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BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameBALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN
Plan identification number 545

BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Death benefits (include travel accident but not life insurance)
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

BALLANTINE COMMUNICATIONS, INC. has sponsored the creation of one or more 401k plans.

Company Name:BALLANTINE COMMUNICATIONS, INC.
Employer identification number (EIN):840621590
NAIC Classification:511110
NAIC Description:Newspaper Publishers

Additional information about BALLANTINE COMMUNICATIONS, INC.

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 1971-03-24
Company Identification Number: 19871227821
Legal Registered Office Address: 1275 Main Ave

Durango
United States of America (USA)
81301

More information about BALLANTINE COMMUNICATIONS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5452019-01-01
5452018-01-01
5452017-01-01JOAN HOLLISTER
5452016-01-01
5452015-04-01ROBERT GANLEY ROBERT GANLEY2016-10-14
5452014-04-01ABIGAIL JOHNSON
5452014-04-01ABIGAIL JOHNSON
5452013-04-01ABIGAIL JOHNSON
5452012-04-01ROBERT WHITSON ROBERT WHITSON2014-01-10
5452011-04-01ROBERT WHITSON ROBERT WHITSON2012-12-05
5452009-04-01ROBERT J WHITSON ROBERT J WHITSON2011-01-07
5452009-04-01ROBERT WHITSON ROBERT WHITSON2011-01-07
5452009-04-01ROBERT J WHITSON ROBERT J WHITSON2011-01-07

Plan Statistics for BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN

Measure Date Value
2019: BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01100
Total number of active participants reported on line 7a of the Form 55002019-01-0186
Number of retired or separated participants receiving benefits2019-01-011
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-0187
2018: BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01110
Total number of active participants reported on line 7a of the Form 55002018-01-0189
Number of retired or separated participants receiving benefits2018-01-0111
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01100
2017: BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01118
Total number of active participants reported on line 7a of the Form 55002017-01-01104
Number of retired or separated participants receiving benefits2017-01-016
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01110
2016: BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01144
Total number of active participants reported on line 7a of the Form 55002016-01-01118
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01118
2015: BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-04-01116
Total number of active participants reported on line 7a of the Form 55002015-04-01142
Number of retired or separated participants receiving benefits2015-04-012
Number of other retired or separated participants entitled to future benefits2015-04-010
Total of all active and inactive participants2015-04-01144
2014: BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-04-01165
Total number of active participants reported on line 7a of the Form 55002014-04-01114
Number of retired or separated participants receiving benefits2014-04-012
Number of other retired or separated participants entitled to future benefits2014-04-010
Total of all active and inactive participants2014-04-01116
2013: BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-04-01116
Total number of active participants reported on line 7a of the Form 55002013-04-01164
Number of retired or separated participants receiving benefits2013-04-011
Number of other retired or separated participants entitled to future benefits2013-04-010
Total of all active and inactive participants2013-04-01165
2012: BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-04-01116
Total number of active participants reported on line 7a of the Form 55002012-04-01115
Number of retired or separated participants receiving benefits2012-04-011
Total of all active and inactive participants2012-04-01116
2011: BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-04-01117
Total number of active participants reported on line 7a of the Form 55002011-04-01114
Number of retired or separated participants receiving benefits2011-04-012
Total of all active and inactive participants2011-04-01116
2009: BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-04-01118
Total number of active participants reported on line 7a of the Form 55002009-04-01102
Total of all active and inactive participants2009-04-01102

