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SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 401k Plan overview

Plan NameSOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST
Plan identification number 501

SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance

401k Sponsoring company profile

SOUTH CAROLINA DENTAL ASSOCIATION has sponsored the creation of one or more 401k plans.

Company Name:SOUTH CAROLINA DENTAL ASSOCIATION
Employer identification number (EIN):816916597
NAIC Classification:621210
NAIC Description:Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-02-01
5012022-02-01
5012021-02-01
5012020-02-01
5012019-02-01
5012018-02-01JOHN (PHIL) LATHAM
5012017-02-01JOHN (PHIL) LATHAM

Plan Statistics for SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST

401k plan membership statisitcs for SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST

Measure Date Value
2023: SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 2023 401k membership
Total participants, beginning-of-year2023-02-01949
Total number of active participants reported on line 7a of the Form 55002023-02-01945
Number of retired or separated participants receiving benefits2023-02-012
Number of other retired or separated participants entitled to future benefits2023-02-010
Total of all active and inactive participants2023-02-01947
2022: SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 2022 401k membership
Total participants, beginning-of-year2022-02-011,060
Total number of active participants reported on line 7a of the Form 55002022-02-01948
Number of retired or separated participants receiving benefits2022-02-011
Number of other retired or separated participants entitled to future benefits2022-02-010
Total of all active and inactive participants2022-02-01949
2021: SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 2021 401k membership
Total participants, beginning-of-year2021-02-011,108
Total number of active participants reported on line 7a of the Form 55002021-02-011,057
Number of retired or separated participants receiving benefits2021-02-013
Number of other retired or separated participants entitled to future benefits2021-02-010
Total of all active and inactive participants2021-02-011,060
2020: SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 2020 401k membership
Total participants, beginning-of-year2020-02-011,111
Total number of active participants reported on line 7a of the Form 55002020-02-011,101
Number of retired or separated participants receiving benefits2020-02-017
Number of other retired or separated participants entitled to future benefits2020-02-010
Total of all active and inactive participants2020-02-011,108
2019: SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 2019 401k membership
Total participants, beginning-of-year2019-02-011,154
Total number of active participants reported on line 7a of the Form 55002019-02-011,104
Number of retired or separated participants receiving benefits2019-02-017
Number of other retired or separated participants entitled to future benefits2019-02-010
Total of all active and inactive participants2019-02-011,111
2018: SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 2018 401k membership
Total participants, beginning-of-year2018-02-011,205
Total number of active participants reported on line 7a of the Form 55002018-02-011,144
Number of retired or separated participants receiving benefits2018-02-0110
Number of other retired or separated participants entitled to future benefits2018-02-010
Total of all active and inactive participants2018-02-011,154
2017: SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 2017 401k membership
Total participants, beginning-of-year2017-02-010
Total number of active participants reported on line 7a of the Form 55002017-02-011,191
Number of retired or separated participants receiving benefits2017-02-0114
Number of other retired or separated participants entitled to future benefits2017-02-010
Total of all active and inactive participants2017-02-011,205

Financial Data on SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST

Measure Date Value
2024 : SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 2024 401k financial data
Total unrealized appreciation/depreciation of assets2024-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2024-01-31$78,301
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2024-01-31$143,333
Total income from all sources (including contributions)2024-01-31$11,399,269
Total loss/gain on sale of assets2024-01-31$0
Total of all expenses incurred2024-01-31$11,375,398
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2024-01-31$11,339,285
Total contributions o plan (from employers,participants, others, non cash contrinutions)2024-01-31$11,399,269
Value of total assets at end of year2024-01-31$136,075
Value of total assets at beginning of year2024-01-31$177,236
Total of administrative expenses incurred including professional, contract, advisory and management fees2024-01-31$36,113
Total interest from all sources2024-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2024-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2024-01-31No
Was this plan covered by a fidelity bond2024-01-31Yes
Value of fidelity bond cover2024-01-31$500,000
If this is an individual account plan, was there a blackout period2024-01-31No
Were there any nonexempt tranactions with any party-in-interest2024-01-31No
Contributions received from participants2024-01-31$58,643
Participant contributions at end of year2024-01-31$1,047
