401k Plan data: U.A. LOCAL 38 HEALTH AND WELFARE PLAN plan

U.A. LOCAL 38 HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	U.A. LOCAL 38 HEALTH AND WELFARE PLAN
Plan identification number	503

U.A. LOCAL 38 HEALTH AND WELFARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

BOARD OF TRUSTEES OF U.A. LOCAL 38 TRUST FUNDS has sponsored the creation of one or more 401k plans.

Company Name: BOARD OF TRUSTEES OF U.A. LOCAL 38 TRUST FUNDS

Employer identification number (EIN): 941285319

NAIC Classification: 238220
NAIC Description: Plumbing, Heating, and Air-Conditioning Contractors

Form 5500 Filing Information

Submission information for form 5500 for 401k plan U.A. LOCAL 38 HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2021-07-01 FRED NURISSO 2023-04-04 LARRY MAZZOLA, JR 2023-04-03
503 2020-07-01
503 2019-07-01
503 2018-07-01
503 2017-07-01
503 2016-07-01 FRED NURISSO LARRY MAZZOLA, JR 2018-04-09
503 2015-07-01 FRED NURISSO LARRY MAZZOLA, JR 2017-04-07
503 2014-07-01 FRED NURISSO LARRY MAZZOLA, JR 2016-04-08
503 2013-07-01 SCOTT STRAWBRIDGE LARRY MAZZOLA, JR 2015-04-07
503 2012-07-01 SCOTT STRAWBRIDGE LARRY MAZZOLA, JR 2014-04-11
503 2011-07-01 SCOTT STRAWBRIDGE LARRY MAZZOLA JR 2013-04-11
503 2010-07-01 SCOTT STRAWBRIDGE LARRY MAZZOLA, JR. 2012-04-10
503 2009-07-01 SCOTT STRAWBRIDGE LARRY MAZZOLA, JR. 2011-04-08

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
503	2021-07-01	FRED NURISSO	2023-04-04	LARRY MAZZOLA, JR	2023-04-03
503	2020-07-01
503	2019-07-01
503	2018-07-01
503	2017-07-01
503	2016-07-01	FRED NURISSO		LARRY MAZZOLA, JR	2018-04-09
503	2015-07-01	FRED NURISSO		LARRY MAZZOLA, JR	2017-04-07
503	2014-07-01	FRED NURISSO		LARRY MAZZOLA, JR	2016-04-08
503	2013-07-01	SCOTT STRAWBRIDGE		LARRY MAZZOLA, JR	2015-04-07
503	2012-07-01	SCOTT STRAWBRIDGE		LARRY MAZZOLA, JR	2014-04-11
503	2011-07-01	SCOTT STRAWBRIDGE		LARRY MAZZOLA JR	2013-04-11
503	2010-07-01	SCOTT STRAWBRIDGE		LARRY MAZZOLA, JR.	2012-04-10
503	2009-07-01	SCOTT STRAWBRIDGE		LARRY MAZZOLA, JR.	2011-04-08

Plan Statistics for U.A. LOCAL 38 HEALTH AND WELFARE PLAN

401k plan membership statisitcs for U.A. LOCAL 38 HEALTH AND WELFARE PLAN

Measure Date Value
2021: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year 2021-07-01 1,607
Total number of active participants reported on line 7a of the Form 5500 2021-07-01 1,182
Number of retired or separated participants receiving benefits 2021-07-01 204
Number of other retired or separated participants entitled to future benefits 2021-07-01 0
Total of all active and inactive participants 2021-07-01 1,386
Number of employers contributing to the scheme 2021-07-01 168
2020: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year 2020-07-01 1,705
Total number of active participants reported on line 7a of the Form 5500 2020-07-01 1,409
Number of retired or separated participants receiving benefits 2020-07-01 198
Number of other retired or separated participants entitled to future benefits 2020-07-01 0
Total of all active and inactive participants 2020-07-01 1,607
Number of employers contributing to the scheme 2020-07-01 150
2019: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year 2019-07-01 1,709
Total number of active participants reported on line 7a of the Form 5500 2019-07-01 1,509
Number of retired or separated participants receiving benefits 2019-07-01 196
Number of other retired or separated participants entitled to future benefits 2019-07-01 0
Total of all active and inactive participants 2019-07-01 1,705
Number of employers contributing to the scheme 2019-07-01 115
2018: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year 2018-07-01 1,595
Total number of active participants reported on line 7a of the Form 5500 2018-07-01 1,509
Number of retired or separated participants receiving benefits 2018-07-01 200
Number of other retired or separated participants entitled to future benefits 2018-07-01 0
Total of all active and inactive participants 2018-07-01 1,709
Number of employers contributing to the scheme 2018-07-01 133
2017: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-07-01 1,587
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 1,390
Number of retired or separated participants receiving benefits 2017-07-01 205
Number of other retired or separated participants entitled to future benefits 2017-07-01 0
Total of all active and inactive participants 2017-07-01 1,595
Number of employers contributing to the scheme 2017-07-01 115
2016: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 1,530
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 1,351
Number of retired or separated participants receiving benefits 2016-07-01 236
Number of other retired or separated participants entitled to future benefits 2016-07-01 0
Total of all active and inactive participants 2016-07-01 1,587
Number of employers contributing to the scheme 2016-07-01 97
2015: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 1,426
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 1,297
Number of retired or separated participants receiving benefits 2015-07-01 233
Number of other retired or separated participants entitled to future benefits 2015-07-01 0
Total of all active and inactive participants 2015-07-01 1,530
Number of employers contributing to the scheme 2015-07-01 112
2014: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 1,282
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 1,186
Number of retired or separated participants receiving benefits 2014-07-01 240
Number of other retired or separated participants entitled to future benefits 2014-07-01 0
Total of all active and inactive participants 2014-07-01 1,426
Number of employers contributing to the scheme 2014-07-01 109
2013: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 1,415
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 1,030
Number of retired or separated participants receiving benefits 2013-07-01 252
Number of other retired or separated participants entitled to future benefits 2013-07-01 0
Total of all active and inactive participants 2013-07-01 1,282
Number of employers contributing to the scheme 2013-07-01 100
2012: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 1,198
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 1,171
Number of retired or separated participants receiving benefits 2012-07-01 244
Number of other retired or separated participants entitled to future benefits 2012-07-01 0
Total of all active and inactive participants 2012-07-01 1,415
Number of employers contributing to the scheme 2012-07-01 153
2011: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 953
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 949
Number of retired or separated participants receiving benefits 2011-07-01 249
Number of other retired or separated participants entitled to future benefits 2011-07-01 0
Total of all active and inactive participants 2011-07-01 1,198
Number of employers contributing to the scheme 2011-07-01 243
2010: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year 2010-07-01 932
Total number of active participants reported on line 7a of the Form 5500 2010-07-01 690
Number of retired or separated participants receiving benefits 2010-07-01 263
Number of other retired or separated participants entitled to future benefits 2010-07-01 0
Total of all active and inactive participants 2010-07-01 953
Number of employers contributing to the scheme 2010-07-01 270
2009: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-07-01 1,302
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 788
Number of retired or separated participants receiving benefits 2009-07-01 367
Number of other retired or separated participants entitled to future benefits 2009-07-01 0
Total of all active and inactive participants 2009-07-01 1,155
Number of employers contributing to the scheme 2009-07-01 254

