Civic Intelligence
Filing

The Interflex Group Inc. Employee Benefits Plan

INTERFLEX ACQUISITION CO., LLC DBA INTERFLEX GROUP • EIN 45-4657307 • Plan year 2022

Company ProfileSource Archive
Filing Insights

Participants

Down

206 → 201

-5 • -2.43%

Assets

No comparison

- → -

No earlier value available.

Investment Management Fee

-

Admin expenses - • Total expenses -

Filing Details

Context

No event flags were generated for this filing.

Status Flags

Fidelity bond in place

Not reported

Limited-scope audit performed

Not reported

Contributions transmitted on time

Not reported

Participant loans in default

Not reported

Leases in default

Not reported

Reportable party-in-interest issues

Not reported

Loss discovered during year

Not reported

Assets with undetermined value

Not reported

Non-cash contributions

Not reported

Assets held for investment

Not reported

5% transactions reported

Not reported

All plan assets distributed

Not reported

Benefits paid when due

Not reported

Plan blackout period

Not reported

Plan termination resolution adopted

Not reported

Counterparties

Company Timeline

This filing is highlighted inside the broader sponsor history.

Year / FilingFilingsParticipantsAssetsContributionsContrib./Participant
20242210$12,928,878$1,400,347$6,668iApproximate average salary by contribution assumption: employee only about $166,708 at 4% or $111,139 at 6%; with 50% employer match about $111,139 at 4% or $74,092 at 6%; with 100% employer match about $83,354 at 4% or $55,569 at 6%.
The Interflex Group Inc. 401(K) Plan-210$12,928,878$1,400,347$6,668iApproximate average salary by contribution assumption: employee only about $166,708 at 4% or $111,139 at 6%; with 50% employer match about $111,139 at 4% or $74,092 at 6%; with 100% employer match about $83,354 at 4% or $55,569 at 6%.
The Interflex Group Inc. Employee Benefits Plan-210---
20232218$11,224,680$1,392,183$6,386iApproximate average salary by contribution assumption: employee only about $159,654 at 4% or $106,436 at 6%; with 50% employer match about $106,436 at 4% or $70,957 at 6%; with 100% employer match about $79,827 at 4% or $53,218 at 6%.
The Interflex Group Inc. 401(K) Plan-210$11,224,680$1,392,183$6,629iApproximate average salary by contribution assumption: employee only about $165,736 at 4% or $110,491 at 6%; with 50% employer match about $110,491 at 4% or $73,660 at 6%; with 100% employer match about $82,868 at 4% or $55,245 at 6%.
The Interflex Group Inc. Employee Benefits Plan-218---
20222206$9,180,508$1,777,564$8,629iApproximate average salary by contribution assumption: employee only about $215,724 at 4% or $143,816 at 6%; with 50% employer match about $143,816 at 4% or $95,877 at 6%; with 100% employer match about $107,862 at 4% or $71,908 at 6%.
The Interflex Group Inc. 401(K) Plan-206$9,180,508$1,777,564$8,629iApproximate average salary by contribution assumption: employee only about $215,724 at 4% or $143,816 at 6%; with 50% employer match about $143,816 at 4% or $95,877 at 6%; with 100% employer match about $107,862 at 4% or $71,908 at 6%.
The Interflex Group Inc. Employee Benefits PlanCurrent201---
20212201$11,191,002$788,026$3,921iApproximate average salary by contribution assumption: employee only about $98,013 at 4% or $65,342 at 6%; with 50% employer match about $65,342 at 4% or $43,561 at 6%; with 100% employer match about $49,007 at 4% or $32,671 at 6%.
The Interflex Group Inc. 401(K) Plan-201$11,191,002$788,026$3,921iApproximate average salary by contribution assumption: employee only about $98,013 at 4% or $65,342 at 6%; with 50% employer match about $65,342 at 4% or $43,561 at 6%; with 100% employer match about $49,007 at 4% or $32,671 at 6%.
The Interflex Group Inc. Employee Benefits Plan-196---
20202229$10,450,657$1,081,984$4,725iApproximate average salary by contribution assumption: employee only about $118,121 at 4% or $78,747 at 6%; with 50% employer match about $78,747 at 4% or $52,498 at 6%; with 100% employer match about $59,060 at 4% or $39,374 at 6%.
The Interflex Group Inc. 401(K) Plan-217$10,450,657$1,081,984$4,986iApproximate average salary by contribution assumption: employee only about $124,653 at 4% or $83,102 at 6%; with 50% employer match about $83,102 at 4% or $55,401 at 6%; with 100% employer match about $62,326 at 4% or $41,551 at 6%.
The Interflex Group Inc. Employee Benefits Plan-229---
20192203$8,795,099$954,953$4,704iApproximate average salary by contribution assumption: employee only about $117,605 at 4% or $78,403 at 6%; with 50% employer match about $78,403 at 4% or $52,269 at 6%; with 100% employer match about $58,803 at 4% or $39,202 at 6%.
