CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST
401k plan membership statisitcs for CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST
| Measure | Date | Value |
|---|
| 2016: CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-10-01 | 53 |
| Number of retired or separated participants receiving benefits | 2016-10-01 | 25 |
| Total of all active and inactive participants | 2016-10-01 | 25 |
| 2015: CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-10-01 | 47 |
| Number of retired or separated participants receiving benefits | 2015-10-01 | 53 |
| Total of all active and inactive participants | 2015-10-01 | 53 |
| 2014: CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-10-01 | 49 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-10-01 | 47 |
| Total of all active and inactive participants | 2014-10-01 | 47 |
| 2013: CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-10-01 | 49 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-10-01 | 49 |
| Total of all active and inactive participants | 2013-10-01 | 49 |
| 2011: CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-10-01 | 63 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-10-01 | 60 |
| Total of all active and inactive participants | 2011-10-01 | 60 |
| 2010: CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-10-01 | 67 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-10-01 | 63 |
| Total of all active and inactive participants | 2010-10-01 | 63 |
| 2009: CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-10-01 | 70 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-10-01 | 67 |
| Total of all active and inactive participants | 2009-10-01 | 67 |
| Measure | Date | Value |
|---|
| 2017 : CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST 2017 401k financial data |
|---|
| Total income from all sources | 2017-09-30 | $219,369 |
| Expenses. Total of all expenses incurred | 2017-09-30 | $355,793 |
| Benefits paid (including direct rollovers) | 2017-09-30 | $328,772 |
| Total plan assets at end of year | 2017-09-30 | $0 |
| Total plan assets at beginning of year | 2017-09-30 | $136,424 |
| Other income received | 2017-09-30 | $51 |
| Net income (gross income less expenses) | 2017-09-30 | $-136,424 |
| Net plan assets at end of year (total assets less liabilities) | 2017-09-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-09-30 | $136,424 |
| Total contributions received or receivable from employer(s) | 2017-09-30 | $219,318 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-09-30 | $27,021 |
| 2016 : CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST 2016 401k financial data |
|---|
| Total income from all sources | 2016-09-30 | $546,229 |
| Expenses. Total of all expenses incurred | 2016-09-30 | $542,292 |
| Benefits paid (including direct rollovers) | 2016-09-30 | $522,765 |
| Total plan assets at end of year | 2016-09-30 | $136,424 |
| Total plan assets at beginning of year | 2016-09-30 | $132,487 |
| Other income received | 2016-09-30 | $69 |
| Net income (gross income less expenses) | 2016-09-30 | $3,937 |
| Net plan assets at end of year (total assets less liabilities) | 2016-09-30 | $136,424 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-09-30 | $132,487 |
| Total contributions received or receivable from employer(s) | 2016-09-30 | $546,160 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-09-30 | $19,527 |
| 2015 : CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST 2015 401k financial data |
|---|
| Total income from all sources | 2015-09-30 | $589,576 |
| Expenses. Total of all expenses incurred | 2015-09-30 | $584,637 |
| Benefits paid (including direct rollovers) | 2015-09-30 | $565,112 |
| Total plan assets at end of year | 2015-09-30 | $132,487 |
| Total plan assets at beginning of year | 2015-09-30 | $127,548 |
| Other income received | 2015-09-30 | $68 |
| Net income (gross income less expenses) | 2015-09-30 | $4,939 |
| Net plan assets at end of year (total assets less liabilities) | 2015-09-30 | $132,487 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-09-30 | $127,548 |
| Total contributions received or receivable from employer(s) | 2015-09-30 | $589,508 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-09-30 | $19,525 |
| 2014 : CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST 2014 401k financial data |
|---|
| Total income from all sources | 2014-09-30 | $540,017 |
| Expenses. Total of all expenses incurred | 2014-09-30 | $534,681 |
| Benefits paid (including direct rollovers) | 2014-09-30 | $514,769 |
| Total plan assets at end of year | 2014-09-30 | $127,548 |
| Total plan assets at beginning of year | 2014-09-30 | $122,212 |
| Other income received | 2014-09-30 | $68 |
| Net income (gross income less expenses) | 2014-09-30 | $5,336 |
| Net plan assets at end of year (total assets less liabilities) | 2014-09-30 | $127,548 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-09-30 | $122,212 |
| Total contributions received or receivable from employer(s) | 2014-09-30 | $539,949 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-09-30 | $19,912 |
| 2012 : CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST 2012 401k financial data |
|---|
| Total income from all sources | 2012-09-30 | $553,435 |
| Expenses. Total of all expenses incurred | 2012-09-30 | $550,274 |
| Benefits paid (including direct rollovers) | 2012-09-30 | $530,324 |
| Total plan assets at end of year | 2012-09-30 | $117,518 |
| Total plan assets at beginning of year | 2012-09-30 | $114,357 |
| Other income received | 2012-09-30 | $95 |
| Net income (gross income less expenses) | 2012-09-30 | $3,161 |
| Net plan assets at end of year (total assets less liabilities) | 2012-09-30 | $117,518 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-09-30 | $114,357 |
| Total contributions received or receivable from employer(s) | 2012-09-30 | $553,340 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2012-09-30 | $19,950 |
