilities)2020-03-31$1,028
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-03-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-03-31No
Were any leases to which the plan was party in default or uncollectible2020-03-31No
Were any leases to which the plan was party in default or uncollectible2020-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-03-31$66,472
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-03-31$66,472
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-03-31$1,028
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-03-31$1,028
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-03-31$806
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-03-31$806
Expenses. Payments to insurance carriers foe the provision of benefits2020-03-31$662,463
Expenses. Payments to insurance carriers foe the provision of benefits2020-03-31$662,463
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-03-31Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-03-31Yes
Was there a failure to transmit to the plan any participant contributions2020-03-31No
Was there a failure to transmit to the plan any participant contributions2020-03-31No
Has the plan failed to provide any benefit when due under the plan2020-03-31No
Has the plan failed to provide any benefit when due under the plan2020-03-31No
Contributions received in cash from employer2020-03-31$2,310,007
Contributions received in cash from employer2020-03-31$2,310,007
Employer contributions (assets) at end of year2020-03-31$64,638
Employer contributions (assets) at end of year2020-03-31$64,638
Employer contributions (assets) at beginning of year2020-03-31$0
Employer contributions (assets) at beginning of year2020-03-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-03-31$1,988,891
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-03-31$1,988,891
Did the plan have assets held for investment2020-03-31Yes
Did the plan have assets held for investment2020-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-03-31No
Opinion of an independent qualified public accountant for this plan2020-03-31Unqualified
Opinion of an independent qualified public accountant for this plan2020-03-31Unqualified
Accountancy firm name2020-03-31ABRAMS FOSTER NOLE & WILLIAMS PA
Accountancy firm name2020-03-31ABRAMS FOSTER NOLE & WILLIAMS PA
Accountancy firm EIN2020-03-31521854049
Accountancy firm EIN2020-03-31521854049
2019 : NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-03-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-03-31$57,188
Total income from all sources (including contributions)2019-03-31$2,285,474
Total loss/gain on sale of assets2019-03-31$0
Total of all expenses incurred2019-03-31$2,284,725
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-03-31$2,179,082
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-03-31$2,284,725
Value of total assets at end of year2019-03-31$1,028
Value of total assets at beginning of year2019-03-31$57,467
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-03-31$105,643
Total interest from all sources2019-03-31$749
Total dividends received (eg from common stock, registered investment company shares)2019-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-03-31No
Was this plan covered by a fidelity bond2019-03-31Yes
Value of fidelity bond cover2019-03-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2019-03-31No
Contributions received from participants2019-03-31$513,944
Administrative expenses (other) incurred2019-03-31$105,643
Liabilities. Value of operating payables at end of year2019-03-31$0
Liabilities. Value of operating payables at beginning of year2019-03-31$57,188
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-03-31No
Value of net income/loss2019-03-31$749
Value of net assets at end of year (total assets less liabilities)2019-03-31$1,028
Value of net assets at beginning of year (total assets less liabilities)2019-03-31$279
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-03-31No
Were any leases to which the plan was party in default or uncollectible2019-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-03-31$1,028
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-03-31$57,467
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-03-31$749
Expenses. Payments to insurance carriers foe the provision of benefits2019-03-31$763,448
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-03-31Yes
Was there a failure to transmit to the plan any participant contributions2019-03-31No
Has the plan failed to provide any benefit when due under the plan2019-03-31No
Contributions received in cash from employer2019-03-31$1,770,781
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-03-31$1,415,634
Did the plan have assets held for investment2019-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-03-31No
Opinion of an independent qualified public accountant for this plan2019-03-31Unqualified
Accountancy firm name2019-03-31ABRAMS FOSTER NOLE & WILLIAMS PA
Accountancy firm EIN2019-03-31521854049
2018 : NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-03-31$57,188
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-03-31$0
Total income from all sources (including contributions)2018-03-31$2,123,457
Total loss/gain on sale of assets2018-03-31$0
Total of all expenses incurred2018-03-31$2,154,015
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-03-31$2,053,997
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-03-31$2,122,970
Value of total assets at end of year2018-03-31$57,467
Value of total assets at beginning of year2018-03-31$30,837
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-03-31$100,018
Total interest from all sources2018-03-31$487
Total dividends received (eg from common stock, registered investment company shares)2018-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-03-31No