Measure	Date	Value
2021: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year	2021-07-01	1,607
Total number of active participants reported on line 7a of the Form 5500	2021-07-01	1,182
Number of retired or separated participants receiving benefits	2021-07-01	204
Number of other retired or separated participants entitled to future benefits	2021-07-01	0
Total of all active and inactive participants	2021-07-01	1,386
Number of employers contributing to the scheme	2021-07-01	168
2020: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year	2020-07-01	1,705
Total number of active participants reported on line 7a of the Form 5500	2020-07-01	1,409
Number of retired or separated participants receiving benefits	2020-07-01	198
Number of other retired or separated participants entitled to future benefits	2020-07-01	0
Total of all active and inactive participants	2020-07-01	1,607
Number of employers contributing to the scheme	2020-07-01	150
2019: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year	2019-07-01	1,709
Total number of active participants reported on line 7a of the Form 5500	2019-07-01	1,509
Number of retired or separated participants receiving benefits	2019-07-01	196
Number of other retired or separated participants entitled to future benefits	2019-07-01	0
Total of all active and inactive participants	2019-07-01	1,705
Number of employers contributing to the scheme	2019-07-01	115
2018: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year	2018-07-01	1,595
Total number of active participants reported on line 7a of the Form 5500	2018-07-01	1,509
Number of retired or separated participants receiving benefits	2018-07-01	200
Number of other retired or separated participants entitled to future benefits	2018-07-01	0
Total of all active and inactive participants	2018-07-01	1,709
Number of employers contributing to the scheme	2018-07-01	133
2017: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-07-01	1,587
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	1,390
Number of retired or separated participants receiving benefits	2017-07-01	205
Number of other retired or separated participants entitled to future benefits	2017-07-01	0
Total of all active and inactive participants	2017-07-01	1,595
Number of employers contributing to the scheme	2017-07-01	115
2016: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	1,530
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	1,351
Number of retired or separated participants receiving benefits	2016-07-01	236
Number of other retired or separated participants entitled to future benefits	2016-07-01	0
Total of all active and inactive participants	2016-07-01	1,587
Number of employers contributing to the scheme	2016-07-01	97
2015: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	1,426
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	1,297
Number of retired or separated participants receiving benefits	2015-07-01	233
Number of other retired or separated participants entitled to future benefits	2015-07-01	0
Total of all active and inactive participants	2015-07-01	1,530
Number of employers contributing to the scheme	2015-07-01	112
2014: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	1,282
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	1,186
Number of retired or separated participants receiving benefits	2014-07-01	240
Number of other retired or separated participants entitled to future benefits	2014-07-01	0
Total of all active and inactive participants	2014-07-01	1,426
Number of employers contributing to the scheme	2014-07-01	109
2013: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	1,415
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	1,030
Number of retired or separated participants receiving benefits	2013-07-01	252
Number of other retired or separated participants entitled to future benefits	2013-07-01	0
Total of all active and inactive participants	2013-07-01	1,282
Number of employers contributing to the scheme	2013-07-01	100
2012: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	1,198
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	1,171
Number of retired or separated participants receiving benefits	2012-07-01	244
Number of other retired or separated participants entitled to future benefits	2012-07-01	0
Total of all active and inactive participants	2012-07-01	1,415
Number of employers contributing to the scheme	2012-07-01	153
2011: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	953
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	949
Number of retired or separated participants receiving benefits	2011-07-01	249
Number of other retired or separated participants entitled to future benefits	2011-07-01	0
Total of all active and inactive participants	2011-07-01	1,198
Number of employers contributing to the scheme	2011-07-01	243
2010: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-07-01	932
Total number of active participants reported on line 7a of the Form 5500	2010-07-01	690
Number of retired or separated participants receiving benefits	2010-07-01	263
Number of other retired or separated participants entitled to future benefits	2010-07-01	0
Total of all active and inactive participants	2010-07-01	953
Number of employers contributing to the scheme	2010-07-01	270
2009: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-07-01	1,302
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	788
Number of retired or separated participants receiving benefits	2009-07-01	367
Number of other retired or separated participants entitled to future benefits	2009-07-01	0
Total of all active and inactive participants	2009-07-01	1,155
Number of employers contributing to the scheme	2009-07-01	254

