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UFCW HEALTH INSURANCE PLAN FOR RETIREES 401k Plan overview

Plan NameUFCW HEALTH INSURANCE PLAN FOR RETIREES
Plan identification number 502

UFCW HEALTH INSURANCE PLAN FOR RETIREES Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Vision
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

UNITED FOOD AND COMMERCIAL WORKERS INT'L UNION has sponsored the creation of one or more 401k plans.

Company Name:UNITED FOOD AND COMMERCIAL WORKERS INT'L UNION
Employer identification number (EIN):811529180
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UFCW HEALTH INSURANCE PLAN FOR RETIREES

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-03-01ANTHONY M. PERRONE, INT'L PRESIDENT2023-12-12
5022021-03-01ANTHONY M. PERRONE, INT'L PRESIDENT2022-12-13
5022020-03-01ANTHONY M. PERRONE, INT'L PRESIDENT2021-12-13
5022019-03-01ANTHONY M. PERRONE, INT'L PRESIDENT2020-12-14
5022018-03-01ANTHONY M. PERRONE, INT'L PRESIDENT2019-12-16
5022017-03-01
5022016-03-01

Plan Statistics for UFCW HEALTH INSURANCE PLAN FOR RETIREES

401k plan membership statisitcs for UFCW HEALTH INSURANCE PLAN FOR RETIREES

Measure Date Value
2022: UFCW HEALTH INSURANCE PLAN FOR RETIREES 2022 401k membership
Total participants, beginning-of-year2022-03-012,968
Total number of active participants reported on line 7a of the Form 55002022-03-012,956
Total of all active and inactive participants2022-03-012,956
Number of employers contributing to the scheme2022-03-0197
2021: UFCW HEALTH INSURANCE PLAN FOR RETIREES 2021 401k membership
Total participants, beginning-of-year2021-03-012,978
Total number of active participants reported on line 7a of the Form 55002021-03-012,968
Total of all active and inactive participants2021-03-012,968
Number of employers contributing to the scheme2021-03-01102
2020: UFCW HEALTH INSURANCE PLAN FOR RETIREES 2020 401k membership
Total participants, beginning-of-year2020-03-013,021
Total number of active participants reported on line 7a of the Form 55002020-03-012,978
Total of all active and inactive participants2020-03-012,978
Number of employers contributing to the scheme2020-03-01107
2019: UFCW HEALTH INSURANCE PLAN FOR RETIREES 2019 401k membership
Total participants, beginning-of-year2019-03-013,030
Total number of active participants reported on line 7a of the Form 55002019-03-013,021
Total of all active and inactive participants2019-03-013,021
Number of employers contributing to the scheme2019-03-01108
2018: UFCW HEALTH INSURANCE PLAN FOR RETIREES 2018 401k membership
Total participants, beginning-of-year2018-03-013,062
Total number of active participants reported on line 7a of the Form 55002018-03-013,030
Total of all active and inactive participants2018-03-013,030
Number of employers contributing to the scheme2018-03-01117
2017: UFCW HEALTH INSURANCE PLAN FOR RETIREES 2017 401k membership
Total participants, beginning-of-year2017-03-013,079
Total number of active participants reported on line 7a of the Form 55002017-03-013,062
Total of all active and inactive participants2017-03-013,062
Number of employers contributing to the scheme2017-03-0187
2016: UFCW HEALTH INSURANCE PLAN FOR RETIREES 2016 401k membership
Total participants, beginning-of-year2016-03-013,082
Total number of active participants reported on line 7a of the Form 55002016-03-013,079
Total of all active and inactive participants2016-03-013,079
Number of employers contributing to the scheme2016-03-0124

