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OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 401k Plan overview

Plan NameOPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND
Plan identification number 501

OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

OPERATING ENGINEERS' LOCAL NO. 428 HEALTH AND WELFARE TRUST FUND has sponsored the creation of one or more 401k plans.

Company Name:OPERATING ENGINEERS' LOCAL NO. 428 HEALTH AND WELFARE TRUST FUND
Employer identification number (EIN):866025730
NAIC Classification:525100
NAIC Description: Insurance and Employee Benefit Funds

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-10-01
5012021-10-01
5012020-10-01
5012019-10-01
5012018-10-01
5012017-10-01
5012016-10-01DAVID MARTIN MICHAEL LEE2018-07-13
5012015-10-01MICHAEL LEE
5012014-10-01DAVID MARTIN MICHAEL LEE2016-07-15
5012013-10-01MICHAEL LEE
5012012-10-01RAUL GARCIA JR
5012011-10-01RAUL GARCIA JR
5012010-10-01RAUL GARCIA JR
5012009-10-01RAUL GARCIA JR
5012008-10-01

Plan Statistics for OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND

401k plan membership statisitcs for OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND

Measure Date Value
2022: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2022 401k membership
Total participants, beginning-of-year2022-10-011,212
Total number of active participants reported on line 7a of the Form 55002022-10-011,486
Number of retired or separated participants receiving benefits2022-10-0172
Total of all active and inactive participants2022-10-011,558
Total participants2022-10-011,558
Number of employers contributing to the scheme2022-10-0185
2021: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2021 401k membership
Total participants, beginning-of-year2021-10-011,187
Total number of active participants reported on line 7a of the Form 55002021-10-011,152
Number of retired or separated participants receiving benefits2021-10-0160
Total of all active and inactive participants2021-10-011,212
Total participants2021-10-011,212
Number of employers contributing to the scheme2021-10-0185
2020: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2020 401k membership
Total participants, beginning-of-year2020-10-011,529
Total number of active participants reported on line 7a of the Form 55002020-10-011,124
Number of retired or separated participants receiving benefits2020-10-0163
Total of all active and inactive participants2020-10-011,187
Total participants2020-10-011,187
Number of employers contributing to the scheme2020-10-0156
2019: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2019 401k membership
Total participants, beginning-of-year2019-10-011,273
Total number of active participants reported on line 7a of the Form 55002019-10-011,463
Number of retired or separated participants receiving benefits2019-10-0166
Total of all active and inactive participants2019-10-011,529
Total participants2019-10-011,529
Number of employers contributing to the scheme2019-10-0177
2018: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2018 401k membership
Total participants, beginning-of-year2018-10-011,223
Total number of active participants reported on line 7a of the Form 55002018-10-011,190
Number of retired or separated participants receiving benefits2018-10-0183
Total of all active and inactive participants2018-10-011,273
Total participants2018-10-011,273
Number of employers contributing to the scheme2018-10-0182
2017: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2017 401k membership
Total participants, beginning-of-year2017-10-01976
Total number of active participants reported on line 7a of the Form 55002017-10-011,197
Number of retired or separated participants receiving benefits2017-10-0126
Total of all active and inactive participants2017-10-011,223
Total participants2017-10-011,223
Number of employers contributing to the scheme2017-10-0180
2016: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2016 401k membership
Total participants, beginning-of-year2016-10-01890
Total number of active participants reported on line 7a of the Form 55002016-10-01976
Number of retired or separated participants receiving benefits2016-10-0170
Total of all active and inactive participants2016-10-011,046
Total participants2016-10-011,046
Number of employers contributing to the scheme2016-10-0180
2015: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2015 401k membership
Total participants, beginning-of-year2015-10-01995
Total number of active participants reported on line 7a of the Form 55002015-10-01819
Number of retired or separated participants receiving benefits2015-10-0171
Total of all active and inactive participants2015-10-01890
Total participants2015-10-01890
Number of employers contributing to the scheme2015-10-0178
2014: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2014 401k membership
Total participants, beginning-of-year2014-10-011,078
Total number of active participants reported on line 7a of the Form 55002014-10-01919
Number of retired or separated participants receiving benefits2014-10-0176
Total of all active and inactive participants2014-10-01995
Total participants2014-10-01995
Number of employers contributing to the scheme2014-10-01100
2013: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2013 401k membership
Total participants, beginning-of-year2013-10-011,047
Total number of active participants reported on line 7a of the Form 55002013-10-01989
Number of retired or separated participants receiving benefits2013-10-0189
Total of all active and inactive participants2013-10-011,078
Total participants2013-10-011,078
Number of employers contributing to the scheme2013-10-0181
2012: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2012 401k membership
Total participants, beginning-of-year2012-10-011,103
Total number of active participants reported on line 7a of the Form 55002012-10-01952
Number of retired or separated participants receiving benefits2012-10-0195
Total of all active and inactive participants2012-10-011,047
Total participants2012-10-011,047
Number of employers contributing to the scheme2012-10-0184
2011: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2011 401k membership
Total participants, beginning-of-year2011-10-011,205
Total number of active participants reported on line 7a of the Form 55002011-10-011,010
Number of retired or separated participants receiving benefits2011-10-0193
Total of all active and inactive participants2011-10-011,103
Total participants2011-10-011,103
Number of employers contributing to the scheme2011-10-0166
2010: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2010 401k membership
Total participants, beginning-of-year2010-10-011,327
Total number of active participants reported on line 7a of the Form 55002010-10-01983
Number of retired or separated participants receiving benefits2010-10-01222
Total of all active and inactive participants2010-10-011,205
2009: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2009 401k membership
Total participants, beginning-of-year2009-10-011,545
Total number of active participants reported on line 7a of the Form 55002009-10-011,113
Number of retired or separated participants receiving benefits2009-10-01214
Total of all active and inactive participants2009-10-011,327

Financial Data on OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND

Measure Date Value
2023 : OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2023 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2023-09-30$628,097
Total unrealized appreciation/depreciation of assets2023-09-30$628,097
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-09-30$11,654,997
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-09-30$9,091,025
Total income from all sources (including contributions)2023-09-30$24,917,663
Total loss/gain on sale of assets2023-09-30$0
Total of all expenses incurred2023-09-30$17,176,661
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-09-30$15,686,213
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-09-30$21,865,700
Value of total assets at end of year2023-09-30$48,188,646
Value of total assets at beginning of year2023-09-30$37,883,672
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-09-30$1,490,448
Total interest from all sources2023-09-30$60,911
Total dividends received (eg from common stock, registered investment company shares)2023-09-30$1,260,849
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2023-09-30$1,260,849
Administrative expenses professional fees incurred2023-09-30$229,026
Was this plan covered by a fidelity bond2023-09-30Yes
Value of fidelity bond cover2023-09-30$2,000,000
Were there any nonexempt tranactions with any party-in-interest2023-09-30No
Contributions received from participants2023-09-30$82,694
Participant contributions at end of year2023-09-30$600
Participant contributions at beginning of year2023-09-30$5,120
Value of other receiveables (less allowance for doubtful accounts) at end of year2023-09-30$664,377
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2023-09-30$468,302
Administrative expenses (other) incurred2023-09-30$902,157
Liabilities. Value of operating payables at end of year2023-09-30$448,036
Liabilities. Value of operating payables at beginning of year2023-09-30$460,520
Total non interest bearing cash at end of year2023-09-30$498,855
Total non interest bearing cash at beginning of year2023-09-30$22,238
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-09-30No
Value of net income/loss2023-09-30$7,741,002
Value of net assets at end of year (total assets less liabilities)2023-09-30$36,533,649
Value of net assets at beginning of year (total assets less liabilities)2023-09-30$28,792,647
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2023-09-30No
Were any leases to which the plan was party in default or uncollectible2023-09-30No