Financial Data on BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN

Measure Date Value
2015 : BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$0
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$133,493
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$133,493
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$0
Value of total assets at end of year2015-12-31$0
Value of total assets at beginning of year2015-12-31$133,493
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$0
Total interest from all sources2015-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$350,000
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Total non interest bearing cash at end of year2015-12-31$0
Total non interest bearing cash at beginning of year2015-12-31$126,835
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-133,493
Value of net assets at end of year (total assets less liabilities)2015-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$133,493
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$6,658
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$6,658
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$133,493
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Did the plan have assets held for investment2015-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountancy firm name2015-12-31HOLBEN HAY LAKE BALZER CPAS LLC
Accountancy firm EIN2015-12-31841474365
Total unrealized appreciation/depreciation of assets2015-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-03-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-03-31$105,221
Total income from all sources (including contributions)2015-03-31$579,292
Total loss/gain on sale of assets2015-03-31$0
Total of all expenses incurred2015-03-31$852,022
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-03-31$821,764
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-03-31$579,263
Value of total assets at end of year2015-03-31$133,493
Value of total assets at beginning of year2015-03-31$511,444
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-03-31$30,258
Total interest from all sources2015-03-31$29
Total dividends received (eg from common stock, registered investment company shares)2015-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-03-31No
Administrative expenses professional fees incurred2015-03-31$30,236
Was this plan covered by a fidelity bond2015-03-31Yes
Value of fidelity bond cover2015-03-31$350,000
Were there any nonexempt tranactions with any party-in-interest2015-03-31No
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-03-31$39,708
Administrative expenses (other) incurred2015-03-31$22
Total non interest bearing cash at end of year2015-03-31$126,835
Total non interest bearing cash at beginning of year2015-03-31$19,066
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-03-31No
Value of net income/loss2015-03-31$-272,730
Value of net assets at end of year (total assets less liabilities)2015-03-31$133,493
Value of net assets at beginning of year (total assets less liabilities)2015-03-31$406,223
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-03-31No
Were any leases to which the plan was party in default or uncollectible2015-03-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-03-31$6,658
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-03-31$345,692
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-03-31$345,692
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-03-31$29
Expenses. Payments to insurance carriers foe the provision of benefits2015-03-31$65,281
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-03-31No
Was there a failure to transmit to the plan any participant contributions2015-03-31No
Has the plan failed to provide any benefit when due under the plan2015-03-31No
Contributions received in cash from employer2015-03-31$579,263
Employer contributions (assets) at beginning of year2015-03-31$146,686
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-03-31$756,483
Liabilities. Value of benefit claims payable at beginning of year2015-03-31$65,513
Did the plan have assets held for investment2015-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-03-31No
Opinion of an independent qualified public accountant for this plan2015-03-31Unqualified
Accountancy firm name2015-03-31HOLBEN HAY LAKE BALZER CPAS LLC
Accountancy firm EIN2015-03-31841474365
2014 : BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-03-31$105,221
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-03-31$98,768
Total income from all sources (including contributions)2014-03-31$888,180
Total loss/gain on sale of assets2014-03-31$0
Total of all expenses incurred2014-03-31$959,526
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-03-31$844,593
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-03-31$888,125
Value of total assets at end of year2014-03-31$511,444
Value of total assets at beginning of year2014-03-31$576,337
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-03-31$114,933
Total interest from all sources2014-03-31$55
Total dividends received (eg from common stock, registered investment company shares)2014-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-03-31No
Administrative expenses professional fees incurred2014-03-31$13,336
Was this plan covered by a fidelity bond2014-03-31Yes
Value of fidelity bond cover2014-03-31$350,000
Were there any nonexempt tranactions with any party-in-interest2014-03-31No
Contributions received from participants2014-03-31$325,050
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-03-31$39,708
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-03-31$43,733
Administrative expenses (other) incurred2014-03-31$35
Liabilities. Value of operating payables at beginning of year2014-03-31$4,961