Financial Data on U.A. LOCAL 38 HEALTH AND WELFARE PLAN

Measure	Date	Value
2022 : U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2022-06-30	$-800,875
Total unrealized appreciation/depreciation of assets	2022-06-30	$-800,875
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-06-30	$597,551
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-06-30	$2,288,046
Total income from all sources (including contributions)	2022-06-30	$31,820,820
Total loss/gain on sale of assets	2022-06-30	$-184,263
Total of all expenses incurred	2022-06-30	$34,776,226
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-06-30	$33,612,634
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-06-30	$31,489,386
Value of total assets at end of year	2022-06-30	$15,591,322
Value of total assets at beginning of year	2022-06-30	$20,237,223
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-06-30	$1,163,592
Total interest from all sources	2022-06-30	$205,823
Total dividends received (eg from common stock, registered investment company shares)	2022-06-30	$96,083
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-06-30	$60,292
Administrative expenses professional fees incurred	2022-06-30	$233,234
Assets. Corporate prefeered stocks other than exployer securities at end of year	2022-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2022-06-30	$0
Was this plan covered by a fidelity bond	2022-06-30	Yes
Value of fidelity bond cover	2022-06-30	$500,000
Were there any nonexempt tranactions with any party-in-interest	2022-06-30	No
Contributions received from participants	2022-06-30	$940,194
Assets. Other investments not covered elsewhere at end of year	2022-06-30	$643,742
Assets. Other investments not covered elsewhere at beginning of year	2022-06-30	$677,494
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2022-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-06-30	$349,892
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-06-30	$388,232
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-06-30	$419,349
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-06-30	$2,053,133
Other income not declared elsewhere	2022-06-30	$1,138,135
Administrative expenses (other) incurred	2022-06-30	$765,555
Liabilities. Value of operating payables at end of year	2022-06-30	$32,774
Liabilities. Value of operating payables at beginning of year	2022-06-30	$85,350
Total non interest bearing cash at end of year	2022-06-30	$557,321
Total non interest bearing cash at beginning of year	2022-06-30	$4,134,374
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-06-30	No
Value of net income/loss	2022-06-30	$-2,955,406
Value of net assets at end of year (total assets less liabilities)	2022-06-30	$14,993,771
Value of net assets at beginning of year (total assets less liabilities)	2022-06-30	$17,949,177
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-06-30	No
Were any leases to which the plan was party in default or uncollectible	2022-06-30	No
Investment advisory and management fees	2022-06-30	$55,620
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-06-30	$1,174,077
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-06-30	$1,237,254
Interest earned on other investments	2022-06-30	$11,068
Income. Interest from US Government securities	2022-06-30	$62,942
Income. Interest from corporate debt instruments	2022-06-30	$131,798
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-06-30	$157,423
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-06-30	$235,566
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-06-30	$235,566
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-06-30	$15
Expenses. Payments to insurance carriers foe the provision of benefits	2022-06-30	$29,583,418
Asset value of US Government securities at end of year	2022-06-30	$3,660,772
Asset value of US Government securities at beginning of year	2022-06-30	$3,387,982
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-06-30	$-123,469
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-06-30	No
Was there a failure to transmit to the plan any participant contributions	2022-06-30	No
Has the plan failed to provide any benefit when due under the plan	2022-06-30	No
Contributions received in cash from employer	2022-06-30	$30,549,192
Employer contributions (assets) at end of year	2022-06-30	$3,040,000
Employer contributions (assets) at beginning of year	2022-06-30	$3,079,000
Income. Dividends from common stock	2022-06-30	$35,791
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-06-30	$4,029,216
Asset. Corporate debt instrument preferred debt at end of year	2022-06-30	$2,000,092
Asset. Corporate debt instrument preferred debt at beginning of year	2022-06-30	$2,182,401
Asset. Corporate debt instrument debt (other) at end of year	2022-06-30	$1,918,077
Asset. Corporate debt instrument debt (other) at beginning of year	2022-06-30	$2,407,315
Contract administrator fees	2022-06-30	$109,183
Assets. Corporate common stocks other than exployer securities at end of year	2022-06-30	$2,089,926
Assets. Corporate common stocks other than exployer securities at beginning of year	2022-06-30	$2,507,605
Liabilities. Value of benefit claims payable at end of year	2022-06-30	$145,428
Liabilities. Value of benefit claims payable at beginning of year	2022-06-30	$149,563
Did the plan have assets held for investment	2022-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-06-30	No
Aggregate proceeds on sale of assets	2022-06-30	$4,065,887
Aggregate carrying amount (costs) on sale of assets	2022-06-30	$4,250,150
Opinion of an independent qualified public accountant for this plan	2022-06-30	Unqualified
Accountancy firm name	2022-06-30	WITHUMSMITH+BROWN, PC
Accountancy firm EIN	2022-06-30	222027092
2021 : U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2021-06-30	$581,699
Total unrealized appreciation/depreciation of assets	2021-06-30	$581,699
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-06-30	$2,288,046
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-06-30	$535,617
Total income from all sources (including contributions)	2021-06-30	$38,368,937
Total loss/gain on sale of assets	2021-06-30	$361,580
Total of all expenses incurred	2021-06-30	$42,379,403
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-06-30	$41,393,640
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-06-30	$36,869,007
Value of total assets at end of year	2021-06-30	$20,237,223
Value of total assets at beginning of year	2021-06-30	$22,495,260
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-06-30	$985,763
Total interest from all sources	2021-06-30	$263,042
Total dividends received (eg from common stock, registered investment company shares)	2021-06-30	$104,580
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-06-30	$59,314
Administrative expenses professional fees incurred	2021-06-30	$179,984
Was this plan covered by a fidelity bond	2021-06-30	Yes
Value of fidelity bond cover	2021-06-30	$500,000
Were there any nonexempt tranactions with any party-in-interest	2021-06-30	No
Contributions received from participants	2021-06-30	$521,121
Assets. Other investments not covered elsewhere at end of year	2021-06-30	$677,494
Assets. Other investments not covered elsewhere at beginning of year	2021-06-30	$505,696
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-06-30	$388,232
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-06-30	$302,134
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-06-30	$2,053,133
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-06-30	$227,973
Other income not declared elsewhere	2021-06-30	$123,458
Administrative expenses (other) incurred	2021-06-30	$637,136
Liabilities. Value of operating payables at end of year	2021-06-30	$85,350
Liabilities. Value of operating payables at beginning of year	2021-06-30	$81,271
Total non interest bearing cash at end of year	2021-06-30	$4,134,374
Total non interest bearing cash at beginning of year	2021-06-30	$3,261,758
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-06-30	No
Value of net income/loss	2021-06-30	$-4,010,466
Value of net assets at end of year (total assets less liabilities)	2021-06-30	$17,949,177
Value of net assets at beginning of year (total assets less liabilities)	2021-06-30	$21,959,643
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-06-30	No
Were any leases to which the plan was party in default or uncollectible	2021-06-30	No
Investment advisory and management fees	2021-06-30	$67,876
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-06-30	$1,237,254
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-06-30	$1,367,094
Interest earned on other investments	2021-06-30	$11,978
Income. Interest from US Government securities	2021-06-30	$77,056
Income. Interest from corporate debt instruments	2021-06-30	$173,989
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-06-30	$235,566
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-06-30	$98,353
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-06-30	$98,353
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-06-30	$19
Expenses. Payments to insurance carriers foe the provision of benefits	2021-06-30	$36,901,252
Asset value of US Government securities at end of year	2021-06-30	$3,387,982
Asset value of US Government securities at beginning of year	2021-06-30	$4,382,185
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-06-30	$65,571
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-06-30	No
Was there a failure to transmit to the plan any participant contributions	2021-06-30	No
Has the plan failed to provide any benefit when due under the plan	2021-06-30	No
Contributions received in cash from employer	2021-06-30	$36,347,886
Employer contributions (assets) at end of year	2021-06-30	$3,079,000
Employer contributions (assets) at beginning of year	2021-06-30	$3,736,000
Income. Dividends from common stock	2021-06-30	$45,266
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-06-30	$4,492,388
Asset. Corporate debt instrument preferred debt at end of year	2021-06-30	$2,182,401
Asset. Corporate debt instrument preferred debt at beginning of year	2021-06-30	$3,166,112
Asset. Corporate debt instrument debt (other) at end of year	2021-06-30	$2,407,315
Asset. Corporate debt instrument debt (other) at beginning of year	2021-06-30	$2,666,070
Contract administrator fees	2021-06-30	$100,767
Assets. Corporate common stocks other than exployer securities at end of year	2021-06-30	$2,507,605
Assets. Corporate common stocks other than exployer securities at beginning of year	2021-06-30	$3,009,858
Liabilities. Value of benefit claims payable at end of year	2021-06-30	$149,563
Liabilities. Value of benefit claims payable at beginning of year	2021-06-30	$226,373
Did the plan have assets held for investment	2021-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-06-30	No
Aggregate proceeds on sale of assets	2021-06-30	$9,134,534
Aggregate carrying amount (costs) on sale of assets	2021-06-30	$8,772,954
Opinion of an independent qualified public accountant for this plan	2021-06-30	Unqualified
Accountancy firm name	2021-06-30	WITHUMSMITH+BROWN, PC
Accountancy firm EIN	2021-06-30	222027092
2020 : U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2020-06-30	$459,420
Total unrealized appreciation/depreciation of assets	2020-06-30	$459,420
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$535,617
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$324,948
Total income from all sources (including contributions)	2020-06-30	$41,764,706
Total loss/gain on sale of assets	2020-06-30	$-43,027
Total of all expenses incurred	2020-06-30	$43,119,338
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-06-30	$42,303,208
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-06-30	$40,914,572
Value of total assets at end of year	2020-06-30	$22,495,260
Value of total assets at beginning of year	2020-06-30	$23,639,223
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-06-30	$816,130
Total interest from all sources	2020-06-30	$307,130
Total dividends received (eg from common stock, registered investment company shares)	2020-06-30	$121,407
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-06-30	$70,670
Administrative expenses professional fees incurred	2020-06-30	$149,377
Was this plan covered by a fidelity bond	2020-06-30	Yes
Value of fidelity bond cover	2020-06-30	$500,000
Were there any nonexempt tranactions with any party-in-interest	2020-06-30	No
Contributions received from participants	2020-06-30	$422,269
Assets. Other investments not covered elsewhere at end of year	2020-06-30	$505,696
Assets. Other investments not covered elsewhere at beginning of year	2020-06-30	$150,922
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-06-30	$302,134
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-06-30	$212,820