Financial Data on UFCW HEALTH INSURANCE PLAN FOR RETIREES

Measure Date Value
2023 : UFCW HEALTH INSURANCE PLAN FOR RETIREES 2023 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2023-02-28$1,552,802
Total unrealized appreciation/depreciation of assets2023-02-28$1,552,802
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-02-28$883,379
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-02-28$861,640
Total income from all sources (including contributions)2023-02-28$22,743,924
Total of all expenses incurred2023-02-28$22,628,118
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-02-28$21,862,620
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-02-28$21,191,122
Value of total assets at end of year2023-02-28$220,000
Value of total assets at beginning of year2023-02-28$82,455
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-02-28$765,498
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-02-28No
Administrative expenses professional fees incurred2023-02-28$295,681
Was this plan covered by a fidelity bond2023-02-28Yes
Value of fidelity bond cover2023-02-28$2,000,000
If this is an individual account plan, was there a blackout period2023-02-28No
Were there any nonexempt tranactions with any party-in-interest2023-02-28No
Contributions received from participants2023-02-28$1,163,764
Administrative expenses (other) incurred2023-02-28$469,817
Total non interest bearing cash at end of year2023-02-28$220,000
Total non interest bearing cash at beginning of year2023-02-28$82,455
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-02-28No
Value of net income/loss2023-02-28$115,806
Value of net assets at end of year (total assets less liabilities)2023-02-28$-663,379
Value of net assets at beginning of year (total assets less liabilities)2023-02-28$-779,185
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2023-02-28No
Were any leases to which the plan was party in default or uncollectible2023-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2023-02-28$3,433,822
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-02-28No
Was there a failure to transmit to the plan any participant contributions2023-02-28No
Has the plan failed to provide any benefit when due under the plan2023-02-28No
Contributions received in cash from employer2023-02-28$20,027,358
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-02-28$18,428,798
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32023-02-28No
Liabilities. Value of benefit claims payable at end of year2023-02-28$883,379
Liabilities. Value of benefit claims payable at beginning of year2023-02-28$861,640
Did the plan have assets held for investment2023-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-02-28No
Opinion of an independent qualified public accountant for this plan2023-02-28Unqualified
Accountancy firm name2023-02-28CALIBRE CPA GROUP PLLC
Accountancy firm EIN2023-02-28470900880
2022 : UFCW HEALTH INSURANCE PLAN FOR RETIREES 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-02-28$1,502,293
Total unrealized appreciation/depreciation of assets2022-02-28$1,502,293
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-02-28$861,640
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-02-28$1,041,718
Total income from all sources (including contributions)2022-02-28$20,143,189
Total of all expenses incurred2022-02-28$20,033,213
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-02-28$19,340,534
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-02-28$18,640,896
Value of total assets at end of year2022-02-28$82,455
Value of total assets at beginning of year2022-02-28$152,557
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-02-28$692,679
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-02-28No
Administrative expenses professional fees incurred2022-02-28$333,066
Was this plan covered by a fidelity bond2022-02-28Yes
Value of fidelity bond cover2022-02-28$2,000,000
If this is an individual account plan, was there a blackout period2022-02-28No
Were there any nonexempt tranactions with any party-in-interest2022-02-28No
Contributions received from participants2022-02-28$1,178,807
Administrative expenses (other) incurred2022-02-28$359,613
Total non interest bearing cash at end of year2022-02-28$82,455
Total non interest bearing cash at beginning of year2022-02-28$152,557
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-02-28No
Value of net income/loss2022-02-28$109,976
Value of net assets at end of year (total assets less liabilities)2022-02-28$-779,185
Value of net assets at beginning of year (total assets less liabilities)2022-02-28$-889,161
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2022-02-28No
Were any leases to which the plan was party in default or uncollectible2022-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2022-02-28$2,573,160
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-02-28No
Was there a failure to transmit to the plan any participant contributions2022-02-28No
Has the plan failed to provide any benefit when due under the plan2022-02-28No
Contributions received in cash from employer2022-02-28$17,462,089
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-02-28$16,767,374
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-02-28No
Liabilities. Value of benefit claims payable at end of year2022-02-28$861,640
Liabilities. Value of benefit claims payable at beginning of year2022-02-28$1,041,718
Did the plan have assets held for investment2022-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-02-28No
Opinion of an independent qualified public accountant for this plan2022-02-28Unqualified
Accountancy firm name2022-02-28CALIBRE CPA GROUP PLLC
Accountancy firm EIN2022-02-28470900880
2021 : UFCW HEALTH INSURANCE PLAN FOR RETIREES 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-02-28$1,041,718
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-02-28$1,051,993
Total income from all sources (including contributions)2021-02-28$25,757,691
Total of all expenses incurred2021-02-28$25,847,069
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-02-28$25,052,290
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-02-28$24,327,925
Value of total assets at end of year2021-02-28$152,557
Value of total assets at beginning of year2021-02-28$252,210
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-02-28$794,779
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-02-28No
Administrative expenses professional fees incurred2021-02-28$373,989
Was this plan covered by a fidelity bond2021-02-28Yes