Total non interest bearing cash at end of year2014-03-31$19,066
Total non interest bearing cash at beginning of year2014-03-31$15,893
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-03-31No
Value of net income/loss2014-03-31$-71,346
Value of net assets at end of year (total assets less liabilities)2014-03-31$406,223
Value of net assets at beginning of year (total assets less liabilities)2014-03-31$477,569
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-03-31No
Were any leases to which the plan was party in default or uncollectible2014-03-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-03-31$345,692
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-03-31$560,444
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-03-31$560,444
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-03-31$55
Expenses. Payments to insurance carriers foe the provision of benefits2014-03-31$232,326
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-03-31No
Was there a failure to transmit to the plan any participant contributions2014-03-31No
Has the plan failed to provide any benefit when due under the plan2014-03-31No
Contributions received in cash from employer2014-03-31$563,075
Employer contributions (assets) at end of year2014-03-31$146,686
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-03-31$612,267
Contract administrator fees2014-03-31$101,562
Liabilities. Value of benefit claims payable at end of year2014-03-31$65,513
Liabilities. Value of benefit claims payable at beginning of year2014-03-31$50,074
Did the plan have assets held for investment2014-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-03-31No
Opinion of an independent qualified public accountant for this plan2014-03-31Unqualified
Accountancy firm name2014-03-31MICHAEL L. ANDERSON & ASSOCIATES
Accountancy firm EIN2014-03-31411799234
2013 : BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-03-31$98,768
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-03-31$106,887
Total income from all sources (including contributions)2013-03-31$891,809
Total of all expenses incurred2013-03-31$811,343
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-03-31$724,973
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-03-31$891,756
Value of total assets at end of year2013-03-31$576,337
Value of total assets at beginning of year2013-03-31$503,990
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-03-31$86,370
Total interest from all sources2013-03-31$53
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-03-31No
Administrative expenses professional fees incurred2013-03-31$12,439
Was this plan covered by a fidelity bond2013-03-31Yes
Value of fidelity bond cover2013-03-31$350,000
If this is an individual account plan, was there a blackout period2013-03-31No
Were there any nonexempt tranactions with any party-in-interest2013-03-31No
Contributions received from participants2013-03-31$384,893
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-03-31$80,516
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-03-31$43,733
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-03-31$57,160
Liabilities. Value of operating payables at end of year2013-03-31$4,961
Liabilities. Value of operating payables at beginning of year2013-03-31$5,653
Total non interest bearing cash at end of year2013-03-31$15,893
Total non interest bearing cash at beginning of year2013-03-31$9,674
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-03-31No
Value of net income/loss2013-03-31$80,466
Value of net assets at end of year (total assets less liabilities)2013-03-31$477,569
Value of net assets at beginning of year (total assets less liabilities)2013-03-31$397,103
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-03-31No
Were any leases to which the plan was party in default or uncollectible2013-03-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-03-31$560,444
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-03-31$409,599
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-03-31$409,599
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-03-31$53
Expenses. Payments to insurance carriers foe the provision of benefits2013-03-31$222,710
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-03-31No
Was there a failure to transmit to the plan any participant contributions2013-03-31No
Has the plan failed to provide any benefit when due under the plan2013-03-31No
Contributions received in cash from employer2013-03-31$506,863
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-03-31$502,263
Contract administrator fees2013-03-31$73,931
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-03-31No
Liabilities. Value of benefit claims payable at end of year2013-03-31$50,074
Liabilities. Value of benefit claims payable at beginning of year2013-03-31$44,074
Assets. Value of buildings and other operty used in plan operation at end of year2013-03-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2013-03-31$4,201
Did the plan have assets held for investment2013-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-03-31No
Opinion of an independent qualified public accountant for this plan2013-03-31Unqualified
Accountancy firm name2013-03-31MICHAEL L. ANDERSON & ASSOCIATES
Accountancy firm EIN2013-03-31411799234
2012 : BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-03-31$106,887
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-03-31$96,459
Total income from all sources (including contributions)2012-03-31$1,095,315
Total of all expenses incurred2012-03-31$958,704
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-03-31$847,035
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-03-31$1,095,276
Value of total assets at end of year2012-03-31$503,990
Value of total assets at beginning of year2012-03-31$356,951
