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FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 401k Plan overview

Plan NameFLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY
Plan identification number 502

FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision
  • Severance pay
  • Other welfare benefit cover

401k Sponsoring company profile

THE GAS COMPANY, LLC has sponsored the creation of one or more 401k plans.

Company Name:THE GAS COMPANY, LLC
Employer identification number (EIN):383679115
NAIC Classification:221210
NAIC Description:Natural Gas Distribution

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022023-01-01
5022023-01-01BARBARA BERMUDES
5022022-01-01
5022022-01-01NATHAN NELSON
5022021-01-01
5022021-01-01BRUCE TAMASHIRO
5022020-01-01
5022019-01-01
5022017-01-01MICHAEL LAPORTE
5022016-01-01MICHAEL LAPORTE
5022015-01-01ALBERT MOSSMAN
5022014-01-01ALBERT MOSSMAN
5022013-01-01ALBERT MOSSMAN
5022012-01-01KENNETH YAMAMOTO
5022011-01-01KENNETH YAMAMOTO
5022010-01-01KENNETH YAMAMOTO
5022009-01-01KENNETH YAMAMOTO

Plan Statistics for FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY

401k plan membership statisitcs for FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY

Measure Date Value
2023: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2023 401k membership
Total participants, beginning-of-year2023-01-01240
Total number of active participants reported on line 7a of the Form 55002023-01-01139
Number of retired or separated participants receiving benefits2023-01-0193
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01232
2022: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2022 401k membership
Total participants, beginning-of-year2022-01-01217
Total number of active participants reported on line 7a of the Form 55002022-01-01141
Number of retired or separated participants receiving benefits2022-01-0199
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01240
2021: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2021 401k membership
Total participants, beginning-of-year2021-01-01206
Total number of active participants reported on line 7a of the Form 55002021-01-01126
Number of retired or separated participants receiving benefits2021-01-0191
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01217
2020: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2020 401k membership
Total participants, beginning-of-year2020-01-01196
Total number of active participants reported on line 7a of the Form 55002020-01-01116
Number of retired or separated participants receiving benefits2020-01-0190
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01206
2019: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2019 401k membership
Total participants, beginning-of-year2019-01-01191
Total number of active participants reported on line 7a of the Form 55002019-01-01115
Number of retired or separated participants receiving benefits2019-01-0181
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01196
2017: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2017 401k membership
Total participants, beginning-of-year2017-01-01176
Total number of active participants reported on line 7a of the Form 55002017-01-01168
Number of retired or separated participants receiving benefits2017-01-0166
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01234
2016: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2016 401k membership
Total participants, beginning-of-year2016-01-01190
Total number of active participants reported on line 7a of the Form 55002016-01-01109
Number of retired or separated participants receiving benefits2016-01-0167
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01176
2015: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2015 401k membership
Total participants, beginning-of-year2015-01-01182
Total number of active participants reported on line 7a of the Form 55002015-01-01112
Number of retired or separated participants receiving benefits2015-01-0178
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01190
2014: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2014 401k membership
Total participants, beginning-of-year2014-01-01382
Total number of active participants reported on line 7a of the Form 55002014-01-01108
Number of retired or separated participants receiving benefits2014-01-0174
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01182
2013: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2013 401k membership
Total participants, beginning-of-year2013-01-01147
Total number of active participants reported on line 7a of the Form 55002013-01-01318
Number of retired or separated participants receiving benefits2013-01-0164
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01382
2012: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2012 401k membership
Total participants, beginning-of-year2012-01-01146
Total number of active participants reported on line 7a of the Form 55002012-01-01100
Number of retired or separated participants receiving benefits2012-01-0147
Total of all active and inactive participants2012-01-01147
Total participants2012-01-01147
2011: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2011 401k membership
Total participants, beginning-of-year2011-01-01139
Total number of active participants reported on line 7a of the Form 55002011-01-01102
Number of retired or separated participants receiving benefits2011-01-0144
Total of all active and inactive participants2011-01-01146
Total participants2011-01-01146
2010: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2010 401k membership
Total participants, beginning-of-year2010-01-01150
Total number of active participants reported on line 7a of the Form 55002010-01-0196
Number of retired or separated participants receiving benefits2010-01-0143
Total of all active and inactive participants2010-01-01139
Total participants2010-01-01139
2009: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2009 401k membership
Total participants, beginning-of-year2009-01-01162
Total number of active participants reported on line 7a of the Form 55002009-01-0199
Number of retired or separated participants receiving benefits2009-01-0151
Total of all active and inactive participants2009-01-01150
Total participants2009-01-01150