Was this plan covered by a fidelity bond2018-03-31Yes
Value of fidelity bond cover2018-03-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2018-03-31No
Contributions received from participants2018-03-31$392,820
Administrative expenses (other) incurred2018-03-31$100,018
Liabilities. Value of operating payables at end of year2018-03-31$57,188
Liabilities. Value of operating payables at beginning of year2018-03-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-03-31No
Value of net income/loss2018-03-31$-30,558
Value of net assets at end of year (total assets less liabilities)2018-03-31$279
Value of net assets at beginning of year (total assets less liabilities)2018-03-31$30,837
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-03-31No
Were any leases to which the plan was party in default or uncollectible2018-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-03-31$57,467
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-03-31$30,837
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-03-31$487
Expenses. Payments to insurance carriers foe the provision of benefits2018-03-31$565,149
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-03-31Yes
Was there a failure to transmit to the plan any participant contributions2018-03-31No
Has the plan failed to provide any benefit when due under the plan2018-03-31No
Contributions received in cash from employer2018-03-31$1,730,150
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-03-31$1,488,848
Did the plan have assets held for investment2018-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-03-31No
Opinion of an independent qualified public accountant for this plan2018-03-31Unqualified
Accountancy firm name2018-03-31ABRAMS FOSTER NOLE & WILLIAMS PA
Accountancy firm EIN2018-03-31521854049
2017 : NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-03-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-03-31$0
Total income from all sources (including contributions)2017-03-31$2,021,985
Total loss/gain on sale of assets2017-03-31$0
Total of all expenses incurred2017-03-31$2,021,833
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-03-31$1,927,253
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-03-31$2,021,834
Value of total assets at end of year2017-03-31$30,837
Value of total assets at beginning of year2017-03-31$30,685
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-03-31$94,580
Total interest from all sources2017-03-31$151
Total dividends received (eg from common stock, registered investment company shares)2017-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-03-31No
Was this plan covered by a fidelity bond2017-03-31Yes
Value of fidelity bond cover2017-03-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2017-03-31No
Contributions received from participants2017-03-31$427,773
Administrative expenses (other) incurred2017-03-31$94,580
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-03-31No
Value of net income/loss2017-03-31$152
Value of net assets at end of year (total assets less liabilities)2017-03-31$30,837
Value of net assets at beginning of year (total assets less liabilities)2017-03-31$30,685
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-03-31No
Were any leases to which the plan was party in default or uncollectible2017-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-03-31$30,837
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-03-31$30,685
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-03-31$151
Expenses. Payments to insurance carriers foe the provision of benefits2017-03-31$611,723
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-03-31Yes
Was there a failure to transmit to the plan any participant contributions2017-03-31No
Has the plan failed to provide any benefit when due under the plan2017-03-31No
Contributions received in cash from employer2017-03-31$1,594,061
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-03-31$1,315,530
Did the plan have assets held for investment2017-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-03-31No
Opinion of an independent qualified public accountant for this plan2017-03-31Unqualified
Accountancy firm name2017-03-31ABRAMS FOSTER NOLE & WILLIAMS PA
Accountancy firm EIN2017-03-31521854049
2016 : NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-03-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-03-31$0
Total income from all sources (including contributions)2016-03-31$2,039,494
Total loss/gain on sale of assets2016-03-31$0
Total of all expenses incurred2016-03-31$2,039,472
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-03-31$1,956,747
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-03-31$2,039,472
Value of total assets at end of year2016-03-31$30,685
Value of total assets at beginning of year2016-03-31$30,663
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-03-31$82,725
Total interest from all sources2016-03-31$22
Total dividends received (eg from common stock, registered investment company shares)2016-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-03-31No
Was this plan covered by a fidelity bond2016-03-31Yes
Value of fidelity bond cover2016-03-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2016-03-31No
Contributions received from participants2016-03-31$377,207
Administrative expenses (other) incurred2016-03-31$82,725
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-03-31No
Value of net income/loss2016-03-31$22
Value of net assets at end of year (total assets less liabilities)2016-03-31$30,685
Value of net assets at beginning of year (total assets less liabilities)2016-03-31$30,663
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-03-31No
Were any leases to which the plan was party in default or uncollectible2016-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-03-31$30,685
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-03-31$24,663