The Interflex Group Inc. 401(K) Plan-203$8,795,099$954,953$4,704iApproximate average salary by contribution assumption: employee only about $117,605 at 4% or $78,403 at 6%; with 50% employer match about $78,403 at 4% or $52,269 at 6%; with 100% employer match about $58,803 at 4% or $39,202 at 6%.
The Interflex Group Inc. Employee Benefits Plan-191---
20182234$7,756,944$1,197,132$5,116iApproximate average salary by contribution assumption: employee only about $127,899 at 4% or $85,266 at 6%; with 50% employer match about $85,266 at 4% or $56,844 at 6%; with 100% employer match about $63,949 at 4% or $42,633 at 6%.
The Interflex Group Inc. 401(K) Plan-234$7,756,944$1,197,132$5,116iApproximate average salary by contribution assumption: employee only about $127,899 at 4% or $85,266 at 6%; with 50% employer match about $85,266 at 4% or $56,844 at 6%; with 100% employer match about $63,949 at 4% or $42,633 at 6%.
The Interflex Group Inc. Employee Benefits Plan-231---
20172280$8,052,965$1,164,840$4,160iApproximate average salary by contribution assumption: employee only about $104,004 at 4% or $69,336 at 6%; with 50% employer match about $69,336 at 4% or $46,224 at 6%; with 100% employer match about $52,002 at 4% or $34,668 at 6%.
The Interflex Group Inc. 401(K) Plan-280$8,052,965$1,164,840$4,160iApproximate average salary by contribution assumption: employee only about $104,004 at 4% or $69,336 at 6%; with 50% employer match about $69,336 at 4% or $46,224 at 6%; with 100% employer match about $52,002 at 4% or $34,668 at 6%.
The Interflex Group Inc. Employee Benefits Plan-276---
20162275$7,299,108$1,230,194$4,473iApproximate average salary by contribution assumption: employee only about $111,836 at 4% or $74,557 at 6%; with 50% employer match about $74,557 at 4% or $49,705 at 6%; with 100% employer match about $55,918 at 4% or $37,279 at 6%.
The Interflex Group Inc. 401(K) Plan-269$7,299,108$1,230,194$4,573iApproximate average salary by contribution assumption: employee only about $114,330 at 4% or $76,220 at 6%; with 50% employer match about $76,220 at 4% or $50,813 at 6%; with 100% employer match about $57,165 at 4% or $38,110 at 6%.
The Interflex Group Inc. Employee Benefits Plan-275---
20152290$6,197,519$1,359,467$4,688iApproximate average salary by contribution assumption: employee only about $117,195 at 4% or $78,130 at 6%; with 50% employer match about $78,130 at 4% or $52,087 at 6%; with 100% employer match about $58,598 at 4% or $39,065 at 6%.
The Interflex Group Inc. 401(K) Plan-266$6,197,519$1,359,467$5,111iApproximate average salary by contribution assumption: employee only about $127,769 at 4% or $85,180 at 6%; with 50% employer match about $85,180 at 4% or $56,786 at 6%; with 100% employer match about $63,885 at 4% or $42,590 at 6%.
The Interflex Group Inc. Employee Benefits Plan-290---
20142286$5,845,163$756,388$2,645iApproximate average salary by contribution assumption: employee only about $66,118 at 4% or $44,079 at 6%; with 50% employer match about $44,079 at 4% or $29,386 at 6%; with 100% employer match about $33,059 at 4% or $22,039 at 6%.
The Interflex Group Inc. 401(K) Plan-264$5,845,163$756,388$2,865iApproximate average salary by contribution assumption: employee only about $71,628 at 4% or $47,752 at 6%; with 50% employer match about $47,752 at 4% or $31,835 at 6%; with 100% employer match about $35,814 at 4% or $23,876 at 6%.
The Interflex Group Inc. Employee Benefits Plan-286---
20134197$5,252,351$617,893$3,137iApproximate average salary by contribution assumption: employee only about $78,413 at 4% or $52,275 at 6%; with 50% employer match about $52,275 at 4% or $34,850 at 6%; with 100% employer match about $39,206 at 4% or $26,138 at 6%.
The Interflex Group Inc. 401(K) Plan-197$5,252,351$617,893$3,137iApproximate average salary by contribution assumption: employee only about $78,413 at 4% or $52,275 at 6%; with 50% employer match about $52,275 at 4% or $34,850 at 6%; with 100% employer match about $39,206 at 4% or $26,138 at 6%.
The Interflex Group Inc. Employee Benefits Plan-187---
The Interflex Group Inc. Employee Benefits Plan-193---
THE HRA PLAN OF INTERFLEX ACQUISITION COMPANY, LLC-0---
20123192$4,587,597$613,606$3,196iApproximate average salary by contribution assumption: employee only about $79,897 at 4% or $53,264 at 6%; with 50% employer match about $53,264 at 4% or $35,510 at 6%; with 100% employer match about $39,948 at 4% or $26,632 at 6%.
The Interflex Group Inc. 401(K) Plan-192$4,587,597$613,606$3,196iApproximate average salary by contribution assumption: employee only about $79,897 at 4% or $53,264 at 6%; with 50% employer match about $53,264 at 4% or $35,510 at 6%; with 100% employer match about $39,948 at 4% or $26,632 at 6%.
THE HRA PLAN OF INTERFLEX ACQUISITION COMPANY, LLC-166---
The Interflex Group Inc. Employee Benefits Plan-106---
Schedule Details