Form 5500 Responses for FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY

2023: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – Section 412(e)(3) insurance ContractsYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: FLEXIBLE SPENDING PLAN FOR EMPLOYEES OF THE GAS COMPANY 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

WORKLIFE HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number0000
Policy instance 4
Insurance contract or identification number0000
Number of Individuals Covered139
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
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
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
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 $2,568
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number2576
Policy instance 3
Insurance contract or identification number2576
Number of Individuals Covered351
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $1,459
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare 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 $147,221
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number32799
Policy instance 2
Insurance contract or identification number32799
Number of Individuals Covered62
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $10,024
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare 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 $291,240
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number18339
Policy instance 1
Insurance contract or identification number18339
Number of Individuals Covered353
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $30,000
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare 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 $1,927,609
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number2576
Policy instance 3
Insurance contract or identification number2576
Number of Individuals Covered321
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $18,386
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare 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 $138,948
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number18339
Policy instance 1
Insurance contract or identification number18339
Number of Individuals Covered339
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $30,000
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare 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 $1,732,015
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number32799
Policy instance 2
Insurance contract or identification number32799
Number of Individuals Covered46
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $10,912
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare 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 $309,314
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WORKLIFE HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number0000
Policy instance 4
Insurance contract or identification number0000
Number of Individuals Covered141
Insurance policy start date2022-01-01
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
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
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 $2,528
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number2576
Policy instance 3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number32799
Policy instance 2
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number18339
Policy instance 1
WORKLIFE HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number0000
Policy instance 4
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number32799
Policy instance 2
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number18339
Policy instance 1
WORKLIFE HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number0000
Policy instance 4
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number2576
Policy instance 3
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number18339
Policy instance 1
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number2576
Policy instance 3
WORKLIFE HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number0000
Policy instance 4
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number32799
Policy instance 2
UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 )
Policy contract number1104
Policy instance 5
WORKLIFE HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number0000
Policy instance 4
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number2576
Policy instance 3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number32799
Policy instance 2
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number18339
Policy instance 1
WORKLIFE HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number0000
Policy instance 5
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: NA )
Policy contract number12221092
Policy instance 4
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number2576
Policy instance 3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number32799
Policy instance 2
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number80056
Policy instance 1
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number80056
Policy instance 1
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number32799
Policy instance 2
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number2576
Policy instance 3
WORKLIFE HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number0000
Policy instance 5
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: NA )
Policy contract number12221092
Policy instance 4
WORKLIFE HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number0000
Policy instance 5
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number2576
Policy instance 3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: NA )
Policy contract number12221092
Policy instance 4
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number32799
Policy instance 2
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number80056
Policy instance 1
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number32799
Policy instance 2
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number80056
Policy instance 1
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: NA )
Policy contract number12221092
Policy instance 4
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number2576
Policy instance 3
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number2576
Policy instance 1
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number80056
Policy instance 2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: NA )
Policy contract number12221092
Policy instance 4
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number32799
Policy instance 3
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number80056/98234-5
Policy instance 1
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number32799
Policy instance 2
HAWAII MEDICAL ASSURANCE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 48330 )
Policy contract number01278H
Policy instance 4
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number2576
Policy instance 5
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: NA )
Policy contract number12221092
Policy instance 6
SUMMERLIN LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 11838 )
Policy contract number01278HACTIVE
Policy instance 3

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