Assets. partnership/joint venture interests at end of year2023-09-30$3,770,944
Assets. partnership/joint venture interests at beginning of year2023-09-30$3,143,510
Investment advisory and management fees2023-09-30$50,715
Value of interest in registered invesment companies (eg mutual funds) at end of year2023-09-30$39,142,821
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2023-09-30$29,959,940
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-09-30$1,860,727
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2023-09-30$2,516,053
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2023-09-30$2,516,053
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2023-09-30$60,911
Expenses. Payments to insurance carriers foe the provision of benefits2023-09-30$340,903
Net investment gain/loss from registered investment companies (e.g. mutual funds)2023-09-30$1,102,106
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-09-30Yes
Was there a failure to transmit to the plan any participant contributions2023-09-30No
Has the plan failed to provide any benefit when due under the plan2023-09-30No
Contributions received in cash from employer2023-09-30$21,783,006
Employer contributions (assets) at end of year2023-09-30$2,250,322
Employer contributions (assets) at beginning of year2023-09-30$1,768,509
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-09-30$15,345,310
Contract administrator fees2023-09-30$308,550
Liabilities. Value of benefit claims payable at end of year2023-09-30$11,206,961
Liabilities. Value of benefit claims payable at beginning of year2023-09-30$8,630,505
Did the plan have assets held for investment2023-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-09-30No
Aggregate proceeds on sale of assets2023-09-30$0
Aggregate carrying amount (costs) on sale of assets2023-09-30$0
Opinion of an independent qualified public accountant for this plan2023-09-30Unqualified
Accountancy firm name2023-09-30BALDWIN MOFFITT BEHM LLP
Accountancy firm EIN2023-09-30464370753
2022 : OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-09-30$-539,430
Total unrealized appreciation/depreciation of assets2022-09-30$-539,430
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-09-30$9,091,025
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-09-30$7,344,677
Total income from all sources (including contributions)2022-09-30$11,303,552
Total loss/gain on sale of assets2022-09-30$0
Total of all expenses incurred2022-09-30$17,093,689
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-09-30$16,252,123
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-09-30$18,324,378
Value of total assets at end of year2022-09-30$37,883,672
Value of total assets at beginning of year2022-09-30$41,927,461
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-09-30$841,566
Total interest from all sources2022-09-30$7,514
Total dividends received (eg from common stock, registered investment company shares)2022-09-30$666,917
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2022-09-30$666,917
Administrative expenses professional fees incurred2022-09-30$271,484
Was this plan covered by a fidelity bond2022-09-30Yes
Value of fidelity bond cover2022-09-30$2,000,000
Were there any nonexempt tranactions with any party-in-interest2022-09-30No
Contributions received from participants2022-09-30$97,435
Participant contributions at end of year2022-09-30$5,120
Participant contributions at beginning of year2022-09-30$9,045
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-09-30$468,302
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-09-30$860,288
Other income not declared elsewhere2022-09-30$924
Administrative expenses (other) incurred2022-09-30$121,488
Liabilities. Value of operating payables at end of year2022-09-30$460,520
Liabilities. Value of operating payables at beginning of year2022-09-30$316,125
Total non interest bearing cash at end of year2022-09-30$22,238
Total non interest bearing cash at beginning of year2022-09-30$143,503
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-09-30No
Value of net income/loss2022-09-30$-5,790,137
Value of net assets at end of year (total assets less liabilities)2022-09-30$28,792,647
Value of net assets at beginning of year (total assets less liabilities)2022-09-30$34,582,784
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-09-30No
Were any leases to which the plan was party in default or uncollectible2022-09-30No
Investment advisory and management fees2022-09-30$48,237
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-09-30$29,959,940
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-09-30$34,676,365
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-09-30$2,516,053
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-09-30$1,153,914
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-09-30$1,153,914
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-09-30$7,514
Expenses. Payments to insurance carriers foe the provision of benefits2022-09-30$702,974
Asset value of US Government securities at end of year2022-09-30$3,143,510
Asset value of US Government securities at beginning of year2022-09-30$3,682,940
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-09-30$-7,156,751
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-09-30Yes
Was there a failure to transmit to the plan any participant contributions2022-09-30No
Has the plan failed to provide any benefit when due under the plan2022-09-30No
Contributions received in cash from employer2022-09-30$18,226,943
Employer contributions (assets) at end of year2022-09-30$1,768,509
Employer contributions (assets) at beginning of year2022-09-30$1,401,406
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-09-30$15,549,149
Contract administrator fees2022-09-30$400,357
Liabilities. Value of benefit claims payable at end of year2022-09-30$8,630,505
Liabilities. Value of benefit claims payable at beginning of year2022-09-30$7,028,552
Did the plan have assets held for investment2022-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-09-30No
Aggregate proceeds on sale of assets2022-09-30$0
Aggregate carrying amount (costs) on sale of assets2022-09-30$0
Opinion of an independent qualified public accountant for this plan2022-09-30Unqualified
Accountancy firm name2022-09-30BALDWIN MOFFITT BEHM LLP
Accountancy firm EIN2022-09-30464370753
2021 : OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2021-09-30$382,940
Total unrealized appreciation/depreciation of assets2021-09-30$382,940
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-09-30$7,344,677
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-09-30$9,694,257
Total income from all sources (including contributions)2021-09-30$20,932,881
Total loss/gain on sale of assets2021-09-30$0
Total of all expenses incurred2021-09-30$11,972,516
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-09-30$11,279,476
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-09-30$16,803,895
Value of total assets at end of year2021-09-30$41,927,461
Value of total assets at beginning of year2021-09-30$35,316,676
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-09-30$693,040
Total interest from all sources2021-09-30$134
Total dividends received (eg from common stock, registered investment company shares)2021-09-30$470,313
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2021-09-30$470,313
Administrative expenses professional fees incurred2021-09-30$200,340
Was this plan covered by a fidelity bond2021-09-30Yes
Value of fidelity bond cover2021-09-30$500,000
Were there any nonexempt tranactions with any party-in-interest2021-09-30No
Contributions received from participants2021-09-30$123,070
Participant contributions at end of year2021-09-30$9,045
Participant contributions at beginning of year2021-09-30$9,530
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-09-30$860,288
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-09-30$603,237
Other income not declared elsewhere2021-09-30$35,962
Administrative expenses (other) incurred2021-09-30$105,111
Liabilities. Value of operating payables at end of year2021-09-30$316,125
Liabilities. Value of operating payables at beginning of year2021-09-30$64,142
Total non interest bearing cash at end of year2021-09-30$143,503
Total non interest bearing cash at beginning of year2021-09-30$1,279,496
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-09-30No
Value of net income/loss2021-09-30$8,960,365
Value of net assets at end of year (total assets less liabilities)2021-09-30$34,582,784
Value of net assets at beginning of year (total assets less liabilities)2021-09-30$25,622,419
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-09-30No
Were any leases to which the plan was party in default or uncollectible2021-09-30No
Assets. partnership/joint venture interests at end of year2021-09-30$3,682,940
Investment advisory and management fees2021-09-30$39,780
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-09-30$34,676,365
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-09-30$30,785,751
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-09-30$1,153,914
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-09-30$357,721
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-09-30$357,721
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-09-30$134
Expenses. Payments to insurance carriers foe the provision of benefits2021-09-30$759,848
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-09-30$3,239,637
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-09-30Yes
Was there a failure to transmit to the plan any participant contributions2021-09-30No
Has the plan failed to provide any benefit when due under the plan2021-09-30No
Contributions received in cash from employer2021-09-30$16,680,825
Employer contributions (assets) at end of year2021-09-30$1,401,406
Employer contributions (assets) at beginning of year2021-09-30$2,280,941
