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MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 401k Plan overview

Plan NameMEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC.
Plan identification number 523

MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental

401k Sponsoring company profile

THE PERMANENTE MEDICAL GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name:THE PERMANENTE MEDICAL GROUP, INC.
Employer identification number (EIN):942728480
NAIC Classification:621112
NAIC Description:Offices of Physicians, Mental Health Specialists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5232022-01-01
5232021-01-01
5232020-01-01
5232019-01-01
5232018-01-01
5232017-01-01JOANNE ARNEAL
5232016-01-01JOANNE ARNEAL
5232015-01-01JOANNE ARNEAL
5232014-01-01JOANNE ARNEAL
5232013-01-01BOB JAKO
5232012-01-01CONNIE WILSON CONNIE WILSON2013-10-08
5232011-01-01CONNIE WILSON CONNIE WILSON2012-10-11
5232009-01-01RONALD C. DE RYK CONNIE WILSON2010-10-14

Plan Statistics for MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC.

401k plan membership statisitcs for MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC.

Measure Date Value
2022: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2022 401k membership
Total participants, beginning-of-year2022-01-01250
Total number of active participants reported on line 7a of the Form 55002022-01-010
Number of retired or separated participants receiving benefits2022-01-01231
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01231
2021: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2021 401k membership
Total participants, beginning-of-year2021-01-01242
Total number of active participants reported on line 7a of the Form 55002021-01-010
Number of retired or separated participants receiving benefits2021-01-01250
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01250
2020: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2020 401k membership
Total participants, beginning-of-year2020-01-01265
Total number of active participants reported on line 7a of the Form 55002020-01-010
Number of retired or separated participants receiving benefits2020-01-01242
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01242
2019: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2019 401k membership
Total participants, beginning-of-year2019-01-01321
Total number of active participants reported on line 7a of the Form 55002019-01-010
Number of retired or separated participants receiving benefits2019-01-01265
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01265
2018: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2018 401k membership
Total participants, beginning-of-year2018-01-01335
Total number of active participants reported on line 7a of the Form 55002018-01-010
Number of retired or separated participants receiving benefits2018-01-01321
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01321
2017: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2017 401k membership
Total participants, beginning-of-year2017-01-01362
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-01335
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01335
2016: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2016 401k membership
Total participants, beginning-of-year2016-01-01380
Total number of active participants reported on line 7a of the Form 55002016-01-010
Number of retired or separated participants receiving benefits2016-01-01359
Number of other retired or separated participants entitled to future benefits2016-01-013
Total of all active and inactive participants2016-01-01362
2015: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2015 401k membership
Total participants, beginning-of-year2015-01-01266
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-01377
Number of other retired or separated participants entitled to future benefits2015-01-013
Total of all active and inactive participants2015-01-01380
2014: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2014 401k membership
Total participants, beginning-of-year2014-01-01449
Total number of active participants reported on line 7a of the Form 55002014-01-010
Number of retired or separated participants receiving benefits2014-01-01262
Number of other retired or separated participants entitled to future benefits2014-01-014
Total of all active and inactive participants2014-01-01266
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-01159
2013: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2013 401k membership
Total participants, beginning-of-year2013-01-01459
Number of retired or separated participants receiving benefits2013-01-01279
Number of other retired or separated participants entitled to future benefits2013-01-0113
Total of all active and inactive participants2013-01-01292
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-01157
2012: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2012 401k membership
Total participants, beginning-of-year2012-01-01327
Total number of active participants reported on line 7a of the Form 55002012-01-010
Number of retired or separated participants receiving benefits2012-01-01300
Number of other retired or separated participants entitled to future benefits2012-01-013
Total of all active and inactive participants2012-01-01303
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-01156
Total participants2012-01-01459
2011: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2011 401k membership
Total participants, beginning-of-year2011-01-01493
Number of retired or separated participants receiving benefits2011-01-01325
Number of other retired or separated participants entitled to future benefits2011-01-012
Total of all active and inactive participants2011-01-01327
2009: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2009 401k membership
Total participants, beginning-of-year2009-01-01201
Total number of active participants reported on line 7a of the Form 55002009-01-010
Number of retired or separated participants receiving benefits2009-01-01369
Number of other retired or separated participants entitled to future benefits2009-01-013
Total of all active and inactive participants2009-01-01372
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-01149

Financial Data on MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC.