Schedule A

Row 1
Form Id
1
Ins Broker Name
JAMES A SCOTT & SON INC
Ins Broker US Address1
628 GREEN VALLEY ROAD
Ins Broker US Address2
SUITE 306
Ins Broker US City
GREENSBORO
Ins Broker US State
NC
Ins Broker US ZIP
27408
Ins Broker Comm Pd Amount
$12,753
Ins Broker Code
3
Row 2
Form Id
6
Ins Broker Name
JAMES A SCOTT & SON INC
Ins Broker US Address1
1301 OLD GRAVES MILL ROAD
Ins Broker US City
LYNCHBURG
Ins Broker US State
VA
Ins Broker US ZIP
24502
Ins Broker Comm Pd Amount
$2,678
Ins Broker Code
3
Row 3
Form Id
2
Ins Broker Name
JAMES A SCOTT & SON INC
Ins Broker US Address1
1301 OLD GRAVES MILL ROAD
Ins Broker US City
LYNCHBURG
Ins Broker US State
VA
Ins Broker US ZIP
24502
Ins Broker Comm Pd Amount
$23,798
Ins Broker Code
3
Row 4
Form Id
6
Ins Broker Name
WATCHTOWER TECHNOLOGIES INC
Ins Broker US Address1
306 WEST ERIE STREET
Ins Broker US Address2
SUITE 300
Ins Broker US City
CHICAGO
Ins Broker US State
IL
Ins Broker US ZIP
60654
Ins Broker Comm Pd Amount
$218
Ins Broker Code
3
Row 5
Form Id
1
Ins Broker Name
JAMES A SCOTT & SON INC
Ins Broker US Address1
1301 OLD GRAVES MILL ROAD
Ins Broker US City
LYNCHBURG
Ins Broker US State
VA
Ins Broker US ZIP
24502
Ins Broker Fees Pd Amount
$1,080
Ins Broker Fees Pd Text
FEES
Ins Broker Code
3
Row 6
Form Id
2
Ins Broker Name
WATCHTOWER TECHNOLOGIES INC
Ins Broker US Address1
306 WEST ERIE STREET
Ins Broker US Address2
SUITE 300
Ins Broker US City
CHICAGO
Ins Broker US State
IL
Ins Broker US ZIP
60654
Ins Broker Comm Pd Amount
$2,380
Ins Broker Code
3
Row 7
Ins Carrier Name: TOKIO MARINE
Form Id
4
Schedule A Plan Year Begin Date
2022-07-01
Schedule A Plan Year End Date
2023-06-30
Schedule A Plan Num
501
Schedule A EIN
45-4657307
Ins Carrier Name
TOKIO MARINE
Ins Carrier EIN
35-1817054
Ins Carrier Naic Code
92711
Ins Contract Num
417005411468
Ins Prsn Covered End of year Count
201
Ins Policy From Date
2022-07-01
Ins Policy To Date
2023-06-30
Alloc Contracts Indiv Indicator
No
Alloc Contracts Group Indicator
No
Alloc Contracts Other Indicator
No
Pens Distr Bnft Terminate Pln Indicator
No
Unalloc Contracts Dep Adm Indicator
No
Unal Contrac Imm Part Guar Indicator
No
Unal Contracts Guar Invest Indicator
No
Unalloc Contracts Other Indicator
No
Pension End Prev Bal Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Bnft Health Indicator
No
Wlfr Bnft Dental Indicator
No
Wlfr Bnft Vision Indicator
No
Wlfr Bnft Life Insur Indicator
No
Wlfr Bnft Temp Disab Indicator
No
Wlfr Bnft Long Terminate Disab Indicator
No
Wlfr Bnft Unemp Indicator
No
Wlfr Bnft Drug Indicator
No
Wlfr Bnft Stop Loss Indicator
Yes
Wlfr Bnft Hmo Indicator
No
Wlfr Bnft Ppo Indicator