Participant contributions at beginning of year2024-01-31$1,406
Value of other receiveables (less allowance for doubtful accounts) at end of year2024-01-31$7,946
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2024-01-31$6,142
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2024-01-31$23,330
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2024-01-31$88,291
Administrative expenses (other) incurred2024-01-31$20,888
Liabilities. Value of operating payables at end of year2024-01-31$2,369
Liabilities. Value of operating payables at beginning of year2024-01-31$625
Total non interest bearing cash at end of year2024-01-31$99,592
Total non interest bearing cash at beginning of year2024-01-31$141,245
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2024-01-31No
Value of net income/loss2024-01-31$23,871
Value of net assets at end of year (total assets less liabilities)2024-01-31$57,774
Value of net assets at beginning of year (total assets less liabilities)2024-01-31$33,903
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2024-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2024-01-31No
Were any leases to which the plan was party in default or uncollectible2024-01-31No
Expenses. Payments to insurance carriers foe the provision of benefits2024-01-31$11,339,285
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2024-01-31No
Was there a failure to transmit to the plan any participant contributions2024-01-31No
Has the plan failed to provide any benefit when due under the plan2024-01-31No
Contributions received in cash from employer2024-01-31$11,340,626
Employer contributions (assets) at end of year2024-01-31$27,490
Employer contributions (assets) at beginning of year2024-01-31$28,443
Liabilities. Value of benefit claims payable at end of year2024-01-31$52,602
Liabilities. Value of benefit claims payable at beginning of year2024-01-31$54,417
Did the plan have assets held for investment2024-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2024-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2024-01-31No
Opinion of an independent qualified public accountant for this plan2024-01-31Unqualified
Accountancy firm name2024-01-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2024-01-31410746749
2023 : SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-31$143,333
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-31$330,743
Total income from all sources (including contributions)2023-01-31$11,785,870
Total loss/gain on sale of assets2023-01-31$0
Total of all expenses incurred2023-01-31$11,783,283
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-01-31$11,755,870
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-01-31$11,785,870
Value of total assets at end of year2023-01-31$177,236
Value of total assets at beginning of year2023-01-31$362,059
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-01-31$27,413
Total interest from all sources2023-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2023-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-01-31No
Administrative expenses professional fees incurred2023-01-31$13,440
Was this plan covered by a fidelity bond2023-01-31Yes
Value of fidelity bond cover2023-01-31$500,000
If this is an individual account plan, was there a blackout period2023-01-31No
Were there any nonexempt tranactions with any party-in-interest2023-01-31No
Contributions received from participants2023-01-31$35,033
Participant contributions at end of year2023-01-31$1,406
Participant contributions at beginning of year2023-01-31$2,992
Value of other receiveables (less allowance for doubtful accounts) at end of year2023-01-31$6,142
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2023-01-31$55
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2023-01-31$88,291
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2023-01-31$264,471
Administrative expenses (other) incurred2023-01-31$13,973
Liabilities. Value of operating payables at end of year2023-01-31$625
Liabilities. Value of operating payables at beginning of year2023-01-31$1,219
Total non interest bearing cash at end of year2023-01-31$141,245
Total non interest bearing cash at beginning of year2023-01-31$329,216
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-31No
Value of net income/loss2023-01-31$2,587
Value of net assets at end of year (total assets less liabilities)2023-01-31$33,903
Value of net assets at beginning of year (total assets less liabilities)2023-01-31$31,316
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-01-31No
Were any leases to which the plan was party in default or uncollectible2023-01-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-01-31No
Was there a failure to transmit to the plan any participant contributions2023-01-31No
Has the plan failed to provide any benefit when due under the plan2023-01-31No
Contributions received in cash from employer2023-01-31$11,750,837
Employer contributions (assets) at end of year2023-01-31$28,443
Employer contributions (assets) at beginning of year2023-01-31$29,796
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-01-31$11,755,870
Liabilities. Value of benefit claims payable at end of year2023-01-31$54,417
Liabilities. Value of benefit claims payable at beginning of year2023-01-31$65,053
Did the plan have assets held for investment2023-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-01-31No
Opinion of an independent qualified public accountant for this plan2023-01-31Unqualified
Accountancy firm name2023-01-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2023-01-31410746749