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-03-31$111,669
Total interest from all sources2012-03-31$39
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-03-31No
Administrative expenses professional fees incurred2012-03-31$13,539
Was this plan covered by a fidelity bond2012-03-31Yes
Value of fidelity bond cover2012-03-31$350,000
If this is an individual account plan, was there a blackout period2012-03-31No
Were there any nonexempt tranactions with any party-in-interest2012-03-31No
Contributions received from participants2012-03-31$414,978
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-03-31$80,516
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-03-31$20,684
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-03-31$57,160
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-03-31$61,419
Liabilities. Value of operating payables at end of year2012-03-31$5,653
Total non interest bearing cash at end of year2012-03-31$9,674
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-03-31No
Value of net income/loss2012-03-31$136,611
Value of net assets at end of year (total assets less liabilities)2012-03-31$397,103
Value of net assets at beginning of year (total assets less liabilities)2012-03-31$260,492
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-03-31No
Were any leases to which the plan was party in default or uncollectible2012-03-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-03-31$409,599
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-03-31$336,267
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-03-31$336,267
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-03-31$39
Expenses. Payments to insurance carriers foe the provision of benefits2012-03-31$243,188
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-03-31No
Was there a failure to transmit to the plan any participant contributions2012-03-31No
Has the plan failed to provide any benefit when due under the plan2012-03-31No
Contributions received in cash from employer2012-03-31$680,298
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-03-31$603,847
Contract administrator fees2012-03-31$98,130
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-03-31No
Liabilities. Value of benefit claims payable at end of year2012-03-31$44,074
Liabilities. Value of benefit claims payable at beginning of year2012-03-31$35,040
Assets. Value of buildings and other operty used in plan operation at end of year2012-03-31$4,201
Did the plan have assets held for investment2012-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-03-31No
Opinion of an independent qualified public accountant for this plan2012-03-31Unqualified
Accountancy firm name2012-03-31MICHAEL L. ANDERSON & ASSOCIATES
Accountancy firm EIN2012-03-31411799234
2011 : BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-03-31$96,459
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-03-31$75,369
Total income from all sources (including contributions)2011-03-31$865,643
Total of all expenses incurred2011-03-31$1,030,428
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-03-31$929,991
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-03-31$865,604
Value of total assets at end of year2011-03-31$356,951
Value of total assets at beginning of year2011-03-31$500,646
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-03-31$100,437
Total interest from all sources2011-03-31$39
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-03-31No
Administrative expenses professional fees incurred2011-03-31$13,664
Was this plan covered by a fidelity bond2011-03-31Yes
Value of fidelity bond cover2011-03-31$350,000
If this is an individual account plan, was there a blackout period2011-03-31No
Were there any nonexempt tranactions with any party-in-interest2011-03-31No
Contributions received from participants2011-03-31$356,351
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-03-31$20,684
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-03-31$101,155
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-03-31$61,419
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-03-31$49,687
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-03-31No
Value of net income/loss2011-03-31$-164,785
Value of net assets at end of year (total assets less liabilities)2011-03-31$260,492
Value of net assets at beginning of year (total assets less liabilities)2011-03-31$425,277
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-03-31No
Were any leases to which the plan was party in default or uncollectible2011-03-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-03-31$336,267
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-03-31$399,491
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-03-31$399,491
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-03-31$39
Expenses. Payments to insurance carriers foe the provision of benefits2011-03-31$179,454
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-03-31No
Was there a failure to transmit to the plan any participant contributions2011-03-31No
Has the plan failed to provide any benefit when due under the plan2011-03-31No
Contributions received in cash from employer2011-03-31$509,253
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-03-31$750,537
Contract administrator fees2011-03-31$86,773
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-03-31No
Liabilities. Value of benefit claims payable at end of year2011-03-31$35,040
Liabilities. Value of benefit claims payable at beginning of year2011-03-31$25,682
Did the plan have assets held for investment2011-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-03-31No
Opinion of an independent qualified public accountant for this plan2011-03-31Unqualified
Accountancy firm name2011-03-31MICHAEL L. ANDERSON & ASSOCIATES
Accountancy firm EIN2011-03-31411799234

