401k Plan data: COLUMBIA UNITED PROVIDERS 401(K) PLAN plan

COLUMBIA UNITED PROVIDERS 401(K) PLAN 401k Plan overview

Plan Name	COLUMBIA UNITED PROVIDERS 401(K) PLAN
Plan identification number	001

COLUMBIA UNITED PROVIDERS 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

COLUMBIA UNITED PROVIDERS, INC has sponsored the creation of one or more 401k plans.

Company Name: COLUMBIA UNITED PROVIDERS, INC

Employer identification number (EIN): 911624736

NAIC Classification: 524140

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COLUMBIA UNITED PROVIDERS 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01 JAMES LARRICK
001 2016-01-01 JAMES LARRICK
001 2015-01-01 JAMES LARRICK
001 2014-01-01 KIMBERLY ROCHA 2015-07-08
001 2013-01-01 JANICE FINLAY 2014-09-12
001 2012-01-01 DEBBI OSLUND 2013-10-08
001 2011-01-01 DEBBI OSLUND 2012-07-19
001 2010-01-01 DEBBI OSLUND DEBBI OSLUND 2011-10-04
001 2009-01-01 SHANNON BOUGHER SHANNON BOUGHER 2010-07-26

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2016-01-01	JAMES LARRICK
001	2016-01-01	JAMES LARRICK
001	2015-01-01	JAMES LARRICK
001	2014-01-01	KIMBERLY ROCHA	2015-07-08
001	2013-01-01	JANICE FINLAY	2014-09-12
001	2012-01-01	DEBBI OSLUND	2013-10-08
001	2011-01-01	DEBBI OSLUND	2012-07-19
001	2010-01-01	DEBBI OSLUND		DEBBI OSLUND	2011-10-04
001	2009-01-01	SHANNON BOUGHER		SHANNON BOUGHER	2010-07-26

Plan Statistics for COLUMBIA UNITED PROVIDERS 401(K) PLAN

401k plan membership statisitcs for COLUMBIA UNITED PROVIDERS 401(K) PLAN

Measure Date Value
2016: COLUMBIA UNITED PROVIDERS 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 119
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 0
Number of participants with account balances 2016-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: COLUMBIA UNITED PROVIDERS 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 127
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 83
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 33
Total of all active and inactive participants 2015-01-01 116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 1
Total participants 2015-01-01 117
Number of participants with account balances 2015-01-01 110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 13
2010: COLUMBIA UNITED PROVIDERS 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 67
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 78
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 4
Total of all active and inactive participants 2010-01-01 82
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 82
Number of participants with account balances 2010-01-01 79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 3
2009: COLUMBIA UNITED PROVIDERS 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 67
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 63
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 4
Total of all active and inactive participants 2009-01-01 67
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 67
Number of participants with account balances 2009-01-01 67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 2

Measure	Date	Value
2016: COLUMBIA UNITED PROVIDERS 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	119
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	0
Number of participants with account balances	2016-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: COLUMBIA UNITED PROVIDERS 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	127
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	83
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	33
Total of all active and inactive participants	2015-01-01	116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	1
Total participants	2015-01-01	117
Number of participants with account balances	2015-01-01	110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	13
2010: COLUMBIA UNITED PROVIDERS 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	67
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	78
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	4
Total of all active and inactive participants	2010-01-01	82
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	82
Number of participants with account balances	2010-01-01	79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	3
2009: COLUMBIA UNITED PROVIDERS 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	67
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	63
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	4
Total of all active and inactive participants	2009-01-01	67
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	67
Number of participants with account balances	2009-01-01	67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	2