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-03-31$22
Expenses. Payments to insurance carriers foe the provision of benefits2016-03-31$251,843
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-03-31Yes
Was there a failure to transmit to the plan any participant contributions2016-03-31No
Has the plan failed to provide any benefit when due under the plan2016-03-31No
Contributions received in cash from employer2016-03-31$1,662,265
Employer contributions (assets) at end of year2016-03-31$0
Employer contributions (assets) at beginning of year2016-03-31$6,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-03-31$1,704,904
Did the plan have assets held for investment2016-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-03-31No
Opinion of an independent qualified public accountant for this plan2016-03-31Unqualified
Accountancy firm name2016-03-31ABRAMS FOSTER NOLE & WILLIAMS PA
Accountancy firm EIN2016-03-31521854049
2015 : NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-03-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-03-31$0
Total income from all sources (including contributions)2015-03-31$2,184,546
Total loss/gain on sale of assets2015-03-31$0
Total of all expenses incurred2015-03-31$2,184,532
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-03-31$2,106,944
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-03-31$2,184,532
Value of total assets at end of year2015-03-31$30,663
Value of total assets at beginning of year2015-03-31$30,649
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-03-31$77,588
Total interest from all sources2015-03-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-03-31No
Administrative expenses professional fees incurred2015-03-31$77,588
Was this plan covered by a fidelity bond2015-03-31Yes
Value of fidelity bond cover2015-03-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2015-03-31No
Contributions received from participants2015-03-31$377,686
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-03-31No
Value of net income/loss2015-03-31$14
Value of net assets at end of year (total assets less liabilities)2015-03-31$30,663
Value of net assets at beginning of year (total assets less liabilities)2015-03-31$30,649
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-03-31No
Were any leases to which the plan was party in default or uncollectible2015-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-03-31$24,663
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-03-31$30,649
Expenses. Payments to insurance carriers foe the provision of benefits2015-03-31$187,676
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-03-31$14
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-03-31Yes
Was there a failure to transmit to the plan any participant contributions2015-03-31No
Has the plan failed to provide any benefit when due under the plan2015-03-31No
Contributions received in cash from employer2015-03-31$1,806,846
Employer contributions (assets) at end of year2015-03-31$6,000
Employer contributions (assets) at beginning of year2015-03-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-03-31$1,919,268
Did the plan have assets held for investment2015-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-03-31No
Opinion of an independent qualified public accountant for this plan2015-03-31Unqualified
Accountancy firm name2015-03-31ABRAMS FOSTER NOLE & WILLIAMS PA
Accountancy firm EIN2015-03-31521854049
2014 : NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-03-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-03-31$46,988
Total income from all sources (including contributions)2014-03-31$2,634,256
Total loss/gain on sale of assets2014-03-31$0
Total of all expenses incurred2014-03-31$2,619,051
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-03-31$2,545,688
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-03-31$2,634,251
Value of total assets at end of year2014-03-31$30,649
Value of total assets at beginning of year2014-03-31$62,432
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-03-31$73,363
Total interest from all sources2014-03-31$0
Total dividends received (eg from common stock, registered investment company shares)2014-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-03-31No
Administrative expenses professional fees incurred2014-03-31$73,363
Was this plan covered by a fidelity bond2014-03-31Yes
Value of fidelity bond cover2014-03-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2014-03-31No
Contributions received from participants2014-03-31$295,957
Liabilities. Value of operating payables at beginning of year2014-03-31$46,988
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-03-31No
Value of net income/loss2014-03-31$15,205
Value of net assets at end of year (total assets less liabilities)2014-03-31$30,649
Value of net assets at beginning of year (total assets less liabilities)2014-03-31$15,444
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-03-31No
Were any leases to which the plan was party in default or uncollectible2014-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-03-31$30,649
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-03-31$62,432
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-03-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-03-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2014-03-31$515,555
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-03-31$5
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-03-31Yes
Was there a failure to transmit to the plan any participant contributions2014-03-31No
Has the plan failed to provide any benefit when due under the plan2014-03-31No
Contributions received in cash from employer2014-03-31$2,338,294
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-03-31$2,030,133
Did the plan have assets held for investment2014-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-03-31No