Form 5500 Responses for BALLANTINE COMMUNICATIONS, INC. EMPLOYEE BENEFIT PLAN

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

Insurance Providers Used on plan

ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 )
Policy contract number196154
Policy instance 2
Insurance contract or identification number196154
Number of Individuals Covered68
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $29,748
Total amount of fees paid to insurance companyUSD $2,249
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare 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 $723,657
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,748
Amount paid for insurance broker fees2249
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number196154
Policy instance 1
Insurance contract or identification number196154
Number of Individuals Covered85
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $441
Total amount of fees paid to insurance companyUSD $33
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $10,727
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $441
Amount paid for insurance broker fees33
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number196154
Policy instance 2
Insurance contract or identification number196154
Number of Individuals Covered89
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $620
Total amount of fees paid to insurance companyUSD $48
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $16,597
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $620
Amount paid for insurance broker fees48
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 )
Policy contract number196154
Policy instance 1
Insurance contract or identification number196154
Number of Individuals Covered71
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $30,411
Total amount of fees paid to insurance companyUSD $2,354
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare 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 $814,718
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,411
Amount paid for insurance broker fees2354
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 )
Policy contract number196154
Policy instance 2
Insurance contract or identification number196154
Number of Individuals Covered161
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $38,155
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 BenefitYes
Dental Insurance Welfare BenefitYes
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 $917,796
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,155
Insurance broker organization code?3
Insurance broker nameALLIANT INSURANCE SERVICES, INC.
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number218447
Policy instance 1
Insurance contract or identification number218447
Number of Individuals Covered102
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,960
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 providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $18,849
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,960
Insurance broker organization code?3
Insurance broker nameALLIANT INSURANCE SERVICES, INC.
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number218447
Policy instance 2
Insurance contract or identification number218447
Number of Individuals Covered147
Insurance policy start date2014-04-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,178
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $17,149
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
QBE A&H (National Association of Insurance Commissioners NAIC id number: 39217 )
Policy contract numberLGS00822-14
Policy instance 1
Insurance contract or identification numberLGS00822-14
Number of Individuals Covered116
Insurance policy start date2014-04-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $21,484
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $214,840
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number218447
Policy instance 1
Insurance contract or identification number218447
Number of Individuals Covered164
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $3,403
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $22,710
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,403
Insurance broker organization code?3
Insurance broker nameDENMAN GRAY & COMPANY INC.
QBE A&H (National Association of Insurance Commissioners NAIC id number: 39217 )
Policy contract numberLGS00822-13
Policy instance 2
Insurance contract or identification numberLGS00822-13
Number of Individuals Covered912
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $214,895
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
QBE A&H (National Association of Insurance Commissioners NAIC id number: 39217 )
Policy contract numberLGS00822-12
Policy instance 3
Insurance contract or identification numberLGS00822-12
Number of Individuals Covered922
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedSTOP LOSS
Welfare Benefit Premiums Paid to CarrierUSD $197,165
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number218447
Policy instance 2
Insurance contract or identification number218447
Number of Individuals Covered167
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $3,831
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,554
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,831
Insurance broker organization code?3
Insurance broker nameDENMAN, GRAY & CO INC
MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number12248
Policy instance 1
Insurance contract or identification number12248
Number of Individuals Covered116
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010093019
Policy instance 2
Insurance contract or identification number000010093019
Number of Individuals Covered154
Insurance policy start date2011-03-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $395
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,911
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number218447
Policy instance 3
Insurance contract or identification number218447
Number of Individuals Covered124
Insurance policy start date2011-07-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $2,558
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,101
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number12248
Policy instance 1
Insurance contract or identification number12248
Number of Individuals Covered116
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010093019
Policy instance 2
Insurance contract or identification number000010093019
Number of Individuals Covered154
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $1,541
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $14,176
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number12248
Policy instance 1
Insurance contract or identification number12248
Number of Individuals Covered117
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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