Financial Data on COLUMBIA UNITED PROVIDERS 401(K) PLAN

Measure	Date	Value
2016 : COLUMBIA UNITED PROVIDERS 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-10-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-10-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-10-31	$0
Total income from all sources (including contributions)	2016-10-31	$29,470
Total loss/gain on sale of assets	2016-10-31	$0
Total of all expenses incurred	2016-10-31	$5,330,300
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-10-31	$5,319,553
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-10-31	$148,974
Value of total assets at end of year	2016-10-31	$0
Value of total assets at beginning of year	2016-10-31	$5,300,830
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-10-31	$10,747
Total interest from all sources	2016-10-31	$9,104
Total dividends received (eg from common stock, registered investment company shares)	2016-10-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-10-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2016-10-31	$0
Was this plan covered by a fidelity bond	2016-10-31	Yes
Value of fidelity bond cover	2016-10-31	$500,000
If this is an individual account plan, was there a blackout period	2016-10-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-10-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-10-31	No
Contributions received from participants	2016-10-31	$71,220
Participant contributions at end of year	2016-10-31	$0
Participant contributions at beginning of year	2016-10-31	$49,551
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-10-31	No
Value of net income/loss	2016-10-31	$-5,300,830
Value of net assets at end of year (total assets less liabilities)	2016-10-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2016-10-31	$5,300,830
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-10-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-10-31	No
Were any leases to which the plan was party in default or uncollectible	2016-10-31	No
Value of interest in pooled separate accounts at end of year	2016-10-31	$0
Value of interest in pooled separate accounts at beginning of year	2016-10-31	$3,818,907
Interest on participant loans	2016-10-31	$266
Interest earned on other investments	2016-10-31	$8,838
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-10-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-10-31	$1,432,372
Net investment gain/loss from pooled separate accounts	2016-10-31	$-128,608
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-10-31	No
Was there a failure to transmit to the plan any participant contributions	2016-10-31	No
Has the plan failed to provide any benefit when due under the plan	2016-10-31	No
Contributions received in cash from employer	2016-10-31	$77,754
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-10-31	$5,319,553
Contract administrator fees	2016-10-31	$10,747
Did the plan have assets held for investment	2016-10-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-10-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-10-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-10-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-10-31	Disclaimer
Accountancy firm name	2016-10-31	DELAP, LLP
Accountancy firm EIN	2016-10-31	930418710
2015 : COLUMBIA UNITED PROVIDERS 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$667,873
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$805,121
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$801,434
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$617,814
Value of total assets at end of year	2015-12-31	$5,300,830
Value of total assets at beginning of year	2015-12-31	$5,438,078
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$3,687
Total interest from all sources	2015-12-31	$55,962
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$310,815
Participant contributions at end of year	2015-12-31	$49,551
Participant contributions at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$14,972
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-137,248
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$5,300,830
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$5,438,078
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in pooled separate accounts at end of year	2015-12-31	$3,818,907
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$3,772,821
Interest on participant loans	2015-12-31	$753
Interest earned on other investments	2015-12-31	$55,209
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$1,432,372
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$1,665,257
Net investment gain/loss from pooled separate accounts	2015-12-31	$-5,903
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$292,027
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$801,434
Contract administrator fees	2015-12-31	$3,687
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	DELAP, LLP
Accountancy firm EIN	2015-12-31	930418710
2010 : COLUMBIA UNITED PROVIDERS 401(K) PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$847,813
Expenses. Total of all expenses incurred	2010-12-31	$330,585
Benefits paid (including direct rollovers)	2010-12-31	$329,694
Total plan assets at end of year	2010-12-31	$3,512,701
Total plan assets at beginning of year	2010-12-31	$2,995,473
Value of fidelity bond covering the plan	2010-12-31	$1,000,000
Total contributions received or receivable from participants	2010-12-31	$279,712
Contributions received from other sources (not participants or employers)	2010-12-31	$11,903
Other income received	2010-12-31	$351,671
Net income (gross income less expenses)	2010-12-31	$517,228
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$3,512,701
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$2,995,473
Total contributions received or receivable from employer(s)	2010-12-31	$204,527
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$891
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : COLUMBIA UNITED PROVIDERS 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for COLUMBIA UNITED PROVIDERS 401(K) PLAN

2016: COLUMBIA UNITED PROVIDERS 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	Yes
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: COLUMBIA UNITED PROVIDERS 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2010: COLUMBIA UNITED PROVIDERS 401(K) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: COLUMBIA UNITED PROVIDERS 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

800844

Policy instance

Insurance contract or identification number	800844
Number of Individuals Covered	0
Insurance policy start date	2016-01-01
Insurance policy end date	2016-10-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

800844

Policy instance

Insurance contract or identification number	800844
Number of Individuals Covered	117
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

800844

Policy instance

Insurance contract or identification number	800844
Number of Individuals Covered	79
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $11,674
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

COLUMBIA UNITED ENTERPRISES INC. 401(K) PLAN [EIN = 831407258]

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Company Name:	COLUMBIA UNITED PROVIDERS, INC
Employer identification number (EIN):	911624736
NAIC Classification:	524140