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CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 401k Plan overview

Plan NameCENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM
Plan identification number 501

CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM Benefits

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

401k Sponsoring company profile

CENTRAL VALLEY ENGINEERING & ASPHAL ASPHALT, INC. has sponsored the creation of one or more 401k plans.

Company Name:CENTRAL VALLEY ENGINEERING & ASPHAL ASPHALT, INC.
Employer identification number (EIN):680446147
NAIC Classification:237310
NAIC Description:Highway, Street, and Bridge Construction

Additional information about CENTRAL VALLEY ENGINEERING & ASPHAL ASPHALT, INC.

Jurisdiction of Incorporation: California Department of State
Incorporation Date: 2000-02-04
Company Identification Number: C2211904
Legal Registered Office Address: 216 Kenroy Lane

Roseville
United States of America (USA)
95678

More information about CENTRAL VALLEY ENGINEERING & ASPHAL ASPHALT, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012024-01-01JAMES WAGNER
5012023-01-01JAMES CASTLE2024-07-06 JAMES CASTLE2024-07-06
5012022-01-01JAMES CASTLE2023-07-12 JAMES CASTLE2023-07-12
5012021-01-01JAMES CASTLE2022-10-04 JAMES CASTLE2022-10-04
5012020-01-01WARREN HOLT2021-10-12 WARREN HOLT2021-10-12
5012019-01-01JAMES CASTLE2020-06-09 JAMES CASTLE2020-06-09
5012018-01-01
5012017-01-01
5012017-01-01
5012016-01-01JAMES CASTLE
5012015-01-01JENNIFER HESSION
5012014-01-01JAMES CASTLE
5012013-01-01JAMES CASTLE
5012012-01-01JAMES CASTLE
5012011-01-01JAMES CASTLE
5012009-01-01JAMES CASTLE JAMES CASTLE2010-10-12