2022 : SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-31$330,743
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-31$126,795
Total income from all sources (including contributions)2022-01-31$11,725,016
Total loss/gain on sale of assets2022-01-31$0
Total of all expenses incurred2022-01-31$11,719,461
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-01-31$11,692,922
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-01-31$11,725,016
Value of total assets at end of year2022-01-31$362,059
Value of total assets at beginning of year2022-01-31$152,556
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-01-31$26,539
Total interest from all sources2022-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2022-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-01-31No
Administrative expenses professional fees incurred2022-01-31$12,180
Was this plan covered by a fidelity bond2022-01-31Yes
Value of fidelity bond cover2022-01-31$500,000
If this is an individual account plan, was there a blackout period2022-01-31No
Were there any nonexempt tranactions with any party-in-interest2022-01-31No
Contributions received from participants2022-01-31$85,688
Participant contributions at end of year2022-01-31$2,992
Participant contributions at beginning of year2022-01-31$4,101
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-01-31$55
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-01-31$9,934
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-01-31$264,471
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-01-31$63,595
Administrative expenses (other) incurred2022-01-31$14,359
Liabilities. Value of operating payables at end of year2022-01-31$1,219
Liabilities. Value of operating payables at beginning of year2022-01-31$1,182
Total non interest bearing cash at end of year2022-01-31$329,216
Total non interest bearing cash at beginning of year2022-01-31$107,173
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-31No
Value of net income/loss2022-01-31$5,555
Value of net assets at end of year (total assets less liabilities)2022-01-31$31,316
Value of net assets at beginning of year (total assets less liabilities)2022-01-31$25,761
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-01-31No
Were any leases to which the plan was party in default or uncollectible2022-01-31No
Expenses. Payments to insurance carriers foe the provision of benefits2022-01-31$11,692,922
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-01-31No
Was there a failure to transmit to the plan any participant contributions2022-01-31No
Has the plan failed to provide any benefit when due under the plan2022-01-31No
Contributions received in cash from employer2022-01-31$11,639,328
Employer contributions (assets) at end of year2022-01-31$29,796
Employer contributions (assets) at beginning of year2022-01-31$31,348
Liabilities. Value of benefit claims payable at end of year2022-01-31$65,053
Liabilities. Value of benefit claims payable at beginning of year2022-01-31$62,018
Did the plan have assets held for investment2022-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-01-31No
Opinion of an independent qualified public accountant for this plan2022-01-31Unqualified
Accountancy firm name2022-01-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2022-01-31410746749
2021 : SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-01-31$126,795
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-01-31$377,400
Total income from all sources (including contributions)2021-01-31$12,132,004
Total loss/gain on sale of assets2021-01-31$0
Total of all expenses incurred2021-01-31$12,161,166
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-01-31$12,134,117
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-01-31$12,132,004
Value of total assets at end of year2021-01-31$152,556
Value of total assets at beginning of year2021-01-31$432,323
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-01-31$27,049
Total interest from all sources2021-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-01-31No
Administrative expenses professional fees incurred2021-01-31$12,075
Was this plan covered by a fidelity bond2021-01-31Yes
Value of fidelity bond cover2021-01-31$500,000
If this is an individual account plan, was there a blackout period2021-01-31No
Were there any nonexempt tranactions with any party-in-interest2021-01-31No
Contributions received from participants2021-01-31$100,795
Participant contributions at end of year2021-01-31$4,101
Participant contributions at beginning of year2021-01-31$4,534
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-01-31$9,934
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-01-31$16,371
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-01-31$63,595
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-01-31$311,049
Administrative expenses (other) incurred2021-01-31$14,974
Liabilities. Value of operating payables at end of year2021-01-31$1,182
Liabilities. Value of operating payables at beginning of year2021-01-31$573
Total non interest bearing cash at end of year2021-01-31$107,173
Total non interest bearing cash at beginning of year2021-01-31$373,975
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-01-31No
Value of net income/loss2021-01-31$-29,162
Value of net assets at end of year (total assets less liabilities)2021-01-31$25,761
Value of net assets at beginning of year (total assets less liabilities)2021-01-31$54,923
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-01-31No
Were any leases to which the plan was party in default or uncollectible2021-01-31No