| 2011 : CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST 2011 401k financial data |
|---|
| Total income from all sources | 2011-09-30 | $545,152 |
| Expenses. Total of all expenses incurred | 2011-09-30 | $541,277 |
| Benefits paid (including direct rollovers) | 2011-09-30 | $521,830 |
| Total plan assets at end of year | 2011-09-30 | $114,357 |
| Total plan assets at beginning of year | 2011-09-30 | $110,482 |
| Other income received | 2011-09-30 | $135 |
| Net income (gross income less expenses) | 2011-09-30 | $3,875 |
| Net plan assets at end of year (total assets less liabilities) | 2011-09-30 | $114,357 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-09-30 | $110,482 |
| Total contributions received or receivable from employer(s) | 2011-09-30 | $545,017 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-09-30 | $19,447 |
| 2016: CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST 2016 form 5500 responses |
|---|
| 2016-10-01 | Type of plan entity | Mulitple employer plan |
| 2016-10-01 | This submission is the final filing | Yes |
| 2016-10-01 | Plan funding arrangement – Insurance | Yes |
| 2016-10-01 | Plan funding arrangement – Trust | Yes |
| 2016-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-10-01 | Plan benefit arrangement - Trust | Yes |
| 2015: CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST 2015 form 5500 responses |
|---|
| 2015-10-01 | Type of plan entity | Mulitple employer plan |
| 2015-10-01 | Plan funding arrangement – Insurance | Yes |
| 2015-10-01 | Plan funding arrangement – Trust | Yes |
| 2015-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-10-01 | Plan benefit arrangement - Trust | Yes |
| 2014: CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST 2014 form 5500 responses |
|---|
| 2014-10-01 | Type of plan entity | Mulitple employer plan |
| 2014-10-01 | Plan funding arrangement – Insurance | Yes |
| 2014-10-01 | Plan funding arrangement – Trust | Yes |
| 2014-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-10-01 | Plan benefit arrangement - Trust | Yes |
| 2013: CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST 2013 form 5500 responses |
|---|
| 2013-10-01 | Type of plan entity | Mulitple employer plan |
| 2013-10-01 | Plan funding arrangement – Insurance | Yes |
| 2013-10-01 | Plan funding arrangement – Trust | Yes |
| 2013-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-10-01 | Plan benefit arrangement - Trust | Yes |
| 2011: CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST 2011 form 5500 responses |
|---|
| 2011-10-01 | Type of plan entity | Mulitple employer plan |
| 2011-10-01 | Plan funding arrangement – Insurance | Yes |
| 2011-10-01 | Plan funding arrangement – Trust | Yes |
| 2011-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-10-01 | Plan benefit arrangement - Trust | Yes |
| 2010: CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST 2010 form 5500 responses |
|---|
| 2010-10-01 | Type of plan entity | Mulitple employer plan |
| 2010-10-01 | Plan funding arrangement – Insurance | Yes |
| 2010-10-01 | Plan funding arrangement – Trust | Yes |
| 2010-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-10-01 | Plan benefit arrangement - Trust | Yes |
| 2009: CRS, INC. & AFFILIATES EMPLOYEE BENEFIT TRUST 2009 form 5500 responses |
|---|
| 2009-10-01 | Type of plan entity | Mulitple employer plan |
| 2009-10-01 | This submission is the final filing | No |
| 2009-10-01 | Plan funding arrangement – Insurance | Yes |
| 2009-10-01 | Plan funding arrangement – Trust | Yes |
| 2009-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-10-01 | Plan benefit arrangement - Trust | Yes |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00466089 |
| Policy instance | 3 |
| Insurance contract or identification number | 00466089 | | Number of Individuals Covered | 53 | | Insurance policy start date | 2015-12-01 | | Insurance policy end date | 2016-11-30 | | Total amount of commissions paid to insurance broker | USD $3,673 | | Total amount of fees paid to insurance company | USD $644 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $55,728 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,601 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 644 | | Insurance broker name | PACIFIC ADVISORS LLC |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 024230G |
| Policy instance | 2 |
| Insurance contract or identification number | 024230G | | Number of Individuals Covered | 32 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2016-02-29 | | Total amount of commissions paid to insurance broker | USD $273 | | Total amount of fees paid to insurance company | USD $30 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,363 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $159 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 30 | | Additional information about fees paid to insurance broker | BONUS PAID | | Insurance broker name | HUB INTERNATIONAL INS SERVICES |
|
| CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 ) |
| Policy contract number | W0001905 |
| Policy instance | 1 |
| Insurance contract or identification number | W0001905 | | Number of Individuals Covered | 52 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2015-11-30 | | Total amount of commissions paid to insurance broker | USD $15,303 | | Total amount of fees paid to insurance company | USD $1,356 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $382,559 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,902 | | Amount paid for insurance broker fees | 1356 | | Additional information about fees paid to insurance broker | BONUS OVERRIDE | | Insurance broker organization code? | 3 | | Insurance broker name | HUB INTERNATIONAL INS SERVICES INC. |
|
| CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 ) |
| Policy contract number | VH1118 |
| Policy instance | 1 |