Value of fidelity bond cover2021-02-28$2,000,000
If this is an individual account plan, was there a blackout period2021-02-28No
Were there any nonexempt tranactions with any party-in-interest2021-02-28No
Contributions received from participants2021-02-28$1,050,244
Other income not declared elsewhere2021-02-28$1,429,766
Administrative expenses (other) incurred2021-02-28$420,790
Total non interest bearing cash at end of year2021-02-28$152,557
Total non interest bearing cash at beginning of year2021-02-28$252,210
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-02-28No
Value of net income/loss2021-02-28$-89,378
Value of net assets at end of year (total assets less liabilities)2021-02-28$-889,161
Value of net assets at beginning of year (total assets less liabilities)2021-02-28$-799,783
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2021-02-28No
Were any leases to which the plan was party in default or uncollectible2021-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2021-02-28$3,655,726
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-02-28No
Was there a failure to transmit to the plan any participant contributions2021-02-28No
Has the plan failed to provide any benefit when due under the plan2021-02-28No
Contributions received in cash from employer2021-02-28$23,277,681
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-02-28$21,396,564
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-02-28No
Liabilities. Value of benefit claims payable at end of year2021-02-28$1,041,718
Liabilities. Value of benefit claims payable at beginning of year2021-02-28$1,051,993
Did the plan have assets held for investment2021-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-02-28No
Opinion of an independent qualified public accountant for this plan2021-02-28Unqualified
Accountancy firm name2021-02-28CALIBRE CPA GROUP PLLC
Accountancy firm EIN2021-02-28470900880
2020 : UFCW HEALTH INSURANCE PLAN FOR RETIREES 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-02-29$1,051,993
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-02-29$1,010,655
Total income from all sources (including contributions)2020-02-29$27,011,748
Total of all expenses incurred2020-02-29$27,045,487
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-02-29$25,944,640
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-02-29$25,540,343
Value of total assets at end of year2020-02-29$252,210
Value of total assets at beginning of year2020-02-29$244,611
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-02-29$1,100,847
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-02-29No
Administrative expenses professional fees incurred2020-02-29$606,403
Was this plan covered by a fidelity bond2020-02-29Yes
Value of fidelity bond cover2020-02-29$2,000,000
If this is an individual account plan, was there a blackout period2020-02-29No
Were there any nonexempt tranactions with any party-in-interest2020-02-29No
Contributions received from participants2020-02-29$1,074,739
Other income not declared elsewhere2020-02-29$1,471,405
Administrative expenses (other) incurred2020-02-29$494,444
Total non interest bearing cash at end of year2020-02-29$252,210
Total non interest bearing cash at beginning of year2020-02-29$244,611
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-02-29No
Value of net income/loss2020-02-29$-33,739
Value of net assets at end of year (total assets less liabilities)2020-02-29$-799,783
Value of net assets at beginning of year (total assets less liabilities)2020-02-29$-766,044
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-02-29No
Were any loans by the plan or fixed income obligations due to the plan in default2020-02-29No
Were any leases to which the plan was party in default or uncollectible2020-02-29No
Expenses. Payments to insurance carriers foe the provision of benefits2020-02-29$2,682,450
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-02-29No
Was there a failure to transmit to the plan any participant contributions2020-02-29No
Has the plan failed to provide any benefit when due under the plan2020-02-29No
Contributions received in cash from employer2020-02-29$24,465,604
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-02-29$23,262,190
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-02-29No
Liabilities. Value of benefit claims payable at end of year2020-02-29$1,051,993
Liabilities. Value of benefit claims payable at beginning of year2020-02-29$1,010,655
Did the plan have assets held for investment2020-02-29No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-02-29No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-02-29No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-02-29No
Opinion of an independent qualified public accountant for this plan2020-02-29Unqualified
Accountancy firm name2020-02-29CALIBRE CPA GROUP PLLC
Accountancy firm EIN2020-02-29470900880
2019 : UFCW HEALTH INSURANCE PLAN FOR RETIREES 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-02-28$1,010,655
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-02-28$1,545,556
Total income from all sources (including contributions)2019-02-28$29,068,475
Total of all expenses incurred2019-02-28$28,544,521
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-02-28$26,607,326
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-02-28$27,511,497
Value of total assets at end of year2019-02-28$244,611
Value of total assets at beginning of year2019-02-28$255,558
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-02-28$1,937,195
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-02-28No
Administrative expenses professional fees incurred2019-02-28$1,439,698
Was this plan covered by a fidelity bond2019-02-28Yes
Value of fidelity bond cover2019-02-28$2,000,000
If this is an individual account plan, was there a blackout period2019-02-28No
Were there any nonexempt tranactions with any party-in-interest2019-02-28No
Contributions received from participants2019-02-28$1,128,573
Other income not declared elsewhere2019-02-28$1,556,978
Administrative expenses (other) incurred2019-02-28$497,497
Total non interest bearing cash at end of year2019-02-28$244,611
Total non interest bearing cash at beginning of year2019-02-28$255,558
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-02-28No
Value of net income/loss2019-02-28$523,954
Value of net assets at end of year (total assets less liabilities)2019-02-28$-766,044
Value of net assets at beginning of year (total assets less liabilities)2019-02-28$-1,289,998