Opinion of an independent qualified public accountant for this plan2014-03-31Unqualified
Accountancy firm name2014-03-31ABRAMS FOSTER NOLE & WILLIAMS PA
Accountancy firm EIN2014-03-31521854049
2013 : NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-03-31$46,988
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-03-31$40,139
Total income from all sources (including contributions)2013-03-31$2,185,523
Total loss/gain on sale of assets2013-03-31$0
Total of all expenses incurred2013-03-31$2,185,518
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-03-31$2,124,600
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-03-31$2,185,518
Value of total assets at end of year2013-03-31$62,432
Value of total assets at beginning of year2013-03-31$55,578
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-03-31$60,918
Total interest from all sources2013-03-31$0
Total dividends received (eg from common stock, registered investment company shares)2013-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-03-31No
Administrative expenses professional fees incurred2013-03-31$60,218
Was this plan covered by a fidelity bond2013-03-31Yes
Value of fidelity bond cover2013-03-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2013-03-31No
Contributions received from participants2013-03-31$258,530
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-03-31$1
Administrative expenses (other) incurred2013-03-31$700
Liabilities. Value of operating payables at end of year2013-03-31$46,988
Liabilities. Value of operating payables at beginning of year2013-03-31$40,139
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-03-31No
Value of net income/loss2013-03-31$5
Value of net assets at end of year (total assets less liabilities)2013-03-31$15,444
Value of net assets at beginning of year (total assets less liabilities)2013-03-31$15,439
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-03-31No
Were any leases to which the plan was party in default or uncollectible2013-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-03-31$62,432
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-03-31$55,577
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-03-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-03-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2013-03-31$414,979
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-03-31$5
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-03-31Yes
Was there a failure to transmit to the plan any participant contributions2013-03-31No
Has the plan failed to provide any benefit when due under the plan2013-03-31No
Contributions received in cash from employer2013-03-31$1,926,988
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-03-31$1,709,621
Did the plan have assets held for investment2013-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-03-31No
Opinion of an independent qualified public accountant for this plan2013-03-31Unqualified
Accountancy firm name2013-03-31ABRAMS, FORSTER, NOLE & WILLIAMS PA
Accountancy firm EIN2013-03-31521854049
2012 : NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-03-31$40,139
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-03-31$0
Total income from all sources (including contributions)2012-03-31$2,103,906
Total loss/gain on sale of assets2012-03-31$0
Total of all expenses incurred2012-03-31$2,103,896
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-03-31$2,044,861
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-03-31$2,103,896
Value of total assets at end of year2012-03-31$55,578
Value of total assets at beginning of year2012-03-31$15,429
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-03-31$59,035
Total interest from all sources2012-03-31$0
Total dividends received (eg from common stock, registered investment company shares)2012-03-31$10
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-03-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-03-31$10
Administrative expenses professional fees incurred2012-03-31$5,950
Was this plan covered by a fidelity bond2012-03-31Yes
Value of fidelity bond cover2012-03-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2012-03-31No
Contributions received from participants2012-03-31$257,792
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-03-31$1
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-03-31$2
Liabilities. Value of operating payables at end of year2012-03-31$40,139
Liabilities. Value of operating payables at beginning of year2012-03-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-03-31No
Value of net income/loss2012-03-31$10
Value of net assets at end of year (total assets less liabilities)2012-03-31$15,439
Value of net assets at beginning of year (total assets less liabilities)2012-03-31$15,429
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-03-31No
Were any leases to which the plan was party in default or uncollectible2012-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-03-31$55,577
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-03-31$15,427
Expenses. Payments to insurance carriers foe the provision of benefits2012-03-31$196,407
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-03-31Yes
Was there a failure to transmit to the plan any participant contributions2012-03-31No
Has the plan failed to provide any benefit when due under the plan2012-03-31No
Contributions received in cash from employer2012-03-31$1,846,104
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-03-31$1,848,454
Contract administrator fees2012-03-31$53,085
Did the plan have assets held for investment2012-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-03-31No
Opinion of an independent qualified public accountant for this plan2012-03-31Unqualified
Accountancy firm name2012-03-31ABRAMS,FOSTER,NOLE & WILLIAMS PA
Accountancy firm EIN2012-03-31521854049
