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VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN 401k Plan overview

Plan NameVIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN
Plan identification number 501

VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN Benefits

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

401k Sponsoring company profile

VIGILANT CONSTRUCTION TRUST OF ARIZONA has sponsored the creation of one or more 401k plans.

Company Name:VIGILANT CONSTRUCTION TRUST OF ARIZONA
Employer identification number (EIN):833466731
NAIC Classification:525100
NAIC Description: Insurance and Employee Benefit Funds

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01
5012022-01-01
5012021-01-01
5012020-01-01
5012019-05-01

Plan Statistics for VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN

401k plan membership statisitcs for VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN

Measure Date Value
2023: VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01479
Total number of active participants reported on line 7a of the Form 55002023-01-01547
Total of all active and inactive participants2023-01-01547
2022: VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01378
Total number of active participants reported on line 7a of the Form 55002022-01-01479
Total of all active and inactive participants2022-01-01479
2021: VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01249
Total number of active participants reported on line 7a of the Form 55002021-01-01378
Total of all active and inactive participants2021-01-01378
2020: VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0164
Total number of active participants reported on line 7a of the Form 55002020-01-01249
Total of all active and inactive participants2020-01-01249
2019: VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN 2019 401k membership
Total participants, beginning-of-year2019-05-010
Total number of active participants reported on line 7a of the Form 55002019-05-0164
Total of all active and inactive participants2019-05-0164