| Insurance contract or identification number | VH1118 | | Number of Individuals Covered | 45 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $14,912 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $478,916 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,980 | | Insurance broker organization code? | 3 | | Insurance broker name | BB&T INSURANCE SVCS OF CALIFORNIA |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 024230G |
| Policy instance | 2 |
| Insurance contract or identification number | 024230G | | Number of Individuals Covered | 32 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $273 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,741 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $159 | | Insurance broker organization code? | 3 | | Insurance broker name | BB&T INSURANCE SVCS OF CALIFORNIA |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00466089 |
| Policy instance | 3 |
| Insurance contract or identification number | 00466089 | | Number of Individuals Covered | 47 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $3,496 | | Total amount of fees paid to insurance company | USD $1,468 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $50,144 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,745 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1468 | | Insurance broker name | CHARLES BOGUE |
|
| CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 ) |
| Policy contract number | VH1118 |
| Policy instance | 1 |
| Insurance contract or identification number | VH1118 | | Number of Individuals Covered | 49 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $14,579 | | Total amount of fees paid to insurance company | USD $540 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $440,829 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,579 | | Amount paid for insurance broker fees | 540 | | Additional information about fees paid to insurance broker | BONUS OVERRIDE ALLOCATION | | Insurance broker organization code? | 3 | | Insurance broker name | HUB INTERNATIONAL INS SERVICES INC. |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00466089 |
| Policy instance | 3 |
| Insurance contract or identification number | 00466089 | | Number of Individuals Covered | 49 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $3,430 | | Total amount of fees paid to insurance company | USD $1,590 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $48,896 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,363 | | Amount paid for insurance broker fees | 1590 | | Insurance broker organization code? | 3 | | Insurance broker name | CHARLES BOGUE |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 024230G |
| Policy instance | 2 |
| Insurance contract or identification number | 024230G | | Number of Individuals Covered | 32 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $275 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,850 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $275 | | Insurance broker organization code? | 3 | | Insurance broker name | HUB INTERNATIONAL INS SERVICES INC. |
|
| CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 ) |
| Policy contract number | VH1118 |
| Policy instance | 1 |
| Insurance contract or identification number | VH1118 | | Number of Individuals Covered | 116 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-02-29 | | Total amount of commissions paid to insurance broker | USD $17,453 | | Total amount of fees paid to insurance company | USD $16 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $529,469 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 024230G |
| Policy instance | 2 |
| Insurance contract or identification number | 024230G | | Number of Individuals Covered | 31 | | Insurance policy start date | 2011-02-01 | | Insurance policy end date | 2012-01-31 | | Total amount of commissions paid to insurance broker | USD $279 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,857 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00466089 |
| Policy instance | 3 |
| Insurance contract or identification number | 00466089 | | Number of Individuals Covered | 60 | | Insurance policy start date | 2011-10-01 | | Insurance policy end date | 2012-09-30 | | Total amount of commissions paid to insurance broker | USD $3,682 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $53,706 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 ) |
| Policy contract number | VH1118 |
| Policy instance | 1 |
| Insurance contract or identification number | VH1118 | | Number of Individuals Covered | 96 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $13,985 | | Total amount of fees paid to insurance company | USD $190 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $442,123 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 024230G |
| Policy instance | 2 |
| Insurance contract or identification number | 024230G | | Number of Individuals Covered | 27 | | Insurance policy start date | 2010-02-01 | | Insurance policy end date | 2011-01-31 | | Total amount of commissions paid to insurance broker | USD $234 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,686 | | 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: ) |
| Policy contract number | 00101335 |
| Policy instance | 3 |
| Insurance contract or identification number | 00101335 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2010-10-01 | | Insurance policy end date | 2011-03-01 | | Total amount of commissions paid to insurance broker | USD $277 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,940 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00466089 |
| Policy instance | 4 |
| Insurance contract or identification number | 00466089 | | Number of Individuals Covered | 63 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2011-09-30 | | Total amount of commissions paid to insurance broker | USD $2,819 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,660 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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