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-09-30$10,519,628
Contract administrator fees2021-09-30$347,809
Liabilities. Value of benefit claims payable at end of year2021-09-30$7,028,552
Liabilities. Value of benefit claims payable at beginning of year2021-09-30$9,513,443
Did the plan have assets held for investment2021-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-09-30No
Aggregate proceeds on sale of assets2021-09-30$0
Aggregate carrying amount (costs) on sale of assets2021-09-30$0
Liabilities. Value of acquisition indebtedness at beginning of year2021-09-30$116,672
Opinion of an independent qualified public accountant for this plan2021-09-30Unqualified
Accountancy firm name2021-09-30BALDWIN MOFFITT BEHM LLP
Accountancy firm EIN2021-09-30464370753
2020 : OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-09-30$9,694,257
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-09-30$7,964,935
Total income from all sources (including contributions)2020-09-30$21,984,832
Total loss/gain on sale of assets2020-09-30$0
Total of all expenses incurred2020-09-30$17,941,545
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-09-30$17,277,415
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-09-30$19,570,602
Value of total assets at end of year2020-09-30$35,316,676
Value of total assets at beginning of year2020-09-30$29,544,067
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-09-30$664,130
Total interest from all sources2020-09-30$9,410
Total dividends received (eg from common stock, registered investment company shares)2020-09-30$601,370
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2020-09-30$601,370
Administrative expenses professional fees incurred2020-09-30$198,558
Was this plan covered by a fidelity bond2020-09-30Yes
Value of fidelity bond cover2020-09-30$1,000,000
Were there any nonexempt tranactions with any party-in-interest2020-09-30No
Contributions received from participants2020-09-30$118,844
Participant contributions at end of year2020-09-30$9,530
Participant contributions at beginning of year2020-09-30$8,153
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-09-30$508,874
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-09-30$177,989
Other income not declared elsewhere2020-09-30$93,101
Administrative expenses (other) incurred2020-09-30$97,883
Liabilities. Value of operating payables at end of year2020-09-30$64,142
Liabilities. Value of operating payables at beginning of year2020-09-30$55,710
Total non interest bearing cash at end of year2020-09-30$1,279,496
Total non interest bearing cash at beginning of year2020-09-30$262,849
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-09-30No
Value of net income/loss2020-09-30$4,043,287
Value of net assets at end of year (total assets less liabilities)2020-09-30$25,622,419
Value of net assets at beginning of year (total assets less liabilities)2020-09-30$21,579,132
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-09-30No
Were any leases to which the plan was party in default or uncollectible2020-09-30No
Investment advisory and management fees2020-09-30$22,000
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-09-30$30,785,751
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-09-30$25,726,079
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-09-30$357,721
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-09-30$1,780,370
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-09-30$1,780,370
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-09-30$9,410
Expenses. Payments to insurance carriers foe the provision of benefits2020-09-30$847,238
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-09-30$1,710,349
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-09-30Yes
Was there a failure to transmit to the plan any participant contributions2020-09-30No
Has the plan failed to provide any benefit when due under the plan2020-09-30No
Contributions received in cash from employer2020-09-30$19,451,758
Employer contributions (assets) at end of year2020-09-30$2,280,941
Employer contributions (assets) at beginning of year2020-09-30$1,496,004
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-09-30$16,430,177
Contract administrator fees2020-09-30$345,689
Liabilities. Value of benefit claims payable at end of year2020-09-30$9,513,443
Liabilities. Value of benefit claims payable at beginning of year2020-09-30$7,909,225
Assets. Value of buildings and other operty used in plan operation at end of year2020-09-30$94,363
Assets. Value of buildings and other operty used in plan operation at beginning of year2020-09-30$92,623
Did the plan have assets held for investment2020-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-09-30No
Liabilities. Value of acquisition indebtedness at end of year2020-09-30$116,672
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-09-30No
Opinion of an independent qualified public accountant for this plan2020-09-30Unqualified
Accountancy firm name2020-09-30BALDWIN MOFFITT PLLC
Accountancy firm EIN2020-09-30464370753
2019 : OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-09-30$7,964,935
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-09-30$6,915,764
Total income from all sources (including contributions)2019-09-30$18,973,693
Total loss/gain on sale of assets2019-09-30$0
Total of all expenses incurred2019-09-30$14,923,831
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-09-30$14,303,924
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-09-30$17,241,661
Value of total assets at end of year2019-09-30$29,544,067
Value of total assets at beginning of year2019-09-30$24,445,034
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-09-30$619,907
Total interest from all sources2019-09-30$18,381
Total dividends received (eg from common stock, registered investment company shares)2019-09-30$590,720
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2019-09-30$590,720
Administrative expenses professional fees incurred2019-09-30$153,209
Was this plan covered by a fidelity bond2019-09-30Yes
Value of fidelity bond cover2019-09-30$1,000,000
Were there any nonexempt tranactions with any party-in-interest2019-09-30No
Contributions received from participants2019-09-30$114,148
Participant contributions at end of year2019-09-30$8,153
Participant contributions at beginning of year2019-09-30$5,820
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-09-30$177,989
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-09-30$339,751
Other income not declared elsewhere2019-09-30$3,962
Administrative expenses (other) incurred2019-09-30$107,780
Liabilities. Value of operating payables at end of year2019-09-30$55,710
Liabilities. Value of operating payables at beginning of year2019-09-30$466,496
Total non interest bearing cash at end of year2019-09-30$262,849
Total non interest bearing cash at beginning of year2019-09-30$327,077
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-09-30No
Value of net income/loss2019-09-30$4,049,862
Value of net assets at end of year (total assets less liabilities)2019-09-30$21,579,132
Value of net assets at beginning of year (total assets less liabilities)2019-09-30$17,529,270
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2019-09-30No
Were any leases to which the plan was party in default or uncollectible2019-09-30No
Investment advisory and management fees2019-09-30$23,469
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-09-30$25,726,079
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-09-30$20,327,455
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-09-30$1,780,370
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-09-30$2,516,435
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-09-30$2,516,435
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-09-30$18,381
Expenses. Payments to insurance carriers foe the provision of benefits2019-09-30$739,796
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-09-30$1,118,969
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-09-30Yes
Was there a failure to transmit to the plan any participant contributions2019-09-30No
Has the plan failed to provide any benefit when due under the plan2019-09-30No
Contributions received in cash from employer2019-09-30$17,127,513
Employer contributions (assets) at end of year2019-09-30$1,496,004
Employer contributions (assets) at beginning of year2019-09-30$828,428
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-09-30$13,564,128
Contract administrator fees2019-09-30$335,449
Liabilities. Value of benefit claims payable at end of year2019-09-30$7,909,225
Liabilities. Value of benefit claims payable at beginning of year2019-09-30$6,449,268
Assets. Value of buildings and other operty used in plan operation at end of year2019-09-30$92,623
Assets. Value of buildings and other operty used in plan operation at beginning of year2019-09-30$100,068
Did the plan have assets held for investment2019-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-09-30No
Opinion of an independent qualified public accountant for this plan2019-09-30Unqualified
Accountancy firm name2019-09-30BALDWIN & BALDWIN, PLLC
Accountancy firm EIN2019-09-30464370753
2018 : OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-09-30$6,915,764
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-09-30$7,412,738
Total income from all sources (including contributions)2018-09-30$13,968,595
Total loss/gain on sale of assets2018-09-30$0
Total of all expenses incurred2018-09-30$12,194,890
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-09-30$11,516,928
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-09-30$13,556,443
Value of total assets at end of year2018-09-30$24,445,034
Value of total assets at beginning of year2018-09-30$23,168,303
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-09-30$677,962
Total interest from all sources2018-09-30$14,771