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2019-02-28No
Were any leases to which the plan was party in default or uncollectible2019-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2019-02-28$826,352
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-02-28No
Was there a failure to transmit to the plan any participant contributions2019-02-28No
Has the plan failed to provide any benefit when due under the plan2019-02-28No
Contributions received in cash from employer2019-02-28$26,382,924
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-02-28$25,780,974
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-02-28No
Liabilities. Value of benefit claims payable at end of year2019-02-28$1,010,655
Liabilities. Value of benefit claims payable at beginning of year2019-02-28$1,545,556
Did the plan have assets held for investment2019-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-02-28No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-02-28No
Opinion of an independent qualified public accountant for this plan2019-02-28Unqualified
Accountancy firm name2019-02-28CALIBRE CPA GROUP PLLC
Accountancy firm EIN2019-02-28470900880
2018 : UFCW HEALTH INSURANCE PLAN FOR RETIREES 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-02-28$1,545,556
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-02-28$1,494,378
Total income from all sources (including contributions)2018-02-28$30,483,076
Total of all expenses incurred2018-02-28$30,618,073
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-02-28$28,815,010
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-02-28$28,934,783
Value of total assets at end of year2018-02-28$255,558
Value of total assets at beginning of year2018-02-28$339,377
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-02-28$1,803,063
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-02-28No
Administrative expenses professional fees incurred2018-02-28$1,479,556
Was this plan covered by a fidelity bond2018-02-28Yes
Value of fidelity bond cover2018-02-28$2,000,000
If this is an individual account plan, was there a blackout period2018-02-28No
Were there any nonexempt tranactions with any party-in-interest2018-02-28No
Contributions received from participants2018-02-28$1,083,339
Other income not declared elsewhere2018-02-28$1,548,293
Administrative expenses (other) incurred2018-02-28$323,507
Total non interest bearing cash at end of year2018-02-28$255,558
Total non interest bearing cash at beginning of year2018-02-28$339,377
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-02-28No
Value of net income/loss2018-02-28$-134,997
Value of net assets at end of year (total assets less liabilities)2018-02-28$-1,289,998
Value of net assets at beginning of year (total assets less liabilities)2018-02-28$-1,155,001
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2018-02-28No
Were any leases to which the plan was party in default or uncollectible2018-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2018-02-28$744,966
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-02-28No
Was there a failure to transmit to the plan any participant contributions2018-02-28No
Has the plan failed to provide any benefit when due under the plan2018-02-28No
Contributions received in cash from employer2018-02-28$27,851,444
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-02-28$28,070,044
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-02-28No
Liabilities. Value of benefit claims payable at end of year2018-02-28$1,545,556
Liabilities. Value of benefit claims payable at beginning of year2018-02-28$1,494,378
Did the plan have assets held for investment2018-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-02-28No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-02-28No
Opinion of an independent qualified public accountant for this plan2018-02-28Unqualified
Accountancy firm name2018-02-28CALIBRE CPA GROUP PLLC
Accountancy firm EIN2018-02-28470900880
2017 : UFCW HEALTH INSURANCE PLAN FOR RETIREES 2017 401k financial data
Total income from all sources (including contributions)2017-02-28$29,560,239
Total of all expenses incurred2017-02-28$29,560,239
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-02-28$27,689,809
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-02-28$27,960,259
Value of total assets at end of year2017-02-28$339,377
Value of total assets at beginning of year2017-02-28$339,377
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-02-28$1,870,430
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-02-28No
Administrative expenses professional fees incurred2017-02-28$317,885
Was this plan covered by a fidelity bond2017-02-28Yes
Value of fidelity bond cover2017-02-28$2,000,000
If this is an individual account plan, was there a blackout period2017-02-28No
Were there any nonexempt tranactions with any party-in-interest2017-02-28No
Contributions received from participants2017-02-28$1,118,086
Other income not declared elsewhere2017-02-28$1,599,980
Administrative expenses (other) incurred2017-02-28$1,552,545
Total non interest bearing cash at end of year2017-02-28$339,377
Total non interest bearing cash at beginning of year2017-02-28$339,377
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-02-28No
Value of net income/loss2017-02-28$0
Value of net assets at end of year (total assets less liabilities)2017-02-28$339,377
Value of net assets at beginning of year (total assets less liabilities)2017-02-28$339,377
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2017-02-28No
Were any leases to which the plan was party in default or uncollectible2017-02-28No
Expenses. Payments to insurance carriers foe the provision of benefits2017-02-28$1,150,211
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-02-28No
Was there a failure to transmit to the plan any participant contributions2017-02-28No
Has the plan failed to provide any benefit when due under the plan2017-02-28No
Contributions received in cash from employer2017-02-28$26,842,173
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-02-28$26,539,598
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-02-28No
Did the plan have assets held for investment2017-02-28No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-02-28No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-02-28No
Opinion of an independent qualified public accountant for this plan2017-02-28Unqualified
Accountancy firm name2017-02-28CALIBRE CPA GROUP PLLC
Accountancy firm EIN2017-02-28470900880