Expenses. Payments to insurance carriers foe the provision of benefits2021-01-31$12,134,117
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-01-31No
Was there a failure to transmit to the plan any participant contributions2021-01-31No
Has the plan failed to provide any benefit when due under the plan2021-01-31No
Contributions received in cash from employer2021-01-31$12,031,209
Employer contributions (assets) at end of year2021-01-31$31,348
Employer contributions (assets) at beginning of year2021-01-31$37,443
Liabilities. Value of benefit claims payable at end of year2021-01-31$62,018
Liabilities. Value of benefit claims payable at beginning of year2021-01-31$65,778
Did the plan have assets held for investment2021-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-01-31No
Opinion of an independent qualified public accountant for this plan2021-01-31Unqualified
Accountancy firm name2021-01-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2021-01-31410746749
2020 : SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-01-31$377,400
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-01-31$397,541
Total income from all sources (including contributions)2020-01-31$12,444,735
Total loss/gain on sale of assets2020-01-31$0
Total of all expenses incurred2020-01-31$12,410,247
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-01-31$12,369,738
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-01-31$12,444,735
Value of total assets at end of year2020-01-31$432,323
Value of total assets at beginning of year2020-01-31$417,976
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-01-31$40,509
Total interest from all sources2020-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-01-31No
Administrative expenses professional fees incurred2020-01-31$25,545
Was this plan covered by a fidelity bond2020-01-31Yes
Value of fidelity bond cover2020-01-31$500,000
If this is an individual account plan, was there a blackout period2020-01-31No
Were there any nonexempt tranactions with any party-in-interest2020-01-31No
Contributions received from participants2020-01-31$90,831
Participant contributions at end of year2020-01-31$4,534
Participant contributions at beginning of year2020-01-31$8,682
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-01-31$16,371
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-01-31$20,541
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-01-31$311,049
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-01-31$266,226
Administrative expenses (other) incurred2020-01-31$14,964
Liabilities. Value of operating payables at end of year2020-01-31$573
Liabilities. Value of operating payables at beginning of year2020-01-31$565
Total non interest bearing cash at end of year2020-01-31$373,975
Total non interest bearing cash at beginning of year2020-01-31$316,537
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-01-31No
Value of net income/loss2020-01-31$34,488
Value of net assets at end of year (total assets less liabilities)2020-01-31$54,923
Value of net assets at beginning of year (total assets less liabilities)2020-01-31$20,435
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-01-31No
Were any leases to which the plan was party in default or uncollectible2020-01-31No
Expenses. Payments to insurance carriers foe the provision of benefits2020-01-31$12,369,738
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-01-31No
Was there a failure to transmit to the plan any participant contributions2020-01-31No
Has the plan failed to provide any benefit when due under the plan2020-01-31No
Contributions received in cash from employer2020-01-31$12,353,904
Employer contributions (assets) at end of year2020-01-31$37,443
Employer contributions (assets) at beginning of year2020-01-31$72,216
Liabilities. Value of benefit claims payable at end of year2020-01-31$65,778
Liabilities. Value of benefit claims payable at beginning of year2020-01-31$130,750
Did the plan have assets held for investment2020-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-01-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-01-31No
Opinion of an independent qualified public accountant for this plan2020-01-31Unqualified
Accountancy firm name2020-01-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2020-01-31410746749
2019 : SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-01-31$397,541
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-01-31$342,811
Total income from all sources (including contributions)2019-01-31$12,370,055
Total loss/gain on sale of assets2019-01-31$0
Total of all expenses incurred2019-01-31$12,361,234
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-01-31$12,343,215
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-01-31$12,370,055
Value of total assets at end of year2019-01-31$417,976
Value of total assets at beginning of year2019-01-31$354,425
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-01-31$18,019
Total interest from all sources2019-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-01-31No
Was this plan covered by a fidelity bond2019-01-31Yes
Value of fidelity bond cover2019-01-31$500,000
If this is an individual account plan, was there a blackout period2019-01-31No
Were there any nonexempt tranactions with any party-in-interest2019-01-31No
Contributions received from participants2019-01-31$130,447
Participant contributions at end of year2019-01-31$8,682
Participant contributions at beginning of year2019-01-31$15,623
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-01-31$20,541