Total dividends received (eg from common stock, registered investment company shares)2018-09-30$526,404
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2018-09-30$526,404
Administrative expenses professional fees incurred2018-09-30$171,925
Was this plan covered by a fidelity bond2018-09-30Yes
Value of fidelity bond cover2018-09-30$1,000,000
Were there any nonexempt tranactions with any party-in-interest2018-09-30No
Contributions received from participants2018-09-30$122,613
Participant contributions at end of year2018-09-30$5,820
Participant contributions at beginning of year2018-09-30$14,445
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-09-30$339,751
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-09-30$418,089
Other income not declared elsewhere2018-09-30$725
Administrative expenses (other) incurred2018-09-30$100,007
Liabilities. Value of operating payables at end of year2018-09-30$466,496
Liabilities. Value of operating payables at beginning of year2018-09-30$429,068
Total non interest bearing cash at end of year2018-09-30$327,077
Total non interest bearing cash at beginning of year2018-09-30$265,079
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-09-30No
Value of net income/loss2018-09-30$1,773,705
Value of net assets at end of year (total assets less liabilities)2018-09-30$17,529,270
Value of net assets at beginning of year (total assets less liabilities)2018-09-30$15,755,565
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2018-09-30No
Were any leases to which the plan was party in default or uncollectible2018-09-30No
Investment advisory and management fees2018-09-30$20,000
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-09-30$20,327,455
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-09-30$20,328,967
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-09-30$2,516,435
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-09-30$983,995
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-09-30$983,995
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-09-30$14,771
Expenses. Payments to insurance carriers foe the provision of benefits2018-09-30$602,706
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-09-30$-129,748
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-09-30Yes
Was there a failure to transmit to the plan any participant contributions2018-09-30No
Has the plan failed to provide any benefit when due under the plan2018-09-30No
Contributions received in cash from employer2018-09-30$13,433,830
Employer contributions (assets) at end of year2018-09-30$828,428
Employer contributions (assets) at beginning of year2018-09-30$1,064,647
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-09-30$10,914,222
Contract administrator fees2018-09-30$386,030
Liabilities. Value of benefit claims payable at end of year2018-09-30$6,449,268
Liabilities. Value of benefit claims payable at beginning of year2018-09-30$6,983,670
Assets. Value of buildings and other operty used in plan operation at end of year2018-09-30$100,068
Assets. Value of buildings and other operty used in plan operation at beginning of year2018-09-30$93,081
Did the plan have assets held for investment2018-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-09-30No
Opinion of an independent qualified public accountant for this plan2018-09-30Unqualified
Accountancy firm name2018-09-30BALDWIN & BALDWIN PLLC
Accountancy firm EIN2018-09-30464370753
2017 : OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-09-30$7,412,738
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-09-30$6,944,552
Total income from all sources (including contributions)2017-09-30$12,256,329
Total loss/gain on sale of assets2017-09-30$0
Total of all expenses incurred2017-09-30$14,655,542
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-09-30$13,720,156
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-09-30$10,697,810
Value of total assets at end of year2017-09-30$23,168,303
Value of total assets at beginning of year2017-09-30$25,099,330
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-09-30$935,386
Total interest from all sources2017-09-30$5,388
Total dividends received (eg from common stock, registered investment company shares)2017-09-30$699,619
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2017-09-30$699,619
Administrative expenses professional fees incurred2017-09-30$156,786
Was this plan covered by a fidelity bond2017-09-30Yes
Value of fidelity bond cover2017-09-30$1,000,000
Were there any nonexempt tranactions with any party-in-interest2017-09-30No
Contributions received from participants2017-09-30$153,392
Participant contributions at end of year2017-09-30$14,445
Participant contributions at beginning of year2017-09-30$28,438
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-09-30$418,089
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-09-30$245,936
Other income not declared elsewhere2017-09-30$240
Administrative expenses (other) incurred2017-09-30$126,374
Liabilities. Value of operating payables at end of year2017-09-30$429,068
Liabilities. Value of operating payables at beginning of year2017-09-30$204,855
Total non interest bearing cash at end of year2017-09-30$265,079
Total non interest bearing cash at beginning of year2017-09-30$276,430
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-09-30No
Value of net income/loss2017-09-30$-2,399,213
Value of net assets at end of year (total assets less liabilities)2017-09-30$15,755,565
Value of net assets at beginning of year (total assets less liabilities)2017-09-30$18,154,778
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2017-09-30No
Were any leases to which the plan was party in default or uncollectible2017-09-30No
Investment advisory and management fees2017-09-30$20,000
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-09-30$20,328,967
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-09-30$22,679,084
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-09-30$983,995
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-09-30$1,014,368
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-09-30$1,014,368
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-09-30$5,388
Expenses. Payments to insurance carriers foe the provision of benefits2017-09-30$552,415
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-09-30$853,272
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-09-30Yes
Was there a failure to transmit to the plan any participant contributions2017-09-30No
Has the plan failed to provide any benefit when due under the plan2017-09-30No
Contributions received in cash from employer2017-09-30$10,544,418
Employer contributions (assets) at end of year2017-09-30$1,064,647
Employer contributions (assets) at beginning of year2017-09-30$765,709
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-09-30$13,167,741
Contract administrator fees2017-09-30$632,226
Liabilities. Value of benefit claims payable at end of year2017-09-30$6,983,670
Liabilities. Value of benefit claims payable at beginning of year2017-09-30$6,739,697
Assets. Value of buildings and other operty used in plan operation at end of year2017-09-30$93,081
Assets. Value of buildings and other operty used in plan operation at beginning of year2017-09-30$89,365
Did the plan have assets held for investment2017-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-09-30No
Opinion of an independent qualified public accountant for this plan2017-09-30Unqualified
Accountancy firm name2017-09-30BALDWIN & BALDWIN PLLC
Accountancy firm EIN2017-09-30464370753
2016 : OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-09-30$6,944,552
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-09-30$6,492,506
Total income from all sources (including contributions)2016-09-30$10,641,886
Total loss/gain on sale of assets2016-09-30$0
Total of all expenses incurred2016-09-30$13,142,182
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-09-30$12,247,952
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-09-30$9,081,964
Value of total assets at end of year2016-09-30$25,099,330
Value of total assets at beginning of year2016-09-30$27,147,580
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-09-30$894,230
Total interest from all sources2016-09-30$3,580
Total dividends received (eg from common stock, registered investment company shares)2016-09-30$677,463
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2016-09-30$677,463
Administrative expenses professional fees incurred2016-09-30$113,573
Was this plan covered by a fidelity bond2016-09-30Yes
Value of fidelity bond cover2016-09-30$1,000,000
Were there any nonexempt tranactions with any party-in-interest2016-09-30No
Contributions received from participants2016-09-30$194,209
Participant contributions at end of year2016-09-30$28,438
Participant contributions at beginning of year2016-09-30$19,825
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-09-30$245,936
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-09-30$139,264
Other income not declared elsewhere2016-09-30$3,989
Liabilities. Value of operating payables at end of year2016-09-30$204,855
Liabilities. Value of operating payables at beginning of year2016-09-30$125,108
Total non interest bearing cash at end of year2016-09-30$276,430
Total non interest bearing cash at beginning of year2016-09-30$28,490
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-09-30No
Value of net income/loss2016-09-30$-2,500,296
Value of net assets at end of year (total assets less liabilities)2016-09-30$18,154,778
Value of net assets at beginning of year (total assets less liabilities)2016-09-30$20,655,074
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-09-30No
Were any leases to which the plan was party in default or uncollectible2016-09-30No
Investment advisory and management fees2016-09-30$28,177
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-09-30$22,679,084