No
Wlfr Bnft Indemnity Indicator
No
Wlfr Bnft Other Indicator
No
Wlfr Total Earned Prem Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Cash Indicator
No
Wlfr Refund Credit Indicator
No
Wlfr Total Charges Paid Amount
$582,092
Ins Fail Provide Info Indicator
No
Row 8
Ins Carrier Name: SUN LIFE ASSURANCE COMPANY OF CANADA
Form Id
2
Schedule A Plan Year Begin Date
2022-07-01
Schedule A Plan Year End Date
2023-06-30
Schedule A Plan Num
501
Schedule A EIN
45-4657307
Ins Carrier Name
SUN LIFE ASSURANCE COMPANY OF CANADA
Ins Carrier EIN
38-1082080
Ins Carrier Naic Code
80802
Ins Contract Num
215973
Ins Prsn Covered End of year Count
147
Ins Policy From Date
2022-07-01
Ins Policy To Date
2023-06-30
Ins Broker Comm Total Amount
$26,178
Ins Broker Fees Total Amount
$0
Alloc Contracts Indiv Indicator
No
Alloc Contracts Group Indicator
No
Alloc Contracts Other Indicator
No
Pens Distr Bnft Terminate Pln Indicator
No
Unalloc Contracts Dep Adm Indicator
No
Unal Contrac Imm Part Guar Indicator
No
Unal Contracts Guar Invest Indicator
No
Unalloc Contracts Other Indicator
No
Pension End Prev Bal Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Bnft Health Indicator
No
Wlfr Bnft Dental Indicator
No
Wlfr Bnft Vision Indicator
No
Wlfr Bnft Life Insur Indicator
Yes
Wlfr Bnft Temp Disab Indicator
Yes
Wlfr Bnft Long Terminate Disab Indicator
Yes
Wlfr Bnft Unemp Indicator
No
Wlfr Bnft Drug Indicator
No
Wlfr Bnft Stop Loss Indicator
No
Wlfr Bnft Hmo Indicator
No
Wlfr Bnft Ppo Indicator
No
Wlfr Bnft Indemnity Indicator
No
Wlfr Bnft Other Indicator
Yes
Wlfr Type Bnft Oth Text
AD&D, SUPPLEMENTAL LIFE, DEPENDENT LIFE
Wlfr Total Earned Prem Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Cash Indicator
No
Wlfr Refund Credit Indicator
No
Wlfr Total Charges Paid Amount
$155,650
Ins Fail Provide Info Indicator
No
Row 9
Ins Carrier Name: MCLAUGHLIN YOUNG EMPLOYEE SERVICES, INC.
Form Id
3
Schedule A Plan Year Begin Date
2022-07-01
Schedule A Plan Year End Date
2023-06-30
Schedule A Plan Num
501
Schedule A EIN
45-4657307
Ins Carrier Name
MCLAUGHLIN YOUNG EMPLOYEE SERVICES, INC.
Ins Carrier EIN
56-1560450
Ins Carrier Naic Code
00000
Ins Contract Num
00000
Ins Prsn Covered End of year Count
190
Ins Policy From Date
2022-07-01
Ins Policy To Date
2023-06-30
Alloc Contracts Indiv Indicator
No
Alloc Contracts Group Indicator
No
Alloc Contracts Other Indicator
No
Pens Distr Bnft Terminate Pln Indicator
No
Unalloc Contracts Dep Adm Indicator
No
Unal Contrac Imm Part Guar Indicator
No
Unal Contracts Guar Invest Indicator
No
Unalloc Contracts Other Indicator
No
Pension End Prev Bal Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Bnft Health Indicator