Financial Data on VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN

Measure Date Value
2023 : VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN 2023 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$93,705
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$79,960
Total income from all sources (including contributions)2023-12-31$4,150,544
Total of all expenses incurred2023-12-31$4,133,767
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$3,656,568
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-12-31$4,150,288
Value of total assets at end of year2023-12-31$97,596
Value of total assets at beginning of year2023-12-31$67,074
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$477,199
Total interest from all sources2023-12-31$256
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-12-31No
Was this plan covered by a fidelity bond2023-12-31Yes
Value of fidelity bond cover2023-12-31$40,000
If this is an individual account plan, was there a blackout period2023-12-31No
Were there any nonexempt tranactions with any party-in-interest2023-12-31No
Contributions received from participants2023-12-31$35,898
Value of other receiveables (less allowance for doubtful accounts) at end of year2023-12-31$5,996
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2023-12-31$487
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2023-12-31$93,705
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2023-12-31$62,037
Administrative expenses (other) incurred2023-12-31$353,287
Liabilities. Value of operating payables at end of year2023-12-31$0
Liabilities. Value of operating payables at beginning of year2023-12-31$10,066
Total non interest bearing cash at end of year2023-12-31$5,583
Total non interest bearing cash at beginning of year2023-12-31$64,992
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Value of net income/loss2023-12-31$16,777
Value of net assets at end of year (total assets less liabilities)2023-12-31$3,891
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$-12,886
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-12-31No
Were any leases to which the plan was party in default or uncollectible2023-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-12-31$83,649
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2023-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2023-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2023-12-31$256
Expenses. Payments to insurance carriers foe the provision of benefits2023-12-31$3,656,568
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-12-31No
Was there a failure to transmit to the plan any participant contributions2023-12-31No
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Contributions received in cash from employer2023-12-31$4,114,390
Employer contributions (assets) at end of year2023-12-31$2,368
Employer contributions (assets) at beginning of year2023-12-31$1,595
Contract administrator fees2023-12-31$115,112
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32023-12-31No
Liabilities. Value of benefit claims payable at end of year2023-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2023-12-31$7,857
Did the plan have assets held for investment2023-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-12-31No
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31SCHOEDEL & SCHOEDEL, CPAS PLLC
Accountancy firm EIN2023-12-31910614823
2022 : VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$79,960
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$128,086
Total income from all sources (including contributions)2022-12-31$3,453,267
Total of all expenses incurred2022-12-31$3,468,802
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$3,052,212
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$3,453,267
Value of total assets at end of year2022-12-31$67,074
Value of total assets at beginning of year2022-12-31$130,735
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$416,590
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Administrative expenses professional fees incurred2022-12-31$315,290
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$40,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$5,270
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$487
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$370
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$62,037
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$94,081
Administrative expenses (other) incurred2022-12-31$5,751
Liabilities. Value of operating payables at end of year2022-12-31$10,066
Liabilities. Value of operating payables at beginning of year2022-12-31$15,521
Total non interest bearing cash at end of year2022-12-31$64,992
Total non interest bearing cash at beginning of year2022-12-31$123,878
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-15,535
Value of net assets at end of year (total assets less liabilities)2022-12-31$-12,886
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$2,649
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$3,052,212
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$3,447,997
Employer contributions (assets) at end of year2022-12-31$1,595
Employer contributions (assets) at beginning of year2022-12-31$6,487
Contract administrator fees2022-12-31$95,549
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-12-31No
Liabilities. Value of benefit claims payable at end of year2022-12-31$7,857
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$18,484
Did the plan have assets held for investment2022-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31SCHOEDEL & SCHOEDEL, CPAS PLLC
Accountancy firm EIN2022-12-31910614823
2021 : VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$128,086
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$44,320
Total income from all sources (including contributions)2021-12-31$2,310,229
Total of all expenses incurred2021-12-31$2,308,302
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$2,032,818
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$2,310,229
Value of total assets at end of year2021-12-31$130,735
Value of total assets at beginning of year2021-12-31$45,042
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$275,484
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Administrative expenses professional fees incurred2021-12-31$206,690
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$40,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$7,833
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$370
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$418
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$94,081
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$35,249
Administrative expenses (other) incurred2021-12-31$5,103
Liabilities. Value of operating payables at end of year2021-12-31$15,521
Liabilities. Value of operating payables at beginning of year2021-12-31$1,387
Total non interest bearing cash at end of year2021-12-31$123,878
Total non interest bearing cash at beginning of year2021-12-31$42,461
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$1,927
Value of net assets at end of year (total assets less liabilities)2021-12-31$2,649
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$722
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$2,032,818
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$2,302,396
Employer contributions (assets) at end of year2021-12-31$6,487
Employer contributions (assets) at beginning of year2021-12-31$2,163
Contract administrator fees2021-12-31$63,691
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-12-31No
Liabilities. Value of benefit claims payable at end of year2021-12-31$18,484
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$7,684
Did the plan have assets held for investment2021-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31SCHOEDEL & SCHOEDEL, CPAS PLLC
Accountancy firm EIN2021-12-31910614823
2020 : VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$44,320
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$79,167
Total income from all sources (including contributions)2020-12-31$1,587,406
Total of all expenses incurred2020-12-31$1,585,747
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$1,409,087
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$1,587,406
Value of total assets at end of year2020-12-31$45,042
Value of total assets at beginning of year2020-12-31$78,230
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$176,660
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Administrative expenses professional fees incurred2020-12-31$128,308
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$40,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$9,109
Participant contributions at end of year2020-12-31$0
Participant contributions at beginning of year2020-12-31$1,107
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$418
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$199
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$35,249
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$74,784
Administrative expenses (other) incurred2020-12-31$4,522
Liabilities. Value of operating payables at end of year2020-12-31$1,387
Liabilities. Value of operating payables at beginning of year2020-12-31$2,531
Total non interest bearing cash at end of year2020-12-31$42,461
Total non interest bearing cash at beginning of year2020-12-31$75,903
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$1,659
Value of net assets at end of year (total assets less liabilities)2020-12-31$722
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$-937
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$1,409,087
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$1,578,297
Employer contributions (assets) at end of year2020-12-31$2,163
Employer contributions (assets) at beginning of year2020-12-31$1,021
Contract administrator fees2020-12-31$43,830
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-12-31No
Liabilities. Value of benefit claims payable at end of year2020-12-31$7,684
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$1,852
Did the plan have assets held for investment2020-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31SCHOEDEL & SCHOEDEL, CPAS PLLC
Accountancy firm EIN2020-12-31910614823
2019 : VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$79,167
Total income from all sources (including contributions)2019-12-31$84,368
Total of all expenses incurred2019-12-31$85,305
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$74,567
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$84,368
Value of total assets at end of year2019-12-31$78,230
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$10,738
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Administrative expenses professional fees incurred2019-12-31$7,485
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$40,000
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$1,665
Participant contributions at end of year2019-12-31$1,107
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$199
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$74,784
Administrative expenses (other) incurred2019-12-31$948
Liabilities. Value of operating payables at end of year2019-12-31$2,531
Total non interest bearing cash at end of year2019-12-31$75,903
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$-937
Value of net assets at end of year (total assets less liabilities)2019-12-31$-937
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$74,567
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$82,703
Employer contributions (assets) at end of year2019-12-31$1,021
Contract administrator fees2019-12-31$2,305
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31No
Liabilities. Value of benefit claims payable at end of year2019-12-31$1,852
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31SCHOEDEL & SCHOEDEL, CPAS PLLC
Accountancy firm EIN2019-12-31910614823