2011 : NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-03-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-03-31$36,805
Total income from all sources (including contributions)2011-03-31$1,360,641
Total loss/gain on sale of assets2011-03-31$0
Total of all expenses incurred2011-03-31$1,360,620
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-03-31$1,176,309
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-03-31$1,360,620
Value of total assets at end of year2011-03-31$15,429
Value of total assets at beginning of year2011-03-31$52,213
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-03-31$184,311
Total interest from all sources2011-03-31$0
Total dividends received (eg from common stock, registered investment company shares)2011-03-31$21
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-03-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-03-31$21
Administrative expenses professional fees incurred2011-03-31$54,678
Was this plan covered by a fidelity bond2011-03-31Yes
Value of fidelity bond cover2011-03-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2011-03-31No
Contributions received from participants2011-03-31$265,296
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-03-31$2
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-03-31$2
Administrative expenses (other) incurred2011-03-31$700
Liabilities. Value of operating payables at end of year2011-03-31$0
Liabilities. Value of operating payables at beginning of year2011-03-31$36,805
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-03-31No
Value of net income/loss2011-03-31$21
Value of net assets at end of year (total assets less liabilities)2011-03-31$15,429
Value of net assets at beginning of year (total assets less liabilities)2011-03-31$15,408
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-03-31No
Were any leases to which the plan was party in default or uncollectible2011-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-03-31$15,427
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-03-31$0
Value of interest in common/collective trusts at end of year2011-03-31$0
Value of interest in common/collective trusts at beginning of year2011-03-31$52,211
Expenses. Payments to insurance carriers foe the provision of benefits2011-03-31$308,268
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-03-31Yes
Was there a failure to transmit to the plan any participant contributions2011-03-31No
Has the plan failed to provide any benefit when due under the plan2011-03-31No
Contributions received in cash from employer2011-03-31$1,095,324
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-03-31$868,041
Contract administrator fees2011-03-31$128,933
Did the plan have assets held for investment2011-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-03-31No
Opinion of an independent qualified public accountant for this plan2011-03-31Unqualified
Accountancy firm name2011-03-31ABRAMS, FOSTER, NOLE & WILLIAMS PA
Accountancy firm EIN2011-03-31521854049

Form 5500 Responses for NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN

2022: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01Submission has been amendedNo
2022-04-01This submission is the final filingNo
2022-04-01This return/report is a short plan year return/report (less than 12 months)No
2022-04-01Plan is a collectively bargained planNo
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan funding arrangement – TrustYes
2022-04-01Plan benefit arrangement – InsuranceYes
2022-04-01Plan benefit arrangement - TrustYes
2021: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Submission has been amendedNo
2021-04-01This submission is the final filingNo
2021-04-01This return/report is a short plan year return/report (less than 12 months)No
2021-04-01Plan is a collectively bargained planNo
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan funding arrangement – TrustYes
2021-04-01Plan benefit arrangement – InsuranceYes
2021-04-01Plan benefit arrangement - TrustYes
2020: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01Submission has been amendedNo
2020-04-01This submission is the final filingNo
2020-04-01This return/report is a short plan year return/report (less than 12 months)No
2020-04-01Plan is a collectively bargained planNo
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan funding arrangement – TrustYes
2020-04-01Plan benefit arrangement – InsuranceYes
2020-04-01Plan benefit arrangement - TrustYes
2019: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Submission has been amendedNo
2019-04-01This submission is the final filingNo
2019-04-01This return/report is a short plan year return/report (less than 12 months)No
2019-04-01Plan is a collectively bargained planNo
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan funding arrangement – TrustYes
2019-04-01Plan benefit arrangement – InsuranceYes
2019-04-01Plan benefit arrangement - TrustYes
2018: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Submission has been amendedNo
2018-04-01This submission is the final filingNo
2018-04-01This return/report is a short plan year return/report (less than 12 months)No
2018-04-01Plan is a collectively bargained planNo
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan funding arrangement – TrustYes
2018-04-01Plan benefit arrangement – InsuranceYes
2018-04-01Plan benefit arrangement - TrustYes
2017: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Submission has been amendedNo
2017-04-01This submission is the final filingNo
2017-04-01This return/report is a short plan year return/report (less than 12 months)No
2017-04-01Plan is a collectively bargained planNo
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan funding arrangement – TrustYes
2017-04-01Plan benefit arrangement – InsuranceYes
2017-04-01Plan benefit arrangement - TrustYes
2016: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Submission has been amendedNo