Financial Data on CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM

Measure Date Value
2023 : CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 2023 401k financial data
Total income from all sources2023-12-31$682,245
Expenses. Total of all expenses incurred2023-12-31$695,141
Benefits paid (including direct rollovers)2023-12-31$688,590
Total plan assets at end of year2023-12-31$153,635
Total plan assets at beginning of year2023-12-31$166,531
Net income (gross income less expenses)2023-12-31$-12,896
Net plan assets at end of year (total assets less liabilities)2023-12-31$153,635
Net plan assets at beginning of year (total assets less liabilities)2023-12-31$166,531
Total contributions received or receivable from employer(s)2023-12-31$682,245
Expenses. Administrative service providers (salaries,fees and commissions)2023-12-31$6,551
2022 : CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 2022 401k financial data
Total income from all sources2022-12-31$653,151
Expenses. Total of all expenses incurred2022-12-31$583,766
Benefits paid (including direct rollovers)2022-12-31$577,898
Total plan assets at end of year2022-12-31$166,531
Total plan assets at beginning of year2022-12-31$97,146
Net income (gross income less expenses)2022-12-31$69,385
Net plan assets at end of year (total assets less liabilities)2022-12-31$166,531
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$97,146
Total contributions received or receivable from employer(s)2022-12-31$653,151
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$5,868
2021 : CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 2021 401k financial data
Total income from all sources2021-12-31$503,800
Expenses. Total of all expenses incurred2021-12-31$549,315
Benefits paid (including direct rollovers)2021-12-31$543,219
Total plan assets at end of year2021-12-31$97,146
Total plan assets at beginning of year2021-12-31$142,661
Net income (gross income less expenses)2021-12-31$-45,515
Net plan assets at end of year (total assets less liabilities)2021-12-31$97,146
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$142,661
Total contributions received or receivable from employer(s)2021-12-31$503,800
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$6,096
2020 : CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 2020 401k financial data
Total income from all sources2020-12-31$601,492
Expenses. Total of all expenses incurred2020-12-31$584,278
Benefits paid (including direct rollovers)2020-12-31$575,181
Total plan assets at end of year2020-12-31$142,661
Total plan assets at beginning of year2020-12-31$125,447
Net income (gross income less expenses)2020-12-31$17,214
Net plan assets at end of year (total assets less liabilities)2020-12-31$142,661
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$125,447
Total contributions received or receivable from employer(s)2020-12-31$601,492
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$9,097
2019 : CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 2019 401k financial data
Total income from all sources2019-12-31$454,949
Expenses. Total of all expenses incurred2019-12-31$461,424
Benefits paid (including direct rollovers)2019-12-31$470,168
Total plan assets at end of year2019-12-31$125,447
Total plan assets at beginning of year2019-12-31$131,922
Net income (gross income less expenses)2019-12-31$-6,475
Net plan assets at end of year (total assets less liabilities)2019-12-31$125,447
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$131,922
Total contributions received or receivable from employer(s)2019-12-31$454,949
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$-8,744
2018 : CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 2018 401k financial data
Total income from all sources2018-12-31$500,719
Expenses. Total of all expenses incurred2018-12-31$481,941
Benefits paid (including direct rollovers)2018-12-31$479,227
Total plan assets at end of year2018-12-31$131,922
Total plan assets at beginning of year2018-12-31$113,144
Net income (gross income less expenses)2018-12-31$18,778
Net plan assets at end of year (total assets less liabilities)2018-12-31$131,922
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$113,144
Total contributions received or receivable from employer(s)2018-12-31$500,719
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$2,714
2017 : CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 2017 401k financial data
Total income from all sources2017-12-31$430,297
Expenses. Total of all expenses incurred2017-12-31$439,035
Benefits paid (including direct rollovers)2017-12-31$401,953
Total plan assets at end of year2017-12-31$113,144
Total plan assets at beginning of year2017-12-31$121,882
Net income (gross income less expenses)2017-12-31$-8,738
Net plan assets at end of year (total assets less liabilities)2017-12-31$113,144
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$121,882
Total contributions received or receivable from employer(s)2017-12-31$430,297
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$37,082
2016 : CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 2016 401k financial data
Total income from all sources2016-12-31$327,127
Expenses. Total of all expenses incurred2016-12-31$354,368
Benefits paid (including direct rollovers)2016-12-31$333,215
Total plan assets at end of year2016-12-31$121,882
Total plan assets at beginning of year2016-12-31$149,123
Net income (gross income less expenses)2016-12-31$-27,241
Net plan assets at end of year (total assets less liabilities)2016-12-31$121,882
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$149,123
Total contributions received or receivable from employer(s)2016-12-31$327,127
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$21,153
2015 : CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 2015 401k financial data
Total income from all sources2015-12-31$423,218
Expenses. Total of all expenses incurred2015-12-31$317,596
Benefits paid (including direct rollovers)2015-12-31$329,388
Total plan assets at end of year2015-12-31$149,123
Total plan assets at beginning of year2015-12-31$43,501
Net income (gross income less expenses)2015-12-31$105,622
Net plan assets at end of year (total assets less liabilities)2015-12-31$149,123
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$43,501
Total contributions received or receivable from employer(s)2015-12-31$423,218
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$-11,792
2014 : CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 2014 401k financial data
Total income from all sources2014-12-31$352,596
Expenses. Total of all expenses incurred2014-12-31$331,446
Benefits paid (including direct rollovers)2014-12-31$316,772
Total plan assets at end of year2014-12-31$43,501
Total plan assets at beginning of year2014-12-31$22,351
Value of fidelity bond covering the plan2014-12-31$3,000
Net income (gross income less expenses)2014-12-31$21,150
Net plan assets at end of year (total assets less liabilities)2014-12-31$43,501
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$22,351
Total contributions received or receivable from employer(s)2014-12-31$352,596
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$14,674
2013 : CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 2013 401k financial data
Total income from all sources2013-12-31$343,828
Expenses. Total of all expenses incurred2013-12-31$363,908
Benefits paid (including direct rollovers)2013-12-31$356,604
Total plan assets at end of year2013-12-31$22,351
Total plan assets at beginning of year2013-12-31$42,431
Net income (gross income less expenses)2013-12-31$-20,080
Net plan assets at end of year (total assets less liabilities)2013-12-31$22,351
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$42,431
Total contributions received or receivable from employer(s)2013-12-31$343,828
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$7,304
2012 : CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 2012 401k financial data
Total income from all sources2012-12-31$257,406
Expenses. Total of all expenses incurred2012-12-31$226,438
Benefits paid (including direct rollovers)2012-12-31$223,466
Total plan assets at end of year2012-12-31$42,431
Total plan assets at beginning of year2012-12-31$11,463
Net income (gross income less expenses)2012-12-31$30,968
Net plan assets at end of year (total assets less liabilities)2012-12-31$42,431
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$11,463
Total contributions received or receivable from employer(s)2012-12-31$257,406
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$2,972
2011 : CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 2011 401k financial data
Total income from all sources2011-12-31$203,283
Expenses. Total of all expenses incurred2011-12-31$216,621
Benefits paid (including direct rollovers)2011-12-31$205,907
Total plan assets at end of year2011-12-31$11,463
Total plan assets at beginning of year2011-12-31$24,801
Net income (gross income less expenses)2011-12-31$-13,338
Net plan assets at end of year (total assets less liabilities)2011-12-31$11,463
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$24,801
Total contributions received or receivable from employer(s)2011-12-31$203,283
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$10,714
2010 : CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 2010 401k financial data
Total income from all sources2010-12-31$197,882
Expenses. Total of all expenses incurred2010-12-31$265,664
Benefits paid (including direct rollovers)2010-12-31$253,045
Total plan assets at end of year2010-12-31$24,801
Total plan assets at beginning of year2010-12-31$92,583
Net income (gross income less expenses)2010-12-31$-67,782
Net plan assets at end of year (total assets less liabilities)2010-12-31$24,801
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$92,583
Total contributions received or receivable from employer(s)2010-12-31$197,882
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$12,619