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-01-31$30,662
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-01-31$266,226
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-01-31$81,834
Administrative expenses (other) incurred2019-01-31$18,019
Liabilities. Value of operating payables at end of year2019-01-31$565
Liabilities. Value of operating payables at beginning of year2019-01-31$571
Total non interest bearing cash at end of year2019-01-31$316,537
Total non interest bearing cash at beginning of year2019-01-31$261,059
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-01-31No
Value of net income/loss2019-01-31$8,821
Value of net assets at end of year (total assets less liabilities)2019-01-31$20,435
Value of net assets at beginning of year (total assets less liabilities)2019-01-31$11,614
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-01-31No
Were any leases to which the plan was party in default or uncollectible2019-01-31No
Expenses. Payments to insurance carriers foe the provision of benefits2019-01-31$12,343,215
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-01-31No
Was there a failure to transmit to the plan any participant contributions2019-01-31No
Has the plan failed to provide any benefit when due under the plan2019-01-31No
Contributions received in cash from employer2019-01-31$12,239,608
Employer contributions (assets) at end of year2019-01-31$72,216
Employer contributions (assets) at beginning of year2019-01-31$47,081
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-01-31No
Liabilities. Value of benefit claims payable at end of year2019-01-31$130,750
Liabilities. Value of benefit claims payable at beginning of year2019-01-31$260,406
Did the plan have assets held for investment2019-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-01-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-01-31No
Opinion of an independent qualified public accountant for this plan2019-01-31Unqualified
Accountancy firm name2019-01-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2019-01-31410746749
2018 : SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-01-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-01-31$342,811
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-01-31$0
Total income from all sources (including contributions)2018-01-31$12,196,867
Total loss/gain on sale of assets2018-01-31$0
Total of all expenses incurred2018-01-31$12,185,253
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-01-31$12,179,867
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-01-31$12,196,867
Value of total assets at end of year2018-01-31$354,425
Value of total assets at beginning of year2018-01-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-01-31$5,386
Total interest from all sources2018-01-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-01-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-01-31No
Was this plan covered by a fidelity bond2018-01-31Yes
Value of fidelity bond cover2018-01-31$500,000
If this is an individual account plan, was there a blackout period2018-01-31No
Were there any nonexempt tranactions with any party-in-interest2018-01-31No
Contributions received from participants2018-01-31$106,961
Participant contributions at end of year2018-01-31$15,623
Participant contributions at beginning of year2018-01-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-01-31$30,662
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-01-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-01-31$81,834
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-01-31$0
Administrative expenses (other) incurred2018-01-31$5,386
Liabilities. Value of operating payables at end of year2018-01-31$571
Liabilities. Value of operating payables at beginning of year2018-01-31$0
Total non interest bearing cash at end of year2018-01-31$261,059
Total non interest bearing cash at beginning of year2018-01-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-01-31No
Value of net income/loss2018-01-31$11,614
Value of net assets at end of year (total assets less liabilities)2018-01-31$11,614
Value of net assets at beginning of year (total assets less liabilities)2018-01-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-01-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-01-31No
Were any leases to which the plan was party in default or uncollectible2018-01-31No
Expenses. Payments to insurance carriers foe the provision of benefits2018-01-31$12,179,867
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-01-31No
Was there a failure to transmit to the plan any participant contributions2018-01-31No
Has the plan failed to provide any benefit when due under the plan2018-01-31No
Contributions received in cash from employer2018-01-31$12,089,906
Employer contributions (assets) at end of year2018-01-31$47,081
Employer contributions (assets) at beginning of year2018-01-31$0
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-01-31No
Liabilities. Value of benefit claims payable at end of year2018-01-31$260,406
Liabilities. Value of benefit claims payable at beginning of year2018-01-31$0
Did the plan have assets held for investment2018-01-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-01-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-01-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-01-31No
Opinion of an independent qualified public accountant for this plan2018-01-31Unqualified
Accountancy firm name2018-01-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2018-01-31410745749