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-09-30$24,782,113
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-09-30$1,014,368
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-09-30$1,312,251
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-09-30$1,312,251
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-09-30$3,580
Expenses. Payments to insurance carriers foe the provision of benefits2016-09-30$492,493
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-09-30$874,890
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-09-30Yes
Was there a failure to transmit to the plan any participant contributions2016-09-30No
Has the plan failed to provide any benefit when due under the plan2016-09-30No
Contributions received in cash from employer2016-09-30$8,887,755
Employer contributions (assets) at end of year2016-09-30$765,709
Employer contributions (assets) at beginning of year2016-09-30$773,412
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-09-30$11,755,459
Contract administrator fees2016-09-30$752,480
Liabilities. Value of benefit claims payable at end of year2016-09-30$6,739,697
Liabilities. Value of benefit claims payable at beginning of year2016-09-30$6,367,398
Assets. Value of buildings and other operty used in plan operation at end of year2016-09-30$89,365
Assets. Value of buildings and other operty used in plan operation at beginning of year2016-09-30$92,225
Did the plan have assets held for investment2016-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-09-30No
Opinion of an independent qualified public accountant for this plan2016-09-30Unqualified
Accountancy firm name2016-09-30BALDWIN & BALDWIN PLLC
Accountancy firm EIN2016-09-30464370753
2015 : OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-09-30$6,492,506
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-09-30$6,097,130
Total income from all sources (including contributions)2015-09-30$10,294,040
Total loss/gain on sale of assets2015-09-30$-331,735
Total of all expenses incurred2015-09-30$12,929,897
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-09-30$11,977,267
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-09-30$10,274,129
Value of total assets at end of year2015-09-30$27,147,580
Value of total assets at beginning of year2015-09-30$29,388,061
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-09-30$952,630
Total interest from all sources2015-09-30$2,042
Total dividends received (eg from common stock, registered investment company shares)2015-09-30$492,743
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2015-09-30$492,743
Administrative expenses professional fees incurred2015-09-30$116,989
Was this plan covered by a fidelity bond2015-09-30Yes
Value of fidelity bond cover2015-09-30$500,000
Were there any nonexempt tranactions with any party-in-interest2015-09-30No
Contributions received from participants2015-09-30$175,645
Participant contributions at end of year2015-09-30$19,825
Participant contributions at beginning of year2015-09-30$12,936
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-09-30$139,264
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-09-30$179,798
Other income not declared elsewhere2015-09-30$62,802
Administrative expenses (other) incurred2015-09-30$233,644
Liabilities. Value of operating payables at end of year2015-09-30$125,108
Liabilities. Value of operating payables at beginning of year2015-09-30$172,555
Total non interest bearing cash at end of year2015-09-30$28,490
Total non interest bearing cash at beginning of year2015-09-30$262,578
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-09-30No
Value of net income/loss2015-09-30$-2,635,857
Value of net assets at end of year (total assets less liabilities)2015-09-30$20,655,074
Value of net assets at beginning of year (total assets less liabilities)2015-09-30$23,290,931
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-09-30No
Were any leases to which the plan was party in default or uncollectible2015-09-30No
Investment advisory and management fees2015-09-30$36,203
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-09-30$24,782,113
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-09-30$25,896,343
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-09-30$1,312,251
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-09-30$1,993,585
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-09-30$1,993,585
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-09-30$2,042
Expenses. Payments to insurance carriers foe the provision of benefits2015-09-30$533,244
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-09-30$-205,941
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-09-30Yes
Was there a failure to transmit to the plan any participant contributions2015-09-30No
Has the plan failed to provide any benefit when due under the plan2015-09-30No
Contributions received in cash from employer2015-09-30$10,098,484
Employer contributions (assets) at end of year2015-09-30$773,412
Employer contributions (assets) at beginning of year2015-09-30$950,738
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-09-30$11,444,023
Contract administrator fees2015-09-30$565,794
Liabilities. Value of benefit claims payable at end of year2015-09-30$6,367,398
Liabilities. Value of benefit claims payable at beginning of year2015-09-30$5,924,575
Assets. Value of buildings and other operty used in plan operation at end of year2015-09-30$92,225
Assets. Value of buildings and other operty used in plan operation at beginning of year2015-09-30$92,083
Did the plan have assets held for investment2015-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-09-30No
Aggregate proceeds on sale of assets2015-09-30$59,244,200
Aggregate carrying amount (costs) on sale of assets2015-09-30$59,575,935
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-09-30No
Opinion of an independent qualified public accountant for this plan2015-09-30Unqualified
Accountancy firm name2015-09-30BALDWIN & BALDWIN PLLC
Accountancy firm EIN2015-09-30464370753
2014 : OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-09-30$6,097,130
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-09-30$6,447,256
Total income from all sources (including contributions)2014-09-30$11,316,940
Total loss/gain on sale of assets2014-09-30$190,108
Total of all expenses incurred2014-09-30$10,766,220
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-09-30$9,939,730
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-09-30$9,955,174
Value of total assets at end of year2014-09-30$29,388,061
Value of total assets at beginning of year2014-09-30$29,187,467
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-09-30$826,490
Total interest from all sources2014-09-30$386
Total dividends received (eg from common stock, registered investment company shares)2014-09-30$486,145
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2014-09-30$486,145
Administrative expenses professional fees incurred2014-09-30$108,293
Was this plan covered by a fidelity bond2014-09-30Yes
Value of fidelity bond cover2014-09-30$500,000
Were there any nonexempt tranactions with any party-in-interest2014-09-30No
Contributions received from participants2014-09-30$196,787
Participant contributions at end of year2014-09-30$12,936
Participant contributions at beginning of year2014-09-30$20,991
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-09-30$179,798
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-09-30$154,389
Other income not declared elsewhere2014-09-30$0
Administrative expenses (other) incurred2014-09-30$115,026
Liabilities. Value of operating payables at end of year2014-09-30$172,555
Liabilities. Value of operating payables at beginning of year2014-09-30$178,360
Total non interest bearing cash at end of year2014-09-30$262,578
Total non interest bearing cash at beginning of year2014-09-30$291,804
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-09-30No
Value of net income/loss2014-09-30$550,720
Value of net assets at end of year (total assets less liabilities)2014-09-30$23,290,931
Value of net assets at beginning of year (total assets less liabilities)2014-09-30$22,740,211
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-09-30No
Were any leases to which the plan was party in default or uncollectible2014-09-30No
Investment advisory and management fees2014-09-30$37,096
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-09-30$25,896,343
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-09-30$26,417,039
Interest earned on other investments2014-09-30$262
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-09-30$1,993,585
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-09-30$1,428,848
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-09-30$1,428,848
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-09-30$124
Expenses. Payments to insurance carriers foe the provision of benefits2014-09-30$508,991
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-09-30$685,127
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-09-30Yes
Was there a failure to transmit to the plan any participant contributions2014-09-30No
Has the plan failed to provide any benefit when due under the plan2014-09-30No
Contributions received in cash from employer2014-09-30$9,758,387
Employer contributions (assets) at end of year2014-09-30$950,738
Employer contributions (assets) at beginning of year2014-09-30$782,090
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-09-30$9,430,739
Contract administrator fees2014-09-30$566,075
Liabilities. Value of benefit claims payable at end of year2014-09-30$5,924,575
Liabilities. Value of benefit claims payable at beginning of year2014-09-30$6,268,896
Assets. Value of buildings and other operty used in plan operation at end of year2014-09-30$92,083
Assets. Value of buildings and other operty used in plan operation at beginning of year2014-09-30$92,306