Form 5500 Responses for UFCW HEALTH INSURANCE PLAN FOR RETIREES

2022: UFCW HEALTH INSURANCE PLAN FOR RETIREES 2022 form 5500 responses
2022-03-01Type of plan entityMulti-employer plan
2022-03-01Plan is a collectively bargained planYes
2022-03-01Plan funding arrangement – InsuranceYes
2022-03-01Plan funding arrangement – TrustYes
2022-03-01Plan funding arrangement – General assets of the sponsorYes
2022-03-01Plan benefit arrangement – InsuranceYes
2022-03-01Plan benefit arrangement - TrustYes
2022-03-01Plan benefit arrangement – General assets of the sponsorYes
2021: UFCW HEALTH INSURANCE PLAN FOR RETIREES 2021 form 5500 responses
2021-03-01Type of plan entityMulti-employer plan
2021-03-01Plan is a collectively bargained planYes
2021-03-01Plan funding arrangement – InsuranceYes
2021-03-01Plan funding arrangement – TrustYes
2021-03-01Plan funding arrangement – General assets of the sponsorYes
2021-03-01Plan benefit arrangement – InsuranceYes
2021-03-01Plan benefit arrangement - TrustYes
2021-03-01Plan benefit arrangement – General assets of the sponsorYes
2020: UFCW HEALTH INSURANCE PLAN FOR RETIREES 2020 form 5500 responses
2020-03-01Type of plan entityMulti-employer plan
2020-03-01Plan is a collectively bargained planYes
2020-03-01Plan funding arrangement – InsuranceYes
2020-03-01Plan funding arrangement – TrustYes
2020-03-01Plan funding arrangement – General assets of the sponsorYes
2020-03-01Plan benefit arrangement – InsuranceYes
2020-03-01Plan benefit arrangement - TrustYes
2020-03-01Plan benefit arrangement – General assets of the sponsorYes
2019: UFCW HEALTH INSURANCE PLAN FOR RETIREES 2019 form 5500 responses
2019-03-01Type of plan entityMulti-employer plan
2019-03-01Plan is a collectively bargained planYes
2019-03-01Plan funding arrangement – InsuranceYes
2019-03-01Plan funding arrangement – TrustYes
2019-03-01Plan funding arrangement – General assets of the sponsorYes
2019-03-01Plan benefit arrangement – InsuranceYes
2019-03-01Plan benefit arrangement - TrustYes
2019-03-01Plan benefit arrangement – General assets of the sponsorYes
2018: UFCW HEALTH INSURANCE PLAN FOR RETIREES 2018 form 5500 responses
2018-03-01Type of plan entityMulti-employer plan
2018-03-01Plan is a collectively bargained planYes
2018-03-01Plan funding arrangement – InsuranceYes
2018-03-01Plan funding arrangement – TrustYes
2018-03-01Plan funding arrangement – General assets of the sponsorYes
2018-03-01Plan benefit arrangement – InsuranceYes
2018-03-01Plan benefit arrangement - TrustYes
2018-03-01Plan benefit arrangement – General assets of the sponsorYes
2017: UFCW HEALTH INSURANCE PLAN FOR RETIREES 2017 form 5500 responses
2017-03-01Type of plan entityMulti-employer plan
2017-03-01Plan is a collectively bargained planYes
2017-03-01Plan funding arrangement – InsuranceYes
2017-03-01Plan funding arrangement – TrustYes
2017-03-01Plan funding arrangement – General assets of the sponsorYes
2017-03-01Plan benefit arrangement – InsuranceYes
2017-03-01Plan benefit arrangement - TrustYes
2017-03-01Plan benefit arrangement – General assets of the sponsorYes
2016: UFCW HEALTH INSURANCE PLAN FOR RETIREES 2016 form 5500 responses
2016-03-01Type of plan entityMulti-employer plan
2016-03-01Plan is a collectively bargained planYes
2016-03-01Plan funding arrangement – InsuranceYes
2016-03-01Plan funding arrangement – TrustYes
2016-03-01Plan funding arrangement – General assets of the sponsorYes
2016-03-01Plan benefit arrangement – InsuranceYes
2016-03-01Plan benefit arrangement - TrustYes
2016-03-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number4501
Policy instance 5
Insurance contract or identification number4501
Number of Individuals Covered29
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $229,948
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number603353
Policy instance 4
Insurance contract or identification number603353
Number of Individuals Covered53
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $222,158
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberSL10042
Policy instance 3
Insurance contract or identification numberSL10042
Number of Individuals Covered565
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $271,930
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number131246
Policy instance 2
Insurance contract or identification number131246
Number of Individuals Covered54
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,160,335
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG/C-8177
Policy instance 1
Insurance contract or identification numberG/C-8177
Number of Individuals Covered4
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $9,069
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG/C-8177
Policy instance 1
Insurance contract or identification numberG/C-8177
Number of Individuals Covered5
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $10,618
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number131246
Policy instance 2
Insurance contract or identification number131246
Number of Individuals Covered51
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $282,343
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberSL10042
Policy instance 3