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-06-30	$227,973
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-06-30	$92,886
Other income not declared elsewhere	2020-06-30	$135,424
Administrative expenses (other) incurred	2020-06-30	$510,017
Liabilities. Value of operating payables at end of year	2020-06-30	$81,271
Liabilities. Value of operating payables at beginning of year	2020-06-30	$94,062
Total non interest bearing cash at end of year	2020-06-30	$3,261,758
Total non interest bearing cash at beginning of year	2020-06-30	$5,600,254
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-06-30	No
Value of net income/loss	2020-06-30	$-1,354,632
Value of net assets at end of year (total assets less liabilities)	2020-06-30	$21,959,643
Value of net assets at beginning of year (total assets less liabilities)	2020-06-30	$23,314,275
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-06-30	No
Were any leases to which the plan was party in default or uncollectible	2020-06-30	No
Investment advisory and management fees	2020-06-30	$68,292
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-06-30	$1,367,094
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-06-30	$1,308,635
Interest earned on other investments	2020-06-30	$12,174
Income. Interest from US Government securities	2020-06-30	$106,762
Income. Interest from corporate debt instruments	2020-06-30	$187,055
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-06-30	$98,353
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-06-30	$175,129
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-06-30	$175,129
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-06-30	$1,139
Expenses. Payments to insurance carriers foe the provision of benefits	2020-06-30	$38,306,474
Asset value of US Government securities at end of year	2020-06-30	$4,382,185
Asset value of US Government securities at beginning of year	2020-06-30	$4,335,836
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-06-30	$-130,220
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-06-30	No
Was there a failure to transmit to the plan any participant contributions	2020-06-30	No
Has the plan failed to provide any benefit when due under the plan	2020-06-30	No
Contributions received in cash from employer	2020-06-30	$40,492,303
Employer contributions (assets) at end of year	2020-06-30	$3,736,000
Employer contributions (assets) at beginning of year	2020-06-30	$4,350,000
Income. Dividends from common stock	2020-06-30	$50,737
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-06-30	$3,996,734
Asset. Corporate debt instrument preferred debt at end of year	2020-06-30	$3,166,112
Asset. Corporate debt instrument preferred debt at beginning of year	2020-06-30	$2,469,904
Asset. Corporate debt instrument debt (other) at end of year	2020-06-30	$2,666,070
Asset. Corporate debt instrument debt (other) at beginning of year	2020-06-30	$2,254,544
Contract administrator fees	2020-06-30	$88,444
Assets. Corporate common stocks other than exployer securities at end of year	2020-06-30	$3,009,858
Assets. Corporate common stocks other than exployer securities at beginning of year	2020-06-30	$2,781,179
Liabilities. Value of benefit claims payable at end of year	2020-06-30	$226,373
Liabilities. Value of benefit claims payable at beginning of year	2020-06-30	$138,000
Did the plan have assets held for investment	2020-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-06-30	No
Aggregate proceeds on sale of assets	2020-06-30	$8,412,639
Aggregate carrying amount (costs) on sale of assets	2020-06-30	$8,455,666
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2020-06-30	No
Opinion of an independent qualified public accountant for this plan	2020-06-30	Unqualified
Accountancy firm name	2020-06-30	LINDQUIST LLP
Accountancy firm EIN	2020-06-30	522385296
2019 : U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2019-06-30	$422,631
Total unrealized appreciation/depreciation of assets	2019-06-30	$422,631
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-06-30	$324,948
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-06-30	$419,094
Total income from all sources (including contributions)	2019-06-30	$44,337,624
Total loss/gain on sale of assets	2019-06-30	$-37,230
Total of all expenses incurred	2019-06-30	$40,139,146
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-06-30	$39,393,475
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-06-30	$43,357,378
Value of total assets at end of year	2019-06-30	$23,639,223
Value of total assets at beginning of year	2019-06-30	$19,534,891
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-06-30	$745,671
Total interest from all sources	2019-06-30	$236,961
Total dividends received (eg from common stock, registered investment company shares)	2019-06-30	$98,340
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-06-30	$55,294
Administrative expenses professional fees incurred	2019-06-30	$123,541
Was this plan covered by a fidelity bond	2019-06-30	Yes
Value of fidelity bond cover	2019-06-30	$500,000
Were there any nonexempt tranactions with any party-in-interest	2019-06-30	No
Contributions received from participants	2019-06-30	$392,756
Assets. Other investments not covered elsewhere at end of year	2019-06-30	$150,922
Assets. Other investments not covered elsewhere at beginning of year	2019-06-30	$111,454
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-06-30	$212,820
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-06-30	$266,577
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-06-30	$92,886
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-06-30	$94,961
Other income not declared elsewhere	2019-06-30	$269,966
Administrative expenses (other) incurred	2019-06-30	$502,640
Liabilities. Value of operating payables at end of year	2019-06-30	$94,062
Liabilities. Value of operating payables at beginning of year	2019-06-30	$205,133
Total non interest bearing cash at end of year	2019-06-30	$5,600,254
Total non interest bearing cash at beginning of year	2019-06-30	$4,851,254
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-06-30	No
Value of net income/loss	2019-06-30	$4,198,478
Value of net assets at end of year (total assets less liabilities)	2019-06-30	$23,314,275
Value of net assets at beginning of year (total assets less liabilities)	2019-06-30	$19,115,797
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-06-30	No
Were any leases to which the plan was party in default or uncollectible	2019-06-30	No
Investment advisory and management fees	2019-06-30	$50,297
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-06-30	$1,308,635
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-06-30	$1,038,764
Interest earned on other investments	2019-06-30	$9,118
Income. Interest from US Government securities	2019-06-30	$66,276
Income. Interest from corporate debt instruments	2019-06-30	$159,556
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-06-30	$175,129
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-06-30	$130,417
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-06-30	$130,417
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-06-30	$2,011
Expenses. Payments to insurance carriers foe the provision of benefits	2019-06-30	$35,756,959
Asset value of US Government securities at end of year	2019-06-30	$4,335,836
Asset value of US Government securities at beginning of year	2019-06-30	$2,649,901
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-06-30	$-10,422
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-06-30	No
Was there a failure to transmit to the plan any participant contributions	2019-06-30	No
Has the plan failed to provide any benefit when due under the plan	2019-06-30	No
Contributions received in cash from employer	2019-06-30	$42,964,622
Employer contributions (assets) at end of year	2019-06-30	$4,350,000
Employer contributions (assets) at beginning of year	2019-06-30	$4,028,000
Income. Dividends from common stock	2019-06-30	$43,046
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-06-30	$3,636,516
Asset. Corporate debt instrument preferred debt at end of year	2019-06-30	$2,469,904
Asset. Corporate debt instrument preferred debt at beginning of year	2019-06-30	$2,567,207
Asset. Corporate debt instrument debt (other) at end of year	2019-06-30	$2,254,544
Asset. Corporate debt instrument debt (other) at beginning of year	2019-06-30	$1,915,649
Contract administrator fees	2019-06-30	$69,193
Assets. Corporate common stocks other than exployer securities at end of year	2019-06-30	$2,781,179
Assets. Corporate common stocks other than exployer securities at beginning of year	2019-06-30	$1,975,668
Liabilities. Value of benefit claims payable at end of year	2019-06-30	$138,000
Liabilities. Value of benefit claims payable at beginning of year	2019-06-30	$119,000
Did the plan have assets held for investment	2019-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-06-30	No
Aggregate proceeds on sale of assets	2019-06-30	$4,380,216
Aggregate carrying amount (costs) on sale of assets	2019-06-30	$4,417,446
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-06-30	No
Opinion of an independent qualified public accountant for this plan	2019-06-30	Unqualified
Accountancy firm name	2019-06-30	LINDQUIST LLP
Accountancy firm EIN	2019-06-30	522385296
2018 : U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2018-06-30	$-249,407
Total unrealized appreciation/depreciation of assets	2018-06-30	$-249,407
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$419,094
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$1,866,692
Total income from all sources (including contributions)	2018-06-30	$38,210,162
Total loss/gain on sale of assets	2018-06-30	$-4,554
Total of all expenses incurred	2018-06-30	$34,443,751
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-06-30	$33,593,051
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-06-30	$38,053,072
Value of total assets at end of year	2018-06-30	$19,534,891
Value of total assets at beginning of year	2018-06-30	$17,216,078
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-06-30	$850,700
Total interest from all sources	2018-06-30	$186,353
Total dividends received (eg from common stock, registered investment company shares)	2018-06-30	$32,527
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-06-30	$31,545
Administrative expenses professional fees incurred	2018-06-30	$222,108
Was this plan covered by a fidelity bond	2018-06-30	Yes
Value of fidelity bond cover	2018-06-30	$500,000
Were there any nonexempt tranactions with any party-in-interest	2018-06-30	No
Contributions received from participants	2018-06-30	$337,120
Assets. Other investments not covered elsewhere at end of year	2018-06-30	$111,454
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-06-30	$266,577
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-06-30	$1,253,414
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-06-30	$94,961
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-06-30	$1,622,135
Other income not declared elsewhere	2018-06-30	$200,041
Administrative expenses (other) incurred	2018-06-30	$531,523
Liabilities. Value of operating payables at end of year	2018-06-30	$205,133
Liabilities. Value of operating payables at beginning of year	2018-06-30	$110,557
Total non interest bearing cash at end of year	2018-06-30	$4,851,254
Total non interest bearing cash at beginning of year	2018-06-30	$11,895,664
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-06-30	No
Value of net income/loss	2018-06-30	$3,766,411
Value of net assets at end of year (total assets less liabilities)	2018-06-30	$19,115,797
Value of net assets at beginning of year (total assets less liabilities)	2018-06-30	$15,349,386
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-06-30	No
Were any leases to which the plan was party in default or uncollectible	2018-06-30	No
Investment advisory and management fees	2018-06-30	$32,569
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-06-30	$1,038,764
Interest earned on other investments	2018-06-30	$2,860
Income. Interest from US Government securities	2018-06-30	$51,754
Income. Interest from corporate debt instruments	2018-06-30	$130,168
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-06-30	$130,417
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-06-30	$1,571
Expenses. Payments to insurance carriers foe the provision of benefits	2018-06-30	$30,061,619
Asset value of US Government securities at end of year	2018-06-30	$2,649,901
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-06-30	$-7,870
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-06-30	Yes
Was there a failure to transmit to the plan any participant contributions	2018-06-30	No
Has the plan failed to provide any benefit when due under the plan	2018-06-30	No