Form 5500 Responses for CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM

2023: CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 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 – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 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 – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 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 – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 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 – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 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 – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 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 – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 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 – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 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 – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 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 – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 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 – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 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 – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 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 – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: CENTRAL VALLEY ENGINEERING & ASPHALT, INC. INSURANCE PROGRAM 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 funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 95019 )
Policy contract number102834A000
Policy instance 3
Insurance contract or identification number102834A000
Number of Individuals Covered48
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 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 $135,356
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
SUTTER EAP RESOURCES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number102834A000
Policy instance 2
Insurance contract or identification number102834A000
Number of Individuals Covered48
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 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 $466,121
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
HUMANA DENTAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number608897001
Policy instance 1
Insurance contract or identification number608897001
Number of Individuals Covered3
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $87,113
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 95019 )
Policy contract number102834A000
Policy instance 3
Insurance contract or identification number102834A000
Number of Individuals Covered49
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 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 $113,507
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
SUTTER EAP RESOURCES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number102834A000
Policy instance 2
Insurance contract or identification number102834A000
Number of Individuals Covered49
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 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 $388,523
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
HUMANA DENTAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number608897-001
Policy instance 1
Insurance contract or identification number608897-001
Number of Individuals Covered5
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $75,867
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
HUMANA DENTAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number608897-001
Policy instance 1
SUTTER EAP RESOURCES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number102834A000
Policy instance 2
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 95019 )
Policy contract number102834A000
Policy instance 3
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 95019 )
Policy contract number102834A000
Policy instance 3
SUTTER EAP RESOURCES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number102834A000
Policy instance 2
HUMANA DENTAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number608897-001
Policy instance 1
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 95019 )
Policy contract number102834A000
Policy instance 3
SUTTER EAP RESOURCES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number102834A000
Policy instance 2
HUMANA DENTAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number608897-001
Policy instance 1
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 95019 )
Policy contract number102834A000
Policy instance 3
SUTTER EAP RESOURCES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number102834A000
Policy instance 2
HUMANA DENTAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number608897-001
Policy instance 1
HUMANA DENTAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number608897-001
Policy instance 2
SUTTER EAP RESOURCES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number102834A000
Policy instance 1
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 95019 )
Policy contract number102834A000
Policy instance 3
SUTTER EAP RESOURCES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number10283A000
Policy instance 2
HUMANA DENTAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number608897-001
Policy instance 1
HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number608897-001
Policy instance 1
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberH25998/624475&6
Policy instance 2
HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number608897-001
Policy instance 2
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberH25998/624475&6
Policy instance 1
HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number608897-001
Policy instance 2
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberH25998/624475&6
Policy instance 1
HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number608897-001
Policy instance 3
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberH25998/624475&6
Policy instance 2
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number352015/0774389
Policy instance 1
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number352015/0774389
Policy instance 1
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number352015/0774389
Policy instance 1

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