No
Wlfr Bnft Dental Indicator
No
Wlfr Bnft Vision Indicator
No
Wlfr Bnft Life Insur Indicator
No
Wlfr Bnft Temp Disab Indicator
No
Wlfr Bnft Long Terminate Disab Indicator
No
Wlfr Bnft Unemp Indicator
No
Wlfr Bnft Drug Indicator
No
Wlfr Bnft Stop Loss Indicator
No
Wlfr Bnft Hmo Indicator
No
Wlfr Bnft Ppo Indicator
No
Wlfr Bnft Indemnity Indicator
No
Wlfr Bnft Other Indicator
Yes
Wlfr Type Bnft Oth Text
EMPLOYEE ASSISTANCE PROGRAM
Wlfr Total Earned Prem Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Cash Indicator
No
Wlfr Refund Credit Indicator
No
Wlfr Total Charges Paid Amount
$2,744
Ins Fail Provide Info Indicator
No
Row 10
Ins Carrier Name: AMERITAS LIFE INSURANCE CORP.
Form Id
1
Schedule A Plan Year Begin Date
2022-07-01
Schedule A Plan Year End Date
2023-06-30
Schedule A Plan Num
501
Schedule A EIN
45-4657307
Ins Carrier Name
AMERITAS LIFE INSURANCE CORP.
Ins Carrier EIN
47-0098400
Ins Carrier Naic Code
61301
Ins Contract Num
010-040794
Ins Prsn Covered End of year Count
158
Ins Policy From Date
2022-07-01
Ins Policy To Date
2023-06-30
Ins Broker Comm Total Amount
$12,753
Ins Broker Fees Total Amount
$1,080
Alloc Contracts Indiv Indicator
No
Alloc Contracts Group Indicator
No
Alloc Contracts Other Indicator
No
Pens Distr Bnft Terminate Pln Indicator
No
Unalloc Contracts Dep Adm Indicator
No
Unal Contrac Imm Part Guar Indicator
No
Unal Contracts Guar Invest Indicator
No
Unalloc Contracts Other Indicator
No
Pension End Prev Bal Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Bnft Health Indicator
No
Wlfr Bnft Dental Indicator
Yes
Wlfr Bnft Vision Indicator
No
Wlfr Bnft Life Insur Indicator
No
Wlfr Bnft Temp Disab Indicator
No
Wlfr Bnft Long Terminate Disab Indicator
No
Wlfr Bnft Unemp Indicator
No
Wlfr Bnft Drug Indicator
No
Wlfr Bnft Stop Loss Indicator
No
Wlfr Bnft Hmo Indicator
No
Wlfr Bnft Ppo Indicator
No
Wlfr Bnft Indemnity Indicator
No
Wlfr Bnft Other Indicator
No
Wlfr Total Earned Prem Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Cash Indicator
No
Wlfr Refund Credit Indicator
No
Wlfr Total Charges Paid Amount
$127,992
Ins Fail Provide Info Indicator
No
Row 11
Ins Carrier Name: TOKIO MARINE
Form Id
5
Schedule A Plan Year Begin Date
2022-07-01
Schedule A Plan Year End Date
2023-06-30
Schedule A Plan Num
501
Schedule A EIN
45-4657307
Ins Carrier Name
TOKIO MARINE
Ins Carrier EIN
35-1817054
Ins Carrier Naic Code
92711
Ins Contract Num
417006411468
Ins Prsn Covered End of year Count
164
Ins Policy From Date
2022-07-01
Ins Policy To Date
2023-06-30
Alloc Contracts Indiv Indicator
No
Alloc Contracts Group Indicator
No