Form 5500 Responses for VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN

2023: VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN 2023 form 5500 responses
2023-01-01Type of plan entityMulitple employer plan
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN 2022 form 5500 responses
2022-01-01Type of plan entityMulitple employer plan
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN 2021 form 5500 responses
2021-01-01Type of plan entityMulitple employer plan
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN 2020 form 5500 responses
2020-01-01Type of plan entityMulitple employer plan
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: VIGILANT CONSTRUCTION TRUST OF ARIZONA PLAN 2019 form 5500 responses
2019-05-01Type of plan entityMulitple employer plan
2019-05-01First time form 5500 has been submittedYes
2019-05-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-05-01Plan funding arrangement – TrustYes
2019-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number011669
Policy instance 3
Insurance contract or identification number011669
Number of Individuals Covered571
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $783
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL D&D, EAP
Welfare Benefit Premiums Paid to CarrierUSD $17,432
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30044146
Policy instance 2
Insurance contract or identification number30044146
Number of Individuals Covered71
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,752
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number52000-52055
Policy instance 1
Insurance contract or identification number52000-52055
Number of Individuals Covered888
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,632,384
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number011669
Policy instance 4
Insurance contract or identification number011669
Number of Individuals Covered484
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 $466
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $9,311
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees466
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30044146
Policy instance 3
Insurance contract or identification number30044146
Number of Individuals Covered92
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
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,059
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number757767
Policy instance 2
Insurance contract or identification number757767
Number of Individuals Covered247
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
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $7,013
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number52000-52043
Policy instance 1
Insurance contract or identification number52000-52043
Number of Individuals Covered715
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $150
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,027,789
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees150
Additional information about fees paid to insurance brokerSPECIAL INCENTIVE
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30044146
Policy instance 3
Insurance contract or identification number30044146
Number of Individuals Covered107
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
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,472
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number757767
Policy instance 2
Insurance contract or identification number757767
Number of Individuals Covered283
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 $342
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $13,307
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees342
Additional information about fees paid to insurance brokerCONTINGENT COMPENSATION
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number052000-031
Policy instance 1
Insurance contract or identification number052000-031
Number of Individuals Covered644
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $250
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,013,039
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees250
Additional information about fees paid to insurance brokerSPECIAL INCENTIVE
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30044146
Policy instance 3
Insurance contract or identification number30044146
Number of Individuals Covered60
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
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,032
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number757767
Policy instance 2
Insurance contract or identification number757767
Number of Individuals Covered194
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
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $8,513
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number052000-002
Policy instance 1
Insurance contract or identification number052000-002
Number of Individuals Covered227
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $150
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,394,542
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees150
Additional information about fees paid to insurance brokerSPECIAL INCENTIVE
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number757767
Policy instance 2
Insurance contract or identification number757767
Number of Individuals Covered63
Insurance policy start date2019-10-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $490
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number052000-002
Policy instance 1
Insurance contract or identification number052000-002
Number of Individuals Covered64
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
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $74,077
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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