2016-04-01This submission is the final filingNo
2016-04-01This return/report is a short plan year return/report (less than 12 months)No
2016-04-01Plan is a collectively bargained planNo
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan funding arrangement – TrustYes
2016-04-01Plan benefit arrangement – InsuranceYes
2016-04-01Plan benefit arrangement - TrustYes
2015: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Submission has been amendedNo
2015-04-01This submission is the final filingNo
2015-04-01This return/report is a short plan year return/report (less than 12 months)No
2015-04-01Plan is a collectively bargained planNo
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan funding arrangement – TrustYes
2015-04-01Plan benefit arrangement – InsuranceYes
2015-04-01Plan benefit arrangement - TrustYes
2014: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Submission has been amendedYes
2014-04-01This submission is the final filingNo
2014-04-01This return/report is a short plan year return/report (less than 12 months)No
2014-04-01Plan is a collectively bargained planNo
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan funding arrangement – TrustYes
2014-04-01Plan benefit arrangement – InsuranceYes
2014-04-01Plan benefit arrangement - TrustYes
2013: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01Submission has been amendedNo
2013-04-01This submission is the final filingNo
2013-04-01This return/report is a short plan year return/report (less than 12 months)No
2013-04-01Plan is a collectively bargained planNo
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan funding arrangement – TrustYes
2013-04-01Plan benefit arrangement – InsuranceYes
2013-04-01Plan benefit arrangement - TrustYes
2012: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01Submission has been amendedNo
2012-04-01This submission is the final filingNo
2012-04-01This return/report is a short plan year return/report (less than 12 months)No
2012-04-01Plan is a collectively bargained planNo
2012-04-01Plan funding arrangement – InsuranceYes
2012-04-01Plan funding arrangement – TrustYes
2012-04-01Plan benefit arrangement – InsuranceYes
2012-04-01Plan benefit arrangement - TrustYes
2011: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2011 form 5500 responses
2011-04-01Type of plan entitySingle employer plan
2011-04-01Submission has been amendedNo
2011-04-01This submission is the final filingNo
2011-04-01This return/report is a short plan year return/report (less than 12 months)No
2011-04-01Plan is a collectively bargained planNo
2011-04-01Plan funding arrangement – InsuranceYes
2011-04-01Plan funding arrangement – TrustYes
2011-04-01Plan benefit arrangement – InsuranceYes
2011-04-01Plan benefit arrangement - TrustYes
2009: NFL EMPLOYEE RECIPROCAL FLEXIBLE BENEFITS PLAN 2009 form 5500 responses
2009-04-01Type of plan entitySingle employer plan
2009-04-01Submission has been amendedYes
2009-04-01This submission is the final filingNo
2009-04-01This return/report is a short plan year return/report (less than 12 months)No
2009-04-01Plan is a collectively bargained planNo
2009-04-01Plan funding arrangement – InsuranceYes
2009-04-01Plan funding arrangement – TrustYes
2009-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number12213969
Policy instance 4
Insurance contract or identification number12213969
Number of Individuals Covered597
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $38,793
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 3
Insurance contract or identification number376515G
Number of Individuals Covered276
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $74,421
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 2
Insurance contract or identification number376515G
Number of Individuals Covered281
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL 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 CarrierUSD $19,126
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 1
Insurance contract or identification number376515G
Number of Individuals Covered337
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $127,631
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3209364
Policy instance 5
Insurance contract or identification number3209364
Number of Individuals Covered598
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $6,655
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number12213969
Policy instance 4
Insurance contract or identification number12213969
Number of Individuals Covered560
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $36,117
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 2
Insurance contract or identification number376515G
Number of Individuals Covered243
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL 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 CarrierUSD $16,939
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 3
Insurance contract or identification number376515G
Number of Individuals Covered243
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $66,550
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3209364
Policy instance 5
Insurance contract or identification number3209364
Number of Individuals Covered561
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $352,120
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 1
Insurance contract or identification number376515G
Number of Individuals Covered298
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $113,842
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 1
Insurance contract or identification number376515G
Number of Individuals Covered269
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $98,050
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 2
Insurance contract or identification number376515G
Number of Individuals Covered215