Did the plan have assets held for investment2014-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-09-30No
Aggregate proceeds on sale of assets2014-09-30$12,460,734
Aggregate carrying amount (costs) on sale of assets2014-09-30$12,270,626
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-09-30No
Opinion of an independent qualified public accountant for this plan2014-09-30Unqualified
Accountancy firm name2014-09-30BALDWIN & BALDWIN, PLLC
Accountancy firm EIN2014-09-30464370753
2013 : OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-09-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-09-30$6,447,256
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-09-30$6,338,572
Total income from all sources (including contributions)2013-09-30$11,114,839
Total loss/gain on sale of assets2013-09-30$925,732
Total of all expenses incurred2013-09-30$12,518,874
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-09-30$11,717,693
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-09-30$10,383,091
Value of total assets at end of year2013-09-30$29,187,467
Value of total assets at beginning of year2013-09-30$30,482,818
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-09-30$801,181
Total interest from all sources2013-09-30$746
Total dividends received (eg from common stock, registered investment company shares)2013-09-30$619,695
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2013-09-30$619,695
Administrative expenses professional fees incurred2013-09-30$111,619
Was this plan covered by a fidelity bond2013-09-30Yes
Value of fidelity bond cover2013-09-30$500,000
Were there any nonexempt tranactions with any party-in-interest2013-09-30No
Contributions received from participants2013-09-30$208,170
Participant contributions at end of year2013-09-30$20,991
Participant contributions at beginning of year2013-09-30$21,346
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-09-30$154,389
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-09-30$96,350
Other income not declared elsewhere2013-09-30$512,308
Administrative expenses (other) incurred2013-09-30$87,285
Liabilities. Value of operating payables at end of year2013-09-30$178,360
Liabilities. Value of operating payables at beginning of year2013-09-30$195,838
Total non interest bearing cash at end of year2013-09-30$291,804
Total non interest bearing cash at beginning of year2013-09-30$260,446
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-09-30No
Value of net income/loss2013-09-30$-1,404,035
Value of net assets at end of year (total assets less liabilities)2013-09-30$22,740,211
Value of net assets at beginning of year (total assets less liabilities)2013-09-30$24,144,246
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-09-30No
Were any leases to which the plan was party in default or uncollectible2013-09-30No
Investment advisory and management fees2013-09-30$36,171
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-09-30$26,417,039
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-09-30$27,684,530
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-09-30$1,428,848
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-09-30$1,410,418
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-09-30$1,410,418
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-09-30$746
Expenses. Payments to insurance carriers foe the provision of benefits2013-09-30$531,984
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-09-30$-1,326,733
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-09-30Yes
Was there a failure to transmit to the plan any participant contributions2013-09-30No
Has the plan failed to provide any benefit when due under the plan2013-09-30No
Contributions received in cash from employer2013-09-30$10,174,921
Employer contributions (assets) at end of year2013-09-30$782,090
Employer contributions (assets) at beginning of year2013-09-30$916,699
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-09-30$11,185,709
Contract administrator fees2013-09-30$566,106
Liabilities. Value of benefit claims payable at end of year2013-09-30$6,268,896
Liabilities. Value of benefit claims payable at beginning of year2013-09-30$6,142,734
Assets. Value of buildings and other operty used in plan operation at end of year2013-09-30$92,306
Assets. Value of buildings and other operty used in plan operation at beginning of year2013-09-30$93,029
Did the plan have assets held for investment2013-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-09-30No
Aggregate proceeds on sale of assets2013-09-30$15,186,014
Aggregate carrying amount (costs) on sale of assets2013-09-30$14,260,282
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-09-30No
Opinion of an independent qualified public accountant for this plan2013-09-30Unqualified
Accountancy firm name2013-09-30ESTES BALDWIN ZOBEL HALL, PLLC
Accountancy firm EIN2013-09-30454250967
2012 : OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-09-30$6,338,572
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-09-30$6,591,702
Total income from all sources (including contributions)2012-09-30$11,536,907
Total loss/gain on sale of assets2012-09-30$115,635
Total of all expenses incurred2012-09-30$11,201,787
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-09-30$10,380,857
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-09-30$8,584,779
Value of total assets at end of year2012-09-30$30,482,818
Value of total assets at beginning of year2012-09-30$30,400,828
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-09-30$820,930
Total interest from all sources2012-09-30$1,786
Total dividends received (eg from common stock, registered investment company shares)2012-09-30$703,054
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2012-09-30$703,054
Administrative expenses professional fees incurred2012-09-30$133,506
Was this plan covered by a fidelity bond2012-09-30Yes
Value of fidelity bond cover2012-09-30$500,000
Were there any nonexempt tranactions with any party-in-interest2012-09-30No
Contributions received from participants2012-09-30$261,254
Participant contributions at end of year2012-09-30$21,346
Participant contributions at beginning of year2012-09-30$33,648
Income. Received or receivable in cash from other sources (including rollovers)2012-09-30$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-09-30$96,350
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-09-30$102,430
Other income not declared elsewhere2012-09-30$941
Administrative expenses (other) incurred2012-09-30$88,801
Liabilities. Value of operating payables at end of year2012-09-30$195,838
Liabilities. Value of operating payables at beginning of year2012-09-30$141,342
Total non interest bearing cash at end of year2012-09-30$260,446
Total non interest bearing cash at beginning of year2012-09-30$164,644
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-09-30No
Income. Non cash contributions2012-09-30$0
Value of net income/loss2012-09-30$335,120
Value of net assets at end of year (total assets less liabilities)2012-09-30$24,144,246
Value of net assets at beginning of year (total assets less liabilities)2012-09-30$23,809,126
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-09-30No
Were any leases to which the plan was party in default or uncollectible2012-09-30No
Investment advisory and management fees2012-09-30$31,534
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-09-30$27,684,530
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-09-30$27,890,765
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-09-30$1,410,418
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-09-30$972,745
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-09-30$972,745
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-09-30$1,786
Assets. Value of investments in 103.12 investment entities at end of year2012-09-30$0
Assets. Value of investments in 103.12 investment entities at beginning of year2012-09-30$844,395
Expenses. Payments to insurance carriers foe the provision of benefits2012-09-30$512,502
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-09-30$2,130,712
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-09-30Yes
Was there a failure to transmit to the plan any participant contributions2012-09-30No
Has the plan failed to provide any benefit when due under the plan2012-09-30No
Contributions received in cash from employer2012-09-30$8,323,525
Employer contributions (assets) at end of year2012-09-30$916,699
Employer contributions (assets) at beginning of year2012-09-30$297,263
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-09-30$9,868,355
Contract administrator fees2012-09-30$567,089
Liabilities. Value of benefit claims payable at end of year2012-09-30$6,142,734
Liabilities. Value of benefit claims payable at beginning of year2012-09-30$6,450,360
Assets. Value of buildings and other operty used in plan operation at end of year2012-09-30$93,029
Assets. Value of buildings and other operty used in plan operation at beginning of year2012-09-30$94,938
Did the plan have assets held for investment2012-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-09-30No
Aggregate proceeds on sale of assets2012-09-30$25,231,012
Aggregate carrying amount (costs) on sale of assets2012-09-30$25,115,377
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-09-30No
Opinion of an independent qualified public accountant for this plan2012-09-30Unqualified
Accountancy firm name2012-09-30ESTES BALDWIN ZOBEL HALL, PLLC
Accountancy firm EIN2012-09-30454250967
2011 : OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-09-30$275,836
Total unrealized appreciation/depreciation of assets2011-09-30$275,836
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-09-30$6,591,702
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-09-30$6,796,303
Total income from all sources (including contributions)2011-09-30$4,082,359
Total loss/gain on sale of assets2011-09-30$81,660