Contributions received in cash from employer	2018-06-30	$37,715,952
Employer contributions (assets) at end of year	2018-06-30	$4,028,000
Employer contributions (assets) at beginning of year	2018-06-30	$4,067,000
Income. Dividends from common stock	2018-06-30	$982
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-06-30	$3,531,432
Asset. Corporate debt instrument preferred debt at end of year	2018-06-30	$2,567,207
Asset. Corporate debt instrument debt (other) at end of year	2018-06-30	$1,915,649
Contract administrator fees	2018-06-30	$64,500
Assets. Corporate common stocks other than exployer securities at end of year	2018-06-30	$1,975,668
Liabilities. Value of benefit claims payable at end of year	2018-06-30	$119,000
Liabilities. Value of benefit claims payable at beginning of year	2018-06-30	$134,000
Did the plan have assets held for investment	2018-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-06-30	No
Aggregate proceeds on sale of assets	2018-06-30	$2,081,730
Aggregate carrying amount (costs) on sale of assets	2018-06-30	$2,086,284
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-06-30	No
Opinion of an independent qualified public accountant for this plan	2018-06-30	Unqualified
Accountancy firm name	2018-06-30	LINDQUIST LLP
Accountancy firm EIN	2018-06-30	522385296
2017 : U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$1,866,692
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$3,117,703
Total income from all sources (including contributions)	2017-06-30	$39,199,248
Total of all expenses incurred	2017-06-30	$33,701,065
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-06-30	$33,057,679
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-06-30	$38,175,751
Value of total assets at end of year	2017-06-30	$17,216,078
Value of total assets at beginning of year	2017-06-30	$12,968,906
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-06-30	$643,386
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-06-30	No
Administrative expenses professional fees incurred	2017-06-30	$102,229
Was this plan covered by a fidelity bond	2017-06-30	Yes
Value of fidelity bond cover	2017-06-30	$500,000
Were there any nonexempt tranactions with any party-in-interest	2017-06-30	No
Contributions received from participants	2017-06-30	$324,114
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-06-30	$1,253,414
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-06-30	$70,844
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-06-30	$1,622,135
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-06-30	$2,592,031
Other income not declared elsewhere	2017-06-30	$1,023,497
Administrative expenses (other) incurred	2017-06-30	$473,036
Liabilities. Value of operating payables at end of year	2017-06-30	$110,557
Liabilities. Value of operating payables at beginning of year	2017-06-30	$406,672
Total non interest bearing cash at end of year	2017-06-30	$11,895,664
Total non interest bearing cash at beginning of year	2017-06-30	$7,828,062
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-06-30	No
Value of net income/loss	2017-06-30	$5,498,183
Value of net assets at end of year (total assets less liabilities)	2017-06-30	$15,349,386
Value of net assets at beginning of year (total assets less liabilities)	2017-06-30	$9,851,203
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-06-30	No
Were any leases to which the plan was party in default or uncollectible	2017-06-30	No
Expenses. Payments to insurance carriers foe the provision of benefits	2017-06-30	$29,875,174
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-06-30	No
Was there a failure to transmit to the plan any participant contributions	2017-06-30	No
Has the plan failed to provide any benefit when due under the plan	2017-06-30	No
Contributions received in cash from employer	2017-06-30	$37,851,637
Employer contributions (assets) at end of year	2017-06-30	$4,067,000
Employer contributions (assets) at beginning of year	2017-06-30	$5,070,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-06-30	$3,182,505
Contract administrator fees	2017-06-30	$68,121
Liabilities. Value of benefit claims payable at end of year	2017-06-30	$134,000
Liabilities. Value of benefit claims payable at beginning of year	2017-06-30	$119,000
Did the plan have assets held for investment	2017-06-30	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-06-30	No
Opinion of an independent qualified public accountant for this plan	2017-06-30	Unqualified
Accountancy firm name	2017-06-30	LINDQUIST LLP
Accountancy firm EIN	2017-06-30	522385296
2016 : U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$3,117,703
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$4,790,205
Total income from all sources (including contributions)	2016-06-30	$35,056,660
Total of all expenses incurred	2016-06-30	$30,092,489
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-06-30	$29,536,465
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-06-30	$34,954,275
Value of total assets at end of year	2016-06-30	$12,968,906
Value of total assets at beginning of year	2016-06-30	$9,677,237
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-06-30	$556,024
Total interest from all sources	2016-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-06-30	No
Administrative expenses professional fees incurred	2016-06-30	$101,309
Was this plan covered by a fidelity bond	2016-06-30	Yes
Value of fidelity bond cover	2016-06-30	$500,000
If this is an individual account plan, was there a blackout period	2016-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2016-06-30	No
Contributions received from participants	2016-06-30	$391,347
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-06-30	$70,844
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-06-30	$257,048
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-06-30	$2,592,031
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-06-30	$4,589,995
Other income not declared elsewhere	2016-06-30	$102,385
Administrative expenses (other) incurred	2016-06-30	$390,215
Liabilities. Value of operating payables at end of year	2016-06-30	$406,672
Liabilities. Value of operating payables at beginning of year	2016-06-30	$46,210
Total non interest bearing cash at end of year	2016-06-30	$7,828,062
Total non interest bearing cash at beginning of year	2016-06-30	$5,709,189
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-06-30	No
Value of net income/loss	2016-06-30	$4,964,171
Value of net assets at end of year (total assets less liabilities)	2016-06-30	$9,851,203
Value of net assets at beginning of year (total assets less liabilities)	2016-06-30	$4,887,032
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-06-30	No
Were any leases to which the plan was party in default or uncollectible	2016-06-30	No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-06-30	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2016-06-30	$26,448,881
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-06-30	No
Was there a failure to transmit to the plan any participant contributions	2016-06-30	No
Has the plan failed to provide any benefit when due under the plan	2016-06-30	No
Contributions received in cash from employer	2016-06-30	$34,562,928
Employer contributions (assets) at end of year	2016-06-30	$5,070,000
Employer contributions (assets) at beginning of year	2016-06-30	$3,711,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-06-30	$3,087,584
Contract administrator fees	2016-06-30	$64,500
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2016-06-30	No
Liabilities. Value of benefit claims payable at end of year	2016-06-30	$119,000
Liabilities. Value of benefit claims payable at beginning of year	2016-06-30	$154,000
Did the plan have assets held for investment	2016-06-30	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-06-30	No
Opinion of an independent qualified public accountant for this plan	2016-06-30	Unqualified
Accountancy firm name	2016-06-30	LINDQUIST LLP
Accountancy firm EIN	2016-06-30	522385296
2015 : U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$4,790,205
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$4,709,415
Total income from all sources (including contributions)	2015-06-30	$31,342,624
Total of all expenses incurred	2015-06-30	$28,619,611
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-06-30	$28,020,988
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-06-30	$31,316,369
Value of total assets at end of year	2015-06-30	$9,677,237
Value of total assets at beginning of year	2015-06-30	$6,873,434
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-06-30	$598,623
Total interest from all sources	2015-06-30	$5
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-06-30	No
Administrative expenses professional fees incurred	2015-06-30	$179,592
Was this plan covered by a fidelity bond	2015-06-30	Yes
Value of fidelity bond cover	2015-06-30	$500,000
If this is an individual account plan, was there a blackout period	2015-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2015-06-30	No
Contributions received from participants	2015-06-30	$427,368
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-06-30	$257,048
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-06-30	$4,589,995
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-06-30	$4,501,867
Other income not declared elsewhere	2015-06-30	$26,250
Administrative expenses (other) incurred	2015-06-30	$354,531
Liabilities. Value of operating payables at end of year	2015-06-30	$46,210
Liabilities. Value of operating payables at beginning of year	2015-06-30	$90,548
Total non interest bearing cash at end of year	2015-06-30	$5,709,189
Total non interest bearing cash at beginning of year	2015-06-30	$80
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Value of net income/loss	2015-06-30	$2,723,013
Value of net assets at end of year (total assets less liabilities)	2015-06-30	$4,887,032
Value of net assets at beginning of year (total assets less liabilities)	2015-06-30	$2,164,019
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-06-30	No
Were any leases to which the plan was party in default or uncollectible	2015-06-30	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-06-30	$3,085,354
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-06-30	$3,085,354
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-06-30	$5
Expenses. Payments to insurance carriers foe the provision of benefits	2015-06-30	$25,096,335
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-06-30	No
Was there a failure to transmit to the plan any participant contributions	2015-06-30	No
Has the plan failed to provide any benefit when due under the plan	2015-06-30	No
Contributions received in cash from employer	2015-06-30	$30,889,001
Employer contributions (assets) at end of year	2015-06-30	$3,711,000
Employer contributions (assets) at beginning of year	2015-06-30	$3,788,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-06-30	$2,924,653
Contract administrator fees	2015-06-30	$64,500
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2015-06-30	No
Liabilities. Value of benefit claims payable at end of year	2015-06-30	$154,000
Liabilities. Value of benefit claims payable at beginning of year	2015-06-30	$117,000
Did the plan have assets held for investment	2015-06-30	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-06-30	No
Opinion of an independent qualified public accountant for this plan	2015-06-30	Unqualified
Accountancy firm name	2015-06-30	LINDQUIST LLP
Accountancy firm EIN	2015-06-30	522385296
2014 : U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$4,709,415
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$4,639,567
Total income from all sources (including contributions)	2014-06-30	$26,287,502
Total of all expenses incurred	2014-06-30	$26,055,574
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-06-30	$25,476,343
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-06-30	$26,215,521
Value of total assets at end of year	2014-06-30	$6,873,434
Value of total assets at beginning of year	2014-06-30	$6,571,658
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-06-30	$579,231
Total interest from all sources	2014-06-30	$2,787
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-06-30	No
Administrative expenses professional fees incurred	2014-06-30	$155,420
Was this plan covered by a fidelity bond	2014-06-30	Yes
Value of fidelity bond cover	2014-06-30	$500,000
If this is an individual account plan, was there a blackout period	2014-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2014-06-30	No
Contributions received from participants	2014-06-30	$498,281
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-06-30	$12,522
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-06-30	$4,501,867
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-06-30	$4,222,529