Form 5500 Responses for SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST

2023: SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 2023 form 5500 responses
2023-02-01Type of plan entityMulitple employer plan
2023-02-01Submission has been amendedNo
2023-02-01This submission is the final filingNo
2023-02-01This return/report is a short plan year return/report (less than 12 months)No
2023-02-01Plan is a collectively bargained planNo
2023-02-01Plan funding arrangement – InsuranceYes
2023-02-01Plan funding arrangement – TrustYes
2023-02-01Plan benefit arrangement – InsuranceYes
2023-02-01Plan benefit arrangement - TrustYes
2022: SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 2022 form 5500 responses
2022-02-01Type of plan entityMulitple employer plan
2022-02-01Submission has been amendedNo
2022-02-01This submission is the final filingNo
2022-02-01This return/report is a short plan year return/report (less than 12 months)No
2022-02-01Plan is a collectively bargained planNo
2022-02-01Plan funding arrangement – InsuranceYes
2022-02-01Plan funding arrangement – TrustYes
2022-02-01Plan benefit arrangement – InsuranceYes
2022-02-01Plan benefit arrangement - TrustYes
2021: SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 2021 form 5500 responses
2021-02-01Type of plan entityMulitple employer plan
2021-02-01Submission has been amendedNo
2021-02-01This submission is the final filingNo
2021-02-01This return/report is a short plan year return/report (less than 12 months)No
2021-02-01Plan is a collectively bargained planNo
2021-02-01Plan funding arrangement – InsuranceYes
2021-02-01Plan funding arrangement – TrustYes
2021-02-01Plan benefit arrangement – InsuranceYes
2021-02-01Plan benefit arrangement - TrustYes
2020: SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 2020 form 5500 responses
2020-02-01Type of plan entityMulitple employer plan
2020-02-01Submission has been amendedNo
2020-02-01This submission is the final filingNo
2020-02-01This return/report is a short plan year return/report (less than 12 months)No
2020-02-01Plan is a collectively bargained planNo
2020-02-01Plan funding arrangement – InsuranceYes
2020-02-01Plan funding arrangement – TrustYes
2020-02-01Plan benefit arrangement – InsuranceYes
2020-02-01Plan benefit arrangement - TrustYes
2019: SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 2019 form 5500 responses
2019-02-01Type of plan entityMulitple employer plan
2019-02-01Submission has been amendedNo
2019-02-01This submission is the final filingNo
2019-02-01This return/report is a short plan year return/report (less than 12 months)No
2019-02-01Plan is a collectively bargained planNo
2019-02-01Plan funding arrangement – InsuranceYes
2019-02-01Plan funding arrangement – TrustYes
2019-02-01Plan benefit arrangement – InsuranceYes
2019-02-01Plan benefit arrangement - TrustYes
2018: SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 2018 form 5500 responses
2018-02-01Type of plan entityMulitple employer plan
2018-02-01Submission has been amendedNo
2018-02-01This submission is the final filingNo
2018-02-01This return/report is a short plan year return/report (less than 12 months)No
2018-02-01Plan is a collectively bargained planNo
2018-02-01Plan funding arrangement – InsuranceYes
2018-02-01Plan funding arrangement – TrustYes
2018-02-01Plan benefit arrangement – InsuranceYes
2018-02-01Plan benefit arrangement - TrustYes
2017: SOUTH CAROLINA DENTAL ASSOCIATION GROUP INSURANCE TRUST 2017 form 5500 responses
2017-02-01Type of plan entityMulitple employer plan
2017-02-01First time form 5500 has been submittedYes
2017-02-01Submission has been amendedNo
2017-02-01This submission is the final filingNo
2017-02-01This return/report is a short plan year return/report (less than 12 months)No
2017-02-01Plan is a collectively bargained planNo
2017-02-01Plan funding arrangement – InsuranceYes
2017-02-01Plan funding arrangement – TrustYes
2017-02-01Plan benefit arrangement – InsuranceYes
2017-02-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number26-56930
Policy instance 4
Insurance contract or identification number26-56930
Number of Individuals Covered127
Insurance policy start date2023-02-01
Insurance policy end date2024-01-31
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 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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number26-56930
Policy instance 3
Insurance contract or identification number26-56930
Number of Individuals Covered326
Insurance policy start date2023-02-01
Insurance policy end date2024-01-31
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 $21,620
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number3852656930
Policy instance 2
Insurance contract or identification number3852656930
Number of Individuals Covered882
Insurance policy start date2023-02-01
Insurance policy end date2024-01-31
Total amount of commissions paid to insurance brokerUSD $4,595
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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 providedAD&D
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 $54,113
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number26-56930
Policy instance 1
Insurance contract or identification number26-56930
Number of Individuals Covered880
Insurance policy start date2023-02-01
Insurance policy end date2024-01-31
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 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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number26-56930