Insurance contract or identification numberSL10042
Number of Individuals Covered601
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $254,209
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number603353
Policy instance 4
Insurance contract or identification number603353
Number of Individuals Covered50
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $318,558
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number4501
Policy instance 5
Insurance contract or identification number4501
Number of Individuals Covered25
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $219,015
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number4501
Policy instance 5
Insurance contract or identification number4501
Number of Individuals Covered27
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $213,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number603353
Policy instance 4
Insurance contract or identification number603353
Number of Individuals Covered50
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $315,218
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberSL10042
Policy instance 3
Insurance contract or identification numberSL10042
Number of Individuals Covered608
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $218,188
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number131246
Policy instance 2
Insurance contract or identification number131246
Number of Individuals Covered54
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $246,820
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG/C-8177
Policy instance 1
Insurance contract or identification numberG/C-8177
Number of Individuals Covered5
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $9,656
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberSL10042
Policy instance 3
Insurance contract or identification numberSL10042
Number of Individuals Covered656
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $225,678
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG/C-8177
Policy instance 1
Insurance contract or identification numberG/C-8177
Number of Individuals Covered5
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $10,777
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number131246
Policy instance 2
Insurance contract or identification number131246
Number of Individuals Covered56
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $305,911
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number603353
Policy instance 4
Insurance contract or identification number603353
Number of Individuals Covered50
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $308,661
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number4501
Policy instance 5
Insurance contract or identification number4501
Number of Individuals Covered24
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $176,710
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number4501
Policy instance 5
Insurance contract or identification number4501
Number of Individuals Covered23
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $162,031
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG/C-8177
Policy instance 1
Insurance contract or identification numberG/C-8177
Number of Individuals Covered6
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $10,685
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number131246
Policy instance 2
Insurance contract or identification number131246
Number of Individuals Covered55
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $291,371
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberSL10042
Policy instance 3
Insurance contract or identification numberSL10042
Number of Individuals Covered709
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $225,318
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number603353
Policy instance 4
Insurance contract or identification number603353
Number of Individuals Covered51
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $288,279
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number4501
Policy instance 5
Insurance contract or identification number4501
Number of Individuals Covered24
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $127,917
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number603353
Policy instance 4
Insurance contract or identification number603353
Number of Individuals Covered55
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $286,973
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberSL10042
Policy instance 3
Insurance contract or identification numberSL10042
Number of Individuals Covered761
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $222,416
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number131246
Policy instance 2
Insurance contract or identification number131246
Number of Individuals Covered49
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $208,297
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG/C-8177
Policy instance 1
Insurance contract or identification numberG/C-8177
Number of Individuals Covered7
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $12,322
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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