Other income not declared elsewhere	2014-06-30	$69,194
Administrative expenses (other) incurred	2014-06-30	$353,076
Liabilities. Value of operating payables at end of year	2014-06-30	$90,548
Liabilities. Value of operating payables at beginning of year	2014-06-30	$334,038
Total non interest bearing cash at end of year	2014-06-30	$80
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Value of net income/loss	2014-06-30	$231,928
Value of net assets at end of year (total assets less liabilities)	2014-06-30	$2,164,019
Value of net assets at beginning of year (total assets less liabilities)	2014-06-30	$1,932,091
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-06-30	No
Were any leases to which the plan was party in default or uncollectible	2014-06-30	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-06-30	$3,085,354
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-06-30	$2,584,136
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-06-30	$2,584,136
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-06-30	$2,787
Expenses. Payments to insurance carriers foe the provision of benefits	2014-06-30	$22,807,454
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-06-30	No
Was there a failure to transmit to the plan any participant contributions	2014-06-30	No
Has the plan failed to provide any benefit when due under the plan	2014-06-30	No
Contributions received in cash from employer	2014-06-30	$25,717,240
Employer contributions (assets) at end of year	2014-06-30	$3,788,000
Employer contributions (assets) at beginning of year	2014-06-30	$3,975,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-06-30	$2,668,889
Contract administrator fees	2014-06-30	$70,735
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2014-06-30	No
Liabilities. Value of benefit claims payable at end of year	2014-06-30	$117,000
Liabilities. Value of benefit claims payable at beginning of year	2014-06-30	$83,000
Did the plan have assets held for investment	2014-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-06-30	No
Opinion of an independent qualified public accountant for this plan	2014-06-30	Unqualified
Accountancy firm name	2014-06-30	LINDQUIST LLP
Accountancy firm EIN	2014-06-30	522385296
2013 : U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$4,639,567
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$5,985,466
Total income from all sources (including contributions)	2013-06-30	$29,771,118
Total of all expenses incurred	2013-06-30	$24,898,445
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-06-30	$24,281,236
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-06-30	$29,717,677
Value of total assets at end of year	2013-06-30	$6,571,658
Value of total assets at beginning of year	2013-06-30	$3,044,884
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-06-30	$617,209
Total interest from all sources	2013-06-30	$1,486
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-06-30	No
Administrative expenses professional fees incurred	2013-06-30	$87,322
Was this plan covered by a fidelity bond	2013-06-30	Yes
Value of fidelity bond cover	2013-06-30	$500,000
If this is an individual account plan, was there a blackout period	2013-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2013-06-30	No
Contributions received from participants	2013-06-30	$347,785
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-06-30	$12,522
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-06-30	$265,830
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-06-30	$4,222,529
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-06-30	$5,840,169
Other income not declared elsewhere	2013-06-30	$51,955
Administrative expenses (other) incurred	2013-06-30	$460,227
Liabilities. Value of operating payables at end of year	2013-06-30	$334,038
Liabilities. Value of operating payables at beginning of year	2013-06-30	$66,297
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Value of net income/loss	2013-06-30	$4,872,673
Value of net assets at end of year (total assets less liabilities)	2013-06-30	$1,932,091
Value of net assets at beginning of year (total assets less liabilities)	2013-06-30	$-2,940,582
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-06-30	No
Were any leases to which the plan was party in default or uncollectible	2013-06-30	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-06-30	$2,584,136
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-06-30	$635,054
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-06-30	$635,054
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-06-30	$1,486
Expenses. Payments to insurance carriers foe the provision of benefits	2013-06-30	$21,879,594
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-06-30	No
Was there a failure to transmit to the plan any participant contributions	2013-06-30	No
Has the plan failed to provide any benefit when due under the plan	2013-06-30	No
Contributions received in cash from employer	2013-06-30	$29,369,892
Employer contributions (assets) at end of year	2013-06-30	$3,975,000
Employer contributions (assets) at beginning of year	2013-06-30	$2,144,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-06-30	$2,401,642
Contract administrator fees	2013-06-30	$69,660
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2013-06-30	No
Liabilities. Value of benefit claims payable at end of year	2013-06-30	$83,000
Liabilities. Value of benefit claims payable at beginning of year	2013-06-30	$79,000
Did the plan have assets held for investment	2013-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-06-30	No
Opinion of an independent qualified public accountant for this plan	2013-06-30	Unqualified
Accountancy firm name	2013-06-30	LINDQUIST LLP
Accountancy firm EIN	2013-06-30	522385296
2012 : U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$5,985,466
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$6,600,643
Total income from all sources (including contributions)	2012-06-30	$20,266,006
Total of all expenses incurred	2012-06-30	$18,455,792
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-06-30	$17,851,712
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-06-30	$20,129,594
Value of total assets at end of year	2012-06-30	$3,044,884
Value of total assets at beginning of year	2012-06-30	$1,849,847
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-06-30	$604,080
Total interest from all sources	2012-06-30	$165
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-06-30	No
Administrative expenses professional fees incurred	2012-06-30	$120,680
Was this plan covered by a fidelity bond	2012-06-30	Yes
Value of fidelity bond cover	2012-06-30	$500,000
If this is an individual account plan, was there a blackout period	2012-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2012-06-30	No
Contributions received from participants	2012-06-30	$517,091
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-06-30	$265,830
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-06-30	$152,397
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-06-30	$5,840,169
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-06-30	$6,495,891
Other income not declared elsewhere	2012-06-30	$136,247
Administrative expenses (other) incurred	2012-06-30	$419,545
Liabilities. Value of operating payables at end of year	2012-06-30	$66,297
Liabilities. Value of operating payables at beginning of year	2012-06-30	$35,752
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Value of net income/loss	2012-06-30	$1,810,214
Value of net assets at end of year (total assets less liabilities)	2012-06-30	$-2,940,582
Value of net assets at beginning of year (total assets less liabilities)	2012-06-30	$-4,750,796
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-06-30	No
Were any leases to which the plan was party in default or uncollectible	2012-06-30	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-06-30	$635,054
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-06-30	$511,450
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-06-30	$511,450
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-06-30	$165
Expenses. Payments to insurance carriers foe the provision of benefits	2012-06-30	$15,913,652
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-06-30	No
Was there a failure to transmit to the plan any participant contributions	2012-06-30	No
Has the plan failed to provide any benefit when due under the plan	2012-06-30	No
Contributions received in cash from employer	2012-06-30	$19,612,503
Employer contributions (assets) at end of year	2012-06-30	$2,144,000
Employer contributions (assets) at beginning of year	2012-06-30	$1,186,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-06-30	$1,938,060
Contract administrator fees	2012-06-30	$63,855
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2012-06-30	No
Liabilities. Value of benefit claims payable at end of year	2012-06-30	$79,000
Liabilities. Value of benefit claims payable at beginning of year	2012-06-30	$69,000
Did the plan have assets held for investment	2012-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-06-30	No
Opinion of an independent qualified public accountant for this plan	2012-06-30	Unqualified
Accountancy firm name	2012-06-30	LINDQUIST LLP
Accountancy firm EIN	2012-06-30	522385296
2011 : U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$6,600,643
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$5,304,420
Total income from all sources (including contributions)	2011-06-30	$11,634,847
Total of all expenses incurred	2011-06-30	$14,171,626
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-06-30	$13,403,556
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-06-30	$11,092,206
Value of total assets at end of year	2011-06-30	$1,849,847
Value of total assets at beginning of year	2011-06-30	$3,090,403
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-06-30	$768,070
Total interest from all sources	2011-06-30	$1,484
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-06-30	No
Administrative expenses professional fees incurred	2011-06-30	$230,578
Was this plan covered by a fidelity bond	2011-06-30	Yes
Value of fidelity bond cover	2011-06-30	$250,000
If this is an individual account plan, was there a blackout period	2011-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2011-06-30	No
Contributions received from participants	2011-06-30	$639,746
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-06-30	$152,397
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-06-30	$679,432
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-06-30	$6,495,891
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-06-30	$5,198,198
Other income not declared elsewhere	2011-06-30	$541,157
Administrative expenses (other) incurred	2011-06-30	$462,027
Liabilities. Value of operating payables at end of year	2011-06-30	$35,752
Liabilities. Value of operating payables at beginning of year	2011-06-30	$26,022
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Value of net income/loss	2011-06-30	$-2,536,779
Value of net assets at end of year (total assets less liabilities)	2011-06-30	$-4,750,796
Value of net assets at beginning of year (total assets less liabilities)	2011-06-30	$-2,214,017
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-06-30	No
Were any leases to which the plan was party in default or uncollectible	2011-06-30	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-06-30	$511,450
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-06-30	$1,582,971
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-06-30	$1,582,971
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-06-30	$1,484
Expenses. Payments to insurance carriers foe the provision of benefits	2011-06-30	$11,569,059
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-06-30	No
Was there a failure to transmit to the plan any participant contributions	2011-06-30	No
Has the plan failed to provide any benefit when due under the plan	2011-06-30	No
Contributions received in cash from employer	2011-06-30	$10,452,460
Employer contributions (assets) at end of year	2011-06-30	$1,186,000
Employer contributions (assets) at beginning of year	2011-06-30	$828,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-06-30	$1,834,497
Contract administrator fees	2011-06-30	$75,465
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-06-30	No
Liabilities. Value of benefit claims payable at end of year	2011-06-30	$69,000
Liabilities. Value of benefit claims payable at beginning of year	2011-06-30	$80,200
Did the plan have assets held for investment	2011-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-06-30	No
Opinion of an independent qualified public accountant for this plan	2011-06-30	Unqualified
Accountancy firm name	2011-06-30	LINDQUIST LLP
Accountancy firm EIN	2011-06-30	522385296