Policy instance 4
Insurance contract or identification number26-56930
Number of Individuals Covered113
Insurance policy start date2022-02-01
Insurance policy end date2023-01-31
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 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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number26-56930
Policy instance 3
Insurance contract or identification number26-56930
Number of Individuals Covered202
Insurance policy start date2022-02-01
Insurance policy end date2023-01-31
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 $15,611
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number3852656930
Policy instance 2
Insurance contract or identification number3852656930
Number of Individuals Covered995
Insurance policy start date2022-02-01
Insurance policy end date2023-01-31
Total amount of commissions paid to insurance brokerUSD $4,991
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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 providedAD&D
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 $60,467
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,023
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number26-56930
Policy instance 1
Insurance contract or identification number26-56930
Number of Individuals Covered948
Insurance policy start date2022-02-01
Insurance policy end date2023-01-31
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 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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number26-56930
Policy instance 3
Insurance contract or identification number26-56930
Number of Individuals Covered220
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
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 $16,838
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number3852656930
Policy instance 2
Insurance contract or identification number3852656930
Number of Individuals Covered1078
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Total amount of commissions paid to insurance brokerUSD $5,184
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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 providedAD&D
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 $63,533
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,177
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number26-56930
Policy instance 1
Insurance contract or identification number26-56930
Number of Individuals Covered1057
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
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 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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number3852656930
Policy instance 2
Insurance contract or identification number3852656930
Number of Individuals Covered1054
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $5,980
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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 providedAD&D
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 $76,129
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,805
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number26-56930
Policy instance 1
Insurance contract or identification number26-56930
Number of Individuals Covered1101
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number3852656930
Policy instance 2
Insurance contract or identification number3852656930
Number of Individuals Covered1089
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Total amount of commissions paid to insurance brokerUSD $12,552
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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 providedAD&D
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 $60,433
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,159
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number26-56930
Policy instance 1
Insurance contract or identification number26-56930
Number of Individuals Covered1104
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number3852656930
Policy instance 2
Insurance contract or identification number3852656930
Number of Individuals Covered1140
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Total amount of commissions paid to insurance brokerUSD $5,602
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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 providedAD&D
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 $70,232
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,512
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number26-56930
Policy instance 1
Insurance contract or identification number26-56930
Number of Individuals Covered1144
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number3852656930
Policy instance 2
Insurance contract or identification number3852656930
Number of Individuals Covered1140
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $6,156
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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 providedAD&D
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 $76,248
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,812
Insurance broker organization code?3
Insurance broker nameBCBS OF SOUTH CAROLINA
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 38520 )
Policy contract number26-56930
Policy instance 1
Insurance contract or identification number26-56930
Number of Individuals Covered1191
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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