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL 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 CarrierUSD $15,099
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 3
Insurance contract or identification number376515G
Number of Individuals Covered220
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $59,601
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number12213969
Policy instance 4
Insurance contract or identification number12213969
Number of Individuals Covered517
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $33,450
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3209364
Policy instance 5
Insurance contract or identification number3209364
Number of Individuals Covered517
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $313,177
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 1
Insurance contract or identification number376515G
Number of Individuals Covered255
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $87,310
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 2
Insurance contract or identification number376515G
Number of Individuals Covered206
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL 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 CarrierUSD $13,889
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 3
Insurance contract or identification number376515G
Number of Individuals Covered211
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $55,002
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number12213969
Policy instance 4
Insurance contract or identification number12213969
Number of Individuals Covered499
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $32,662
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3209364
Policy instance 5
Insurance contract or identification number3209364
Number of Individuals Covered499
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $256,804
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 1
Insurance contract or identification number376515G
Number of Individuals Covered232
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $72,203
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 2
Insurance contract or identification number376515G
Number of Individuals Covered185
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL 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 CarrierUSD $12,064
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376605G
Policy instance 3
Insurance contract or identification number376605G
Number of Individuals Covered189
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $47,749
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number12213969
Policy instance 4
Insurance contract or identification number12213969
Number of Individuals Covered486
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $31,020
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3209364
Policy instance 5
Insurance contract or identification number3209364
Number of Individuals Covered487
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $272,666
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376605G
Policy instance 3
Insurance contract or identification number376605G
Number of Individuals Covered183
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $46,875
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number12213969
Policy instance 4
Insurance contract or identification number12213969
Number of Individuals Covered482
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $25,534
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3209364
Policy instance 5
Insurance contract or identification number3209364
Number of Individuals Covered482
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $8,071
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number947-4648
Policy instance 6
Insurance contract or identification number947-4648
Number of Individuals Covered482
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $232,986
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 2
Insurance contract or identification number376515G
Number of Individuals Covered178
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL 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 CarrierUSD $11,598
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515G
Policy instance 1
Insurance contract or identification number376515G
Number of Individuals Covered219
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $69,145
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515
Policy instance 1
Insurance contract or identification number376515
Number of Individuals Covered214
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $80,313
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515
Policy instance 2
Insurance contract or identification number376515
Number of Individuals Covered149
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL 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 CarrierUSD $10,323
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376605
Policy instance 3
Insurance contract or identification number376605
Number of Individuals Covered157
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $42,385
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number12213969
Policy instance 4
Insurance contract or identification number12213969
Number of Individuals Covered424
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $22,816
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3209364
Policy instance 5
Insurance contract or identification number3209364
Number of Individuals Covered422
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $96,006
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3209364
Policy instance 5
Insurance contract or identification number3209364
Number of Individuals Covered384
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $29,222