Form 5500 Responses for U.A. LOCAL 38 HEALTH AND WELFARE PLAN

2021: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-07-01	Type of plan entity	Multi-employer plan
2021-07-01	Submission has been amended	No
2021-07-01	This submission is the final filing	No
2021-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-07-01	Plan is a collectively bargained plan	Yes
2021-07-01	Plan funding arrangement – Trust	Yes
2021-07-01	Plan benefit arrangement – Insurance	Yes
2021-07-01	Plan benefit arrangement - Trust	Yes
2020: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-07-01	Type of plan entity	Multi-employer plan
2020-07-01	Plan is a collectively bargained plan	Yes
2020-07-01	Plan funding arrangement – Trust	Yes
2020-07-01	Plan benefit arrangement – Insurance	Yes
2020-07-01	Plan benefit arrangement - Trust	Yes
2019: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-07-01	Type of plan entity	Multi-employer plan
2019-07-01	Plan is a collectively bargained plan	Yes
2019-07-01	Plan funding arrangement – Trust	Yes
2019-07-01	Plan benefit arrangement – Insurance	Yes
2019-07-01	Plan benefit arrangement - Trust	Yes
2018: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-07-01	Type of plan entity	Multi-employer plan
2018-07-01	Plan is a collectively bargained plan	Yes
2018-07-01	Plan funding arrangement – Trust	Yes
2018-07-01	Plan benefit arrangement – Insurance	Yes
2018-07-01	Plan benefit arrangement - Trust	Yes
2017: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-07-01	Type of plan entity	Multi-employer plan
2017-07-01	Plan is a collectively bargained plan	Yes
2017-07-01	Plan funding arrangement – Trust	Yes
2017-07-01	Plan benefit arrangement – Insurance	Yes
2017-07-01	Plan benefit arrangement - Trust	Yes
2016: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Multi-employer plan
2016-07-01	Plan is a collectively bargained plan	Yes
2016-07-01	Plan funding arrangement – Trust	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement - Trust	Yes
2015: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Multi-employer plan
2015-07-01	Plan is a collectively bargained plan	Yes
2015-07-01	Plan funding arrangement – Trust	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement - Trust	Yes
2014: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Multi-employer plan
2014-07-01	Plan is a collectively bargained plan	Yes
2014-07-01	Plan funding arrangement – Trust	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement - Trust	Yes
2013: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Multi-employer plan
2013-07-01	Submission has been amended	Yes
2013-07-01	Plan is a collectively bargained plan	Yes
2013-07-01	Plan funding arrangement – Trust	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement - Trust	Yes
2012: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Multi-employer plan
2012-07-01	Plan is a collectively bargained plan	Yes
2012-07-01	Plan funding arrangement – Trust	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement - Trust	Yes
2011: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2011 form 5500 responses
2011-07-01	Type of plan entity	Multi-employer plan
2011-07-01	Plan is a collectively bargained plan	Yes
2011-07-01	Plan funding arrangement – Trust	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement - Trust	Yes
2010: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2010 form 5500 responses
2010-07-01	Type of plan entity	Multi-employer plan
2010-07-01	Plan is a collectively bargained plan	Yes
2010-07-01	Plan funding arrangement – Trust	Yes
2010-07-01	Plan benefit arrangement – Insurance	Yes
2010-07-01	Plan benefit arrangement - Trust	Yes
2009: U.A. LOCAL 38 HEALTH AND WELFARE PLAN 2009 form 5500 responses
2009-07-01	Type of plan entity	Multi-employer plan
2009-07-01	This submission is the final filing	No
2009-07-01	Plan is a collectively bargained plan	Yes
2009-07-01	Plan funding arrangement – Trust	Yes
2009-07-01	Plan benefit arrangement – Insurance	Yes
2009-07-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3333558

Policy instance

Insurance contract or identification number	3333558
Number of Individuals Covered	0
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )

Policy contract number

W0072983

Policy instance

Insurance contract or identification number	W0072983
Number of Individuals Covered	1864
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $201,592
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $16,053,158
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	201592
Additional information about fees paid to insurance broker	PRODUCER SERVICE FEES
Insurance broker organization code?	3

DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

18406

Policy instance

Insurance contract or identification number	18406
Number of Individuals Covered	1289
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $87,706
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $2,781,209
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $87,706
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00445300

Policy instance

Insurance contract or identification number	00445300
Number of Individuals Covered	16
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $982
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&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 Carrier	USD $6,780
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $963
Insurance broker organization code?	3

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

27425

Policy instance

Insurance contract or identification number	27425
Number of Individuals Covered	1768
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $128,849
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $8,618,807
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $128,849
Insurance broker organization code?	3

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

Policy instance

Insurance contract or identification number	99
Number of Individuals Covered	73
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $4,529
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $259,750
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,529
Insurance broker organization code?	3

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )

Policy contract number

G3059 G4340

Policy instance

Insurance contract or identification number	G3059 G4340
Number of Individuals Covered	1243
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $21,200
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
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 Carrier	USD $212,002
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $21,200
Insurance broker organization code?	3

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12121924

Policy instance

Insurance contract or identification number	12121924
Number of Individuals Covered	1223
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $21,783
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $21,783
Insurance broker organization code?	3

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

27425

Policy instance

Insurance contract or identification number	27425
Number of Individuals Covered	2054
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
Total amount of commissions paid to insurance broker	USD $252,122
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $11,700,842
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $252,122
Insurance broker organization code?	3

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

Policy instance

Insurance contract or identification number	99
Number of Individuals Covered	60
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
Total amount of commissions paid to insurance broker	USD $5,854
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $336,351
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,854
Insurance broker organization code?	3

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12121924

Policy instance

Insurance contract or identification number	12121924
Number of Individuals Covered	1456
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
Total amount of commissions paid to insurance broker	USD $23,366
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $23,366
Insurance broker organization code?	3

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )

Policy contract number

G3059 C4340

Policy instance

Insurance contract or identification number	G3059 C4340
Number of Individuals Covered	1301
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
Total amount of commissions paid to insurance broker	USD $22,894
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $228,937
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,894
Insurance broker organization code?	3

DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

18406

Policy instance

Insurance contract or identification number	18406
Number of Individuals Covered	1476
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
Total amount of commissions paid to insurance broker	USD $98,992
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,299,726
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $98,992
Insurance broker organization code?	3

CIGNA HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: N/A )

Policy contract number

3333558

Policy instance

Insurance contract or identification number	3333558
Number of Individuals Covered	292
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
Total amount of commissions paid to insurance broker	USD $79,779
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $79,779
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3333558

Policy instance

Insurance contract or identification number	3333558
Number of Individuals Covered	2046
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
Total amount of commissions paid to insurance broker	USD $596,382
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,357,342
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $596,382
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00445300

Policy instance

Insurance contract or identification number	00445300
Number of Individuals Covered	17
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
Total amount of commissions paid to insurance broker	USD $972
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $6,654
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $953
Insurance broker organization code?	3

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

Policy instance

Insurance contract or identification number	99
Number of Individuals Covered	49
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $5,242
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $284,967
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,242
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3333558

Policy instance

Insurance contract or identification number	3333558
Number of Individuals Covered	1822
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $579,776
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Were dividends or retroactive rate refunds paid as a credit?	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,535,985
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $583,361
Insurance broker organization code?	3

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12121924

Policy instance

Insurance contract or identification number	12121924
Number of Individuals Covered	1560
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $27,740
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $27,740
Insurance broker organization code?	3

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )

Policy contract number

G3059 C4340

Policy instance

Insurance contract or identification number	G3059 C4340
Number of Individuals Covered	1501
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $24,519
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $245,207
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $24,519
Insurance broker organization code?	3

DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

18406

Policy instance

Insurance contract or identification number	18406
Number of Individuals Covered	1575
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $103,813
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,460,417
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $52,238
Insurance broker organization code?	3

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

27425

Policy instance

Insurance contract or identification number	27425
Number of Individuals Covered	2137
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $269,540
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $11,804,864
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $269,540
Insurance broker organization code?	3

CIGNA HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: N/A )

Policy contract number

3333558

Policy instance

Insurance contract or identification number	3333558
Number of Individuals Covered	308
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $74,734
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Were dividends or retroactive rate refunds paid as a credit?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $75,252
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00445300

Policy instance

Insurance contract or identification number	00445300
Number of Individuals Covered	16
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $949
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $6,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $931
Insurance broker organization code?	3

DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

18406

Policy instance

Insurance contract or identification number	18406
Number of Individuals Covered	1543
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $86,744
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,891,481
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $86,744
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00445300

Policy instance

Insurance contract or identification number	00445300
Number of Individuals Covered	16
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $918
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $6,401
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $900
Insurance broker organization code?	3

CIGNA HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: N/A )

Policy contract number

3333558

Policy instance

Insurance contract or identification number	3333558
Number of Individuals Covered	336
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $80,139
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $53,305
Insurance broker organization code?	3

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )

Policy contract number

G3059 C4340

Policy instance

Insurance contract or identification number	G3059 C4340
Number of Individuals Covered	1514
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $21,975
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $240,253
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $21,975
Insurance broker organization code?	3

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12121924

Policy instance

Insurance contract or identification number	12121924
Number of Individuals Covered	1567
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $4,811
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,811
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3333558

Policy instance

Insurance contract or identification number	3333558
Number of Individuals Covered	2168
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $559,399
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,477,974
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $372,012
Insurance broker organization code?	3

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

27425

Policy instance

Insurance contract or identification number	27425
Number of Individuals Covered	2038
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $166,821
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $10,333,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $166,821
Insurance broker organization code?	3

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

Policy instance

Insurance contract or identification number	99
Number of Individuals Covered	43
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $3,676
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $262,497
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,676
Insurance broker organization code?	3

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

27425

Policy instance

Insurance contract or identification number	27425
Number of Individuals Covered	1791
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $160,980
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $8,489,551
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: 0000 )

Policy contract number

Policy instance

Insurance contract or identification number	99
Number of Individuals Covered	52
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $5,050
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $270,818
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12121924

Policy instance

Insurance contract or identification number	12121924
Number of Individuals Covered	1412
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $17,130
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3333558

Policy instance

Insurance contract or identification number	3333558
Number of Individuals Covered	2125
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $510,969
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,830,149
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )

Policy contract number

G3059 C4340

Policy instance

Insurance contract or identification number	G3059 C4340
Number of Individuals Covered	1404
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $21,845
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $218,451
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: N/A )

Policy contract number

3333558

Policy instance

Insurance contract or identification number	3333558
Number of Individuals Covered	353
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $84,689
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $218,451
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00445300

Policy instance

Insurance contract or identification number	00445300
Number of Individuals Covered	15
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $1,035
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $7,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

18406

Policy instance

Insurance contract or identification number	18406
Number of Individuals Covered	1474
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $75,449
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,514,960
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12121924

Policy instance

Insurance contract or identification number	12121924
Number of Individuals Covered	1273
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $12,088
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,088
Insurance broker organization code?	3
Insurance broker name	R.L. MILSNER INC.

UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )

Policy contract number

907277-099,-000

Policy instance

Insurance contract or identification number	907277-099,-000
Number of Individuals Covered	3323
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $58,073
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $58,073
Insurance broker organization code?	3
Insurance broker name	R.L. MILSNER INC.

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )

Policy contract number

C4340

Policy instance

Insurance contract or identification number	C4340
Number of Individuals Covered	1269
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $29,310
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: N/A )

Policy contract number

3333558

Policy instance

Insurance contract or identification number	3333558
Number of Individuals Covered	337
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $74,158
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Were dividends or retroactive rate refunds paid as a credit?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $74,158
Insurance broker organization code?	3
Insurance broker name	R.L. MILSNER INC.

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

27425

Policy instance

Insurance contract or identification number	27425
Number of Individuals Covered	1537
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $7,716,674
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: 0000 )

Policy contract number

Policy instance

Insurance contract or identification number	99
Number of Individuals Covered	47
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $300,001
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3333558

Policy instance

Insurance contract or identification number	3333558
Number of Individuals Covered	1987
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $387,396
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Were dividends or retroactive rate refunds paid as a credit?	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,737,534
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $387,396
Insurance broker organization code?	3
Insurance broker name	R.L. MILSNER INC.

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )

Policy contract number

G3059

Policy instance

Insurance contract or identification number	G3059
Number of Individuals Covered	1269
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $17,666
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $17,666
Insurance broker organization code?	3
Insurance broker name	R.L. MILSNER INC.

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12121924

Policy instance

Insurance contract or identification number	12121924
Number of Individuals Covered	1147
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $11,330
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,330
Insurance broker organization code?	3
Insurance broker name	R.L. MILSNER INC.

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

27425

Policy instance

Insurance contract or identification number	27425
Number of Individuals Covered	1380
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $7,423,702
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )

Policy contract number

G3059

Policy instance

Insurance contract or identification number	G3059
Number of Individuals Covered	1143
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $13,544
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,544
Insurance broker organization code?	3
Insurance broker name	R.L. MILSNER INC.

CIGNA HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: N/A )

Policy contract number

3333558

Policy instance

Insurance contract or identification number	3333558
Number of Individuals Covered	356
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $76,566
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Were dividends or retroactive rate refunds paid as a credit?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $76,566
Insurance broker organization code?	3
Insurance broker name	R.L. MILSNER INC.

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

Policy instance

Insurance contract or identification number	99
Number of Individuals Covered	51
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $347,559
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3333558

Policy instance

Insurance contract or identification number	3333558
Number of Individuals Covered	1034
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $355,714
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Were dividends or retroactive rate refunds paid as a credit?	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,910,852
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $355,714
Insurance broker organization code?	3
Insurance broker name	R.L. MILSNER INC.

UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )

Policy contract number

907277-099,-000

Policy instance

Insurance contract or identification number	907277-099,-000
Number of Individuals Covered	2945
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $59,124
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $59,124
Insurance broker name	R.L. MILSNER INC.

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )

Policy contract number

C4340

Policy instance

Insurance contract or identification number	C4340
Number of Individuals Covered	1143
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $27,196
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: N/A )

Policy contract number

3333558

Policy instance

Insurance contract or identification number	3333558
Number of Individuals Covered	346
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $69,976
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $69,976
Insurance broker organization code?	3
Insurance broker name	R.L. MILSNER INC.

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )

Policy contract number

G3059

Policy instance

Insurance contract or identification number	G3059
Number of Individuals Covered	1016
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $11,449
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,449
Insurance broker organization code?	3
Insurance broker name	R.L. MILSNER INC.

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12121924

Policy instance

Insurance contract or identification number	12121924
Number of Individuals Covered	1049
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $13,377
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,377
Insurance broker organization code?	3
Insurance broker name	R.L. MILSNER INC.

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3333558

Policy instance

Insurance contract or identification number	3333558
Number of Individuals Covered	1406
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $338,609
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,855,132
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $338,609
Insurance broker organization code?	3
Insurance broker name	R.L. MILSNER INC.

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )

Policy contract number

C4340

Policy instance

Insurance contract or identification number	C4340
Number of Individuals Covered	1016
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $26,502
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

KM05993594

Policy instance

Insurance contract or identification number	KM05993594
Number of Individuals Covered	1064
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $62,441
Total amount of fees paid to insurance company	USD $12,423
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,065,078
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $62,441
Amount paid for insurance broker fees	12423
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	R.L. MILSNER INC.

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

Policy instance

Insurance contract or identification number	99
Number of Individuals Covered	54
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $305,678
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: 0000 )

Policy contract number

27425

Policy instance

Insurance contract or identification number	27425
Number of Individuals Covered	1222
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $6,680,675
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: N/A )

Policy contract number

3333558

Policy instance

Insurance contract or identification number	3333558
Number of Individuals Covered	347
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $70,328
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Were dividends or retroactive rate refunds paid as a credit?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $70,328
Insurance broker organization code?	3
Insurance broker name	R.L. MILSNER INC.

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )

Policy contract number

G3059

Policy instance

Insurance contract or identification number	G3059
Number of Individuals Covered	1140
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $11,201
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,201
Insurance broker organization code?	3
Insurance broker name	R.L. MILSNER INC.

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12121924

Policy instance

Insurance contract or identification number	12121924
Number of Individuals Covered	1185
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $13,035
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,035
Insurance broker organization code?	3
Insurance broker name	R.L. MILSNER INC.

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )

Policy contract number

C4340

Policy instance

Insurance contract or identification number	C4340
Number of Individuals Covered	1140
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $25,931
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

KM05993594

Policy instance

Insurance contract or identification number	KM05993594
Number of Individuals Covered	1166
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $54,742
Total amount of fees paid to insurance company	USD $61,094
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,002,202
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $54,742
Amount paid for insurance broker fees	61094
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	R.L. MILSNER INC.

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3333558

Policy instance

Insurance contract or identification number	3333558
Number of Individuals Covered	1484
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $344,641
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Were dividends or retroactive rate refunds paid as a credit?	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,616,747
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $344,641
Insurance broker organization code?	3
Insurance broker name	R.L. MILSNER INC.

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

Policy instance

Insurance contract or identification number	99
Number of Individuals Covered	46
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $280,697
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: 0000 )

Policy contract number

27425

Policy instance

Insurance contract or identification number	27425
Number of Individuals Covered	1293
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,841,919
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: N/A )

Policy contract number

3333558

Policy instance

Insurance contract or identification number	3333558
Number of Individuals Covered	338
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $51,341
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Were dividends or retroactive rate refunds paid as a credit?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )

Policy contract number

G3059

Policy instance

Insurance contract or identification number	G3059
Number of Individuals Covered	937
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $10,052
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )

Policy contract number

C4340

Policy instance

Insurance contract or identification number	C4340
Number of Individuals Covered	937
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $19,572
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

249

Policy instance

Insurance contract or identification number	249
Number of Individuals Covered	964
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $50,533
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )

Policy contract number

3333558

Policy instance

Insurance contract or identification number	3333558
Number of Individuals Covered	1615
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $213,491
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Were dividends or retroactive rate refunds paid as a credit?	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,129,225
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

Policy instance

Insurance contract or identification number	99
Number of Individuals Covered	48
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $230,765
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: 0000 )

Policy contract number

27425

Policy instance

Insurance contract or identification number	27425
Number of Individuals Covered	1030
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,642,036
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12121924

Policy instance

Insurance contract or identification number	12121924
Number of Individuals Covered	955
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $9,233
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12121924

Policy instance

Insurance contract or identification number	12121924
Number of Individuals Covered	714
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $8,133
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )

Policy contract number

G3059/C4340

Policy instance

Insurance contract or identification number	G3059/C4340
Number of Individuals Covered	685
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $8,541
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $83,424
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

249

Policy instance

Insurance contract or identification number	249
Number of Individuals Covered	727
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $41,315
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )

Policy contract number

3333558

Policy instance

Insurance contract or identification number	3333558
Number of Individuals Covered	1346
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $108,950
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $757,588
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: 0000 )

Policy contract number

27425

Policy instance

Insurance contract or identification number	27425
Number of Individuals Covered	805
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,692,010
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: 0000 )

Policy contract number

Policy instance

Insurance contract or identification number	99
Number of Individuals Covered	45
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $177,829
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	BOARD OF TRUSTEES OF U.A. LOCAL 38 TRUST FUNDS
Employer identification number (EIN):	941285319
NAIC Classification:	238220
NAIC Description:	Plumbing, Heating, and Air-Conditioning Contractors