Total of all expenses incurred2011-09-30$12,992,375
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-09-30$12,170,637
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-09-30$2,883,729
Value of total assets at end of year2011-09-30$30,400,828
Value of total assets at beginning of year2011-09-30$39,515,445
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-09-30$821,738
Total interest from all sources2011-09-30$1,899
Total dividends received (eg from common stock, registered investment company shares)2011-09-30$743,580
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-09-30No
Total dividends received from registered investment company shares (eg mutual funds)2011-09-30$743,580
Administrative expenses professional fees incurred2011-09-30$116,876
Was this plan covered by a fidelity bond2011-09-30Yes
Value of fidelity bond cover2011-09-30$500,000
Were there any nonexempt tranactions with any party-in-interest2011-09-30No
Contributions received from participants2011-09-30$375,149
Participant contributions at end of year2011-09-30$33,648
Participant contributions at beginning of year2011-09-30$9,866
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-09-30$102,430
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-09-30$166,352
Other income not declared elsewhere2011-09-30$139,743
Administrative expenses (other) incurred2011-09-30$115,096
Liabilities. Value of operating payables at end of year2011-09-30$141,342
Liabilities. Value of operating payables at beginning of year2011-09-30$406,963
Total non interest bearing cash at end of year2011-09-30$164,644
Total non interest bearing cash at beginning of year2011-09-30$240,364
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-09-30No
Value of net income/loss2011-09-30$-8,910,016
Value of net assets at end of year (total assets less liabilities)2011-09-30$23,809,126
Value of net assets at beginning of year (total assets less liabilities)2011-09-30$32,719,142
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-09-30No
Were any leases to which the plan was party in default or uncollectible2011-09-30No
Assets. partnership/joint venture interests at end of year2011-09-30$0
Assets. partnership/joint venture interests at beginning of year2011-09-30$8,899,164
Investment advisory and management fees2011-09-30$35,657
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-09-30$27,890,765
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-09-30$27,332,184
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-09-30$972,745
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-09-30$726,267
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-09-30$726,267
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-09-30$1,899
Assets. Value of investments in 103.12 investment entities at end of year2011-09-30$844,395
Assets. Value of investments in 103.12 investment entities at beginning of year2011-09-30$1,670,774
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-09-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-09-30$0
Expenses. Payments to insurance carriers foe the provision of benefits2011-09-30$570,895
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-09-30$-69,508
Net investment gain or loss from common/collective trusts2011-09-30$25,420
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-09-30Yes
Was there a failure to transmit to the plan any participant contributions2011-09-30No
Has the plan failed to provide any benefit when due under the plan2011-09-30No
Contributions received in cash from employer2011-09-30$2,508,580
Employer contributions (assets) at end of year2011-09-30$297,263
Employer contributions (assets) at beginning of year2011-09-30$374,670
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-09-30$11,599,742
Contract administrator fees2011-09-30$554,109
Liabilities. Value of benefit claims payable at end of year2011-09-30$6,450,360
Liabilities. Value of benefit claims payable at beginning of year2011-09-30$6,389,340
Assets. Value of buildings and other operty used in plan operation at end of year2011-09-30$94,938
Assets. Value of buildings and other operty used in plan operation at beginning of year2011-09-30$95,804
Did the plan have assets held for investment2011-09-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-09-30No
Aggregate proceeds on sale of assets2011-09-30$55,094,109
Aggregate carrying amount (costs) on sale of assets2011-09-30$55,012,449
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-09-30No
Opinion of an independent qualified public accountant for this plan2011-09-30Unqualified
Accountancy firm name2011-09-30ZOBEL & HALL, P.C.
Accountancy firm EIN2011-09-30860511407

Form 5500 Responses for OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND

2022: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2022 form 5500 responses
2022-10-01Type of plan entityMulti-employer plan
2022-10-01Submission has been amendedNo
2022-10-01This submission is the final filingNo
2022-10-01This return/report is a short plan year return/report (less than 12 months)No
2022-10-01Plan is a collectively bargained planYes
2022-10-01Plan funding arrangement – TrustYes
2022-10-01Plan benefit arrangement – InsuranceYes
2022-10-01Plan benefit arrangement - TrustYes
2021: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2021 form 5500 responses
2021-10-01Type of plan entityMulti-employer plan
2021-10-01Submission has been amendedNo
2021-10-01This submission is the final filingNo
2021-10-01This return/report is a short plan year return/report (less than 12 months)No
2021-10-01Plan is a collectively bargained planYes
2021-10-01Plan funding arrangement – TrustYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement - TrustYes
2020: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2020 form 5500 responses
2020-10-01Type of plan entityMulti-employer plan
2020-10-01Submission has been amendedNo
2020-10-01This submission is the final filingNo
2020-10-01This return/report is a short plan year return/report (less than 12 months)No
2020-10-01Plan is a collectively bargained planYes
2020-10-01Plan funding arrangement – TrustYes
2020-10-01Plan benefit arrangement – InsuranceYes
2020-10-01Plan benefit arrangement - TrustYes
2019: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2019 form 5500 responses
2019-10-01Type of plan entityMulti-employer plan
2019-10-01Submission has been amendedNo
2019-10-01This submission is the final filingNo
2019-10-01This return/report is a short plan year return/report (less than 12 months)No
2019-10-01Plan is a collectively bargained planYes
2019-10-01Plan funding arrangement – TrustYes
2019-10-01Plan benefit arrangement – InsuranceYes
2019-10-01Plan benefit arrangement - TrustYes
2018: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2018 form 5500 responses
2018-10-01Type of plan entityMulti-employer plan
2018-10-01Submission has been amendedNo
2018-10-01This submission is the final filingNo
2018-10-01This return/report is a short plan year return/report (less than 12 months)No
2018-10-01Plan is a collectively bargained planYes
2018-10-01Plan funding arrangement – TrustYes
2018-10-01Plan benefit arrangement – InsuranceYes
2018-10-01Plan benefit arrangement - TrustYes
2017: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2017 form 5500 responses
2017-10-01Type of plan entityMulti-employer plan
2017-10-01Submission has been amendedNo
2017-10-01This submission is the final filingNo
2017-10-01This return/report is a short plan year return/report (less than 12 months)No
2017-10-01Plan is a collectively bargained planYes
2017-10-01Plan funding arrangement – TrustYes
2017-10-01Plan benefit arrangement – InsuranceYes
2017-10-01Plan benefit arrangement - TrustYes
2016: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2016 form 5500 responses
2016-10-01Type of plan entityMulti-employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planYes
2016-10-01Plan funding arrangement – TrustYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-10-01Plan benefit arrangement - TrustYes
2015: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2015 form 5500 responses
2015-10-01Type of plan entityMulti-employer plan
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingNo
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planYes
2015-10-01Plan funding arrangement – TrustYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement - TrustYes
2014: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2014 form 5500 responses
2014-10-01Type of plan entityMulti-employer plan
2014-10-01Submission has been amendedNo
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planYes
2014-10-01Plan funding arrangement – TrustYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement - TrustYes
2013: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2013 form 5500 responses
2013-10-01Type of plan entityMulti-employer plan
2013-10-01Submission has been amendedNo
2013-10-01This submission is the final filingNo
2013-10-01This return/report is a short plan year return/report (less than 12 months)No
2013-10-01Plan is a collectively bargained planYes
2013-10-01Plan funding arrangement – TrustYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-10-01Plan benefit arrangement - TrustYes
2012: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2012 form 5500 responses
2012-10-01Type of plan entityMulti-employer plan
2012-10-01Submission has been amendedNo
2012-10-01This submission is the final filingNo
2012-10-01This return/report is a short plan year return/report (less than 12 months)No
2012-10-01Plan is a collectively bargained planYes
2012-10-01Plan funding arrangement – TrustYes
2012-10-01Plan benefit arrangement – InsuranceYes
2012-10-01Plan benefit arrangement - TrustYes
2011: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2011 form 5500 responses