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376605
Policy instance 3
Insurance contract or identification number376605
Number of Individuals Covered130
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $42,084
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number12213969
Policy instance 4
Insurance contract or identification number12213969
Number of Individuals Covered383
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $20,654
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515
Policy instance 1
Insurance contract or identification number376515
Number of Individuals Covered174
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $85,215
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number376515
Policy instance 2
Insurance contract or identification number376515
Number of Individuals Covered121
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL 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 CarrierUSD $10,502
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number12213969
Policy instance 4
Insurance contract or identification number12213969
Number of Individuals Covered412
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $18,999
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number40207
Policy instance 2
Insurance contract or identification number40207
Number of Individuals Covered129
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & 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 CarrierUSD $13,509
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number83084999
Policy instance 3
Insurance contract or identification number83084999
Number of Individuals Covered138
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $46,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number40207
Policy instance 1
Insurance contract or identification number40207
Number of Individuals Covered128
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $76,576
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3209364
Policy instance 5
Insurance contract or identification number3209364
Number of Individuals Covered412
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $350,401
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3209364
Policy instance 5
Insurance contract or identification number3209364
Number of Individuals Covered409
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $273,313
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number12213969
Policy instance 4
Insurance contract or identification number12213969
Number of Individuals Covered409
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $17,626
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number83084999
Policy instance 3
Insurance contract or identification number83084999
Number of Individuals Covered136
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $43,895
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number40207
Policy instance 2
Insurance contract or identification number40207
Number of Individuals Covered127
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & 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 CarrierUSD $12,895
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number40207
Policy instance 1
Insurance contract or identification number40207
Number of Individuals Covered195
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $66,135
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number83084999
Policy instance 4
Insurance contract or identification number83084999
Number of Individuals Covered131
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $43,451
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number40207
Policy instance 3
Insurance contract or identification number40207
Number of Individuals Covered124
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $66,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3209364
Policy instance 2
Insurance contract or identification number3209364
Number of Individuals Covered401
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $196,407
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number40207
Policy instance 1
Insurance contract or identification number40207
Number of Individuals Covered124
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & 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 CarrierUSD $12,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number12213969
Policy instance 5
Insurance contract or identification number12213969
Number of Individuals Covered400
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $17,944
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number40207
Policy instance 4
Insurance contract or identification number40207
Number of Individuals Covered122
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & 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 CarrierUSD $12,259
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number12213969
Policy instance 3
Insurance contract or identification number12213969
Number of Individuals Covered419
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $16,044
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number83084999
Policy instance 2
Insurance contract or identification number83084999
Number of Individuals Covered131
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $42,192
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number40207
Policy instance 1
Insurance contract or identification number40207
Number of Individuals Covered127
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $64,158
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3209364
Policy instance 5
Insurance contract or identification number3209364
Number of Individuals Covered419
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $173,615
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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