Alloc Contracts Other Indicator
No
Pens Distr Bnft Terminate Pln Indicator
No
Unalloc Contracts Dep Adm Indicator
No
Unal Contrac Imm Part Guar Indicator
No
Unal Contracts Guar Invest Indicator
No
Unalloc Contracts Other Indicator
No
Pension End Prev Bal Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Bnft Health Indicator
No
Wlfr Bnft Dental Indicator
No
Wlfr Bnft Vision Indicator
No
Wlfr Bnft Life Insur Indicator
No
Wlfr Bnft Temp Disab Indicator
No
Wlfr Bnft Long Terminate Disab Indicator
No
Wlfr Bnft Unemp Indicator
No
Wlfr Bnft Drug Indicator
No
Wlfr Bnft Stop Loss Indicator
No
Wlfr Bnft Hmo Indicator
No
Wlfr Bnft Ppo Indicator
No
Wlfr Bnft Indemnity Indicator
No
Wlfr Bnft Other Indicator
Yes
Wlfr Type Bnft Oth Text
TRANSPLANT
Wlfr Total Earned Prem Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Cash Indicator
No
Wlfr Refund Credit Indicator
No
Wlfr Total Charges Paid Amount
$24,351
Ins Fail Provide Info Indicator
No
Row 12
Ins Carrier Name: SUN LIFE ASSURANCE COMPANY OF CANADA
Form Id
6
Schedule A Plan Year Begin Date
2022-07-01
Schedule A Plan Year End Date
2023-06-30
Schedule A Plan Num
501
Schedule A EIN
45-4657307
Ins Carrier Name
SUN LIFE ASSURANCE COMPANY OF CANADA
Ins Carrier EIN
38-1082080
Ins Carrier Naic Code
80802
Ins Contract Num
912334
Ins Prsn Covered End of year Count
53
Ins Policy From Date
2022-07-01
Ins Policy To Date
2023-06-30
Ins Broker Comm Total Amount
$2,896
Ins Broker Fees Total Amount
$0
Alloc Contracts Indiv Indicator
No
Alloc Contracts Group Indicator
No
Alloc Contracts Other Indicator
No
Pens Distr Bnft Terminate Pln Indicator
No
Unalloc Contracts Dep Adm Indicator
No
Unal Contrac Imm Part Guar Indicator
No
Unal Contracts Guar Invest Indicator
No
Unalloc Contracts Other Indicator
No
Pension End Prev Bal Amount
$0
Pension Total Additions Amount
$0
Pension Total Bal Addn Amount
$0
Pension Total Ded Amount
$0
Pension End of year Bal Amount
$0
Wlfr Bnft Health Indicator
No
Wlfr Bnft Dental Indicator
No
Wlfr Bnft Vision Indicator
No
Wlfr Bnft Life Insur Indicator
No
Wlfr Bnft Temp Disab Indicator
No
Wlfr Bnft Long Terminate Disab Indicator
No
Wlfr Bnft Unemp Indicator
No
Wlfr Bnft Drug Indicator
No
Wlfr Bnft Stop Loss Indicator
No
Wlfr Bnft Hmo Indicator
No
Wlfr Bnft Ppo Indicator
No
Wlfr Bnft Indemnity Indicator
No
Wlfr Bnft Other Indicator
Yes
Wlfr Type Bnft Oth Text
ACCIDENT, CRITICAL ILLNESS
Wlfr Total Earned Prem Amount
$0
Wlfr Incurred Claim Amount
$0
Wlfr Ret Total Amount
$0
Wlfr Refund Cash Indicator
No
Wlfr Refund Credit Indicator
No
Wlfr Total Charges Paid Amount
$16,155
Ins Fail Provide Info Indicator
No

Filing received by DOL Mar 11, 2024