2011-10-01Type of plan entityMulti-employer plan
2011-10-01Submission has been amendedNo
2011-10-01This submission is the final filingNo
2011-10-01This return/report is a short plan year return/report (less than 12 months)No
2011-10-01Plan is a collectively bargained planNo
2011-10-01Plan funding arrangement – TrustYes
2011-10-01Plan benefit arrangement – InsuranceYes
2011-10-01Plan benefit arrangement - TrustYes
2010: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2010 form 5500 responses
2010-10-01Type of plan entityMulti-employer plan
2010-10-01Submission has been amendedNo
2010-10-01This submission is the final filingNo
2010-10-01This return/report is a short plan year return/report (less than 12 months)No
2010-10-01Plan is a collectively bargained planYes
2010-10-01Plan funding arrangement – TrustYes
2010-10-01Plan benefit arrangement – InsuranceYes
2010-10-01Plan benefit arrangement - TrustYes
2009: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2009 form 5500 responses
2009-10-01Type of plan entityMulti-employer plan
2009-10-01Submission has been amendedNo
2009-10-01This submission is the final filingNo
2009-10-01This return/report is a short plan year return/report (less than 12 months)No
2009-10-01Plan is a collectively bargained planYes
2009-10-01Plan funding arrangement – TrustYes
2009-10-01Plan benefit arrangement – InsuranceYes
2009-10-01Plan benefit arrangement - TrustYes
2008: OPERATING ENGINEERS' LOCAL NO. 428 HEALTH & WELFARE TRUST FUND 2008 form 5500 responses
2008-10-01Type of plan entityMulti-employer plan
2008-10-01Submission has been amendedNo
2008-10-01This submission is the final filingNo
2008-10-01This return/report is a short plan year return/report (less than 12 months)No
2008-10-01Plan is a collectively bargained planNo

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number
Policy instance 5
Number of Individuals Covered1486
Insurance policy start date2023-01-01
Insurance policy end date2023-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $179,353
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MINES AND ASSOCIATES, P.C. (National Association of Insurance Commissioners NAIC id number: 62419 )
Policy contract number
Policy instance 4
Number of Individuals Covered1486
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedMEMBER ASSISTANCE AND BEHAVIORAL HEALTH
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $15,592
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract numberG2986C4275
Policy instance 3
Insurance contract or identification numberG2986C4275
Number of Individuals Covered1486
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $73,535
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16012918000
Policy instance 2
Insurance contract or identification number16012918000
Number of Individuals Covered1486
Insurance policy start date2022-10-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $74,286
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: 39616 )
Policy contract number121380880001
Policy instance 1
Insurance contract or identification number121380880001
Number of Individuals Covered1486
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $18,045
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: 39616 )
Policy contract number121380880001
Policy instance 1
Insurance contract or identification number121380880001
Number of Individuals Covered1212
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $15,744
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16012918000
Policy instance 2
Insurance contract or identification number16012918000
Number of Individuals Covered1212
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $301,985
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract numberG2986C4275
Policy instance 3
Insurance contract or identification numberG2986C4275
Number of Individuals Covered1212
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $65,169
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MINES AND ASSOCIATES, P.C. (National Association of Insurance Commissioners NAIC id number: 62419 )
Policy contract number
Policy instance 4
Number of Individuals Covered1212
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedMEMBER ASSISTANCE AND BEHAVIORAL HEALTH
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 $28,994
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNION DENTAL CARE OF ARIZONA, INC. (National Association of Insurance Commissioners NAIC id number: 47708 )
Policy contract numberEB13
Policy instance 5
Insurance contract or identification numberEB13
Number of Individuals Covered120
Insurance policy start date2019-10-01
Insurance policy end date2021-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $23,593
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MINES AND ASSOCIATES, P.C. (National Association of Insurance Commissioners NAIC id number: 62419 )
Policy contract number
Policy instance 4
Number of Individuals Covered1187
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedMEMBER ASSISTANCE AND BEHAVIORAL HEALTH
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $31,982
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract numberG2986C4275
Policy instance 3
Insurance contract or identification numberG2986C4275
Number of Individuals Covered1187
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $71,692
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16012918000
Policy instance 2
Insurance contract or identification number16012918000
Number of Individuals Covered1187
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $404,186
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: 39616 )
Policy contract number121380880001
Policy instance 1
Insurance contract or identification number121380880001
Number of Individuals Covered1187
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $19,971
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MINES AND ASSOCIATES, P.C. (National Association of Insurance Commissioners NAIC id number: 62419 )
Policy contract number
Policy instance 5
Number of Individuals Covered1467
Insurance policy start date2020-02-01
Insurance policy end date2020-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedMEMBER ASSISTANCE AND BEHAVIORAL HEALTH
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 $23,284
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract numberG2986C4275
Policy instance 4
Insurance contract or identification numberG2986C4275
Number of Individuals Covered1472
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $74,854
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16012918000
Policy instance 3
Insurance contract or identification number16012918000
Number of Individuals Covered1368
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $402,256
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: 39616 )
Policy contract number121380880001
Policy instance 2
Insurance contract or identification number121380880001
Number of Individuals Covered1370
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $20,175
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNION DENTAL CARE OF ARIZONA, INC. (National Association of Insurance Commissioners NAIC id number: 47708 )
Policy contract numberEB13
Policy instance 1
Insurance contract or identification numberEB13
Number of Individuals Covered113
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $31,811
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNION DENTAL CARE OF ARIZONA, INC. (National Association of Insurance Commissioners NAIC id number: 47708 )
Policy contract numberEB13
Policy instance 1
Insurance contract or identification numberEB13
Number of Individuals Covered1283
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $28,351
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: 39616 )
Policy contract number121380880001
Policy instance 2
Insurance contract or identification number121380880001
Number of Individuals Covered1283
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $12,084
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16012918000
Policy instance 3
Insurance contract or identification number16012918000
Number of Individuals Covered1283
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $361,367
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract numberG2986C4275
Policy instance 4
Insurance contract or identification numberG2986C4275
Number of Individuals Covered1283
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
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 $70,015
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNION DENTAL CARE OF ARIZONA, INC. (National Association of Insurance Commissioners NAIC id number: 47708 )
Policy contract numberEB13
Policy instance 4
Insurance contract or identification numberEB13
Number of Individuals Covered93
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $26,283
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: 39616 )
Policy contract number12 138088 0001
Policy instance 3
Insurance contract or identification number12 138088 0001
Number of Individuals Covered1306
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $100,948
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract numberG2986 C4275
Policy instance 1
Insurance contract or identification numberG2986 C4275
Number of Individuals Covered1295
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
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 $60,530
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-012918-000
Policy instance 2
Insurance contract or identification number16-012918-000
Number of Individuals Covered1364
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of fees paid to insurance companyUSD $5,105
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $284,815
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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