Measure Date Value
2022 : MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$-288,328
Total unrealized appreciation/depreciation of assets2022-12-31$-288,328
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-230,446
Total loss/gain on sale of assets2022-12-31$-169,112
Total of all expenses incurred2022-12-31$1,428,365
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$1,413,327
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$0
Value of total assets at end of year2022-12-31$4,082,403
Value of total assets at beginning of year2022-12-31$5,741,214
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$15,038
Total interest from all sources2022-12-31$226,994
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Administrative expenses professional fees incurred2022-12-31$12,323
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$5,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Assets. Other investments not covered elsewhere at end of year2022-12-31$3,662,850
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$5,542,292
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-12-31$31,860
Administrative expenses (other) incurred2022-12-31$321
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-1,658,811
Value of net assets at end of year (total assets less liabilities)2022-12-31$4,082,403
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$5,741,214
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Interest earned on other investments2022-12-31$226,994
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$419,553
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$198,922
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$198,922
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$1,045,158
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31Yes
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$336,309
Contract administrator fees2022-12-31$2,394
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Aggregate proceeds on sale of assets2022-12-31$1,434,410
Aggregate carrying amount (costs) on sale of assets2022-12-31$1,603,522
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31BDO USA, P.C.
Accountancy firm EIN2022-12-31135381590
2021 : MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2021-12-31$-183,305
Total unrealized appreciation/depreciation of assets2021-12-31$-183,305
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$61,653
Total loss/gain on sale of assets2021-12-31$-37,846
Total of all expenses incurred2021-12-31$1,751,690
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,741,923
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$0
Value of total assets at end of year2021-12-31$5,741,214
Value of total assets at beginning of year2021-12-31$7,431,251
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$9,767
Total interest from all sources2021-12-31$282,804
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Administrative expenses professional fees incurred2021-12-31$7,310
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Assets. Other investments not covered elsewhere at end of year2021-12-31$5,542,292
Assets. Other investments not covered elsewhere at beginning of year2021-12-31$7,038,451
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2021-12-31$37,365
Administrative expenses (other) incurred2021-12-31$199
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$-1,690,037
Value of net assets at end of year (total assets less liabilities)2021-12-31$5,741,214
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$7,431,251
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Interest earned on other investments2021-12-31$282,804
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$198,922
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$392,800
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$392,800
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$1,322,674
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31Yes
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$381,884
Contract administrator fees2021-12-31$2,258
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Aggregate proceeds on sale of assets2021-12-31$1,291,064
Aggregate carrying amount (costs) on sale of assets2021-12-31$1,328,910
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31BDO USA, LLP
Accountancy firm EIN2021-12-31135381590
2020 : MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2020-12-31$16,413
Total unrealized appreciation/depreciation of assets2020-12-31$16,413
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$333,407
Total loss/gain on sale of assets2020-12-31$-50,037
Total of all expenses incurred2020-12-31$1,886,050
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$1,879,484
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$0
Value of total assets at end of year2020-12-31$7,431,251
Value of total assets at beginning of year2020-12-31$8,983,894
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$6,566
Total interest from all sources2020-12-31$367,031
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Administrative expenses professional fees incurred2020-12-31$2,599
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Assets. Other investments not covered elsewhere at end of year2020-12-31$7,038,451
Assets. Other investments not covered elsewhere at beginning of year2020-12-31$8,523,230
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-12-31$20,111
Administrative expenses (other) incurred2020-12-31$12
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$-1,552,643
Value of net assets at end of year (total assets less liabilities)2020-12-31$7,431,251
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$8,983,894
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Interest earned on other investments2020-12-31$367,031
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$392,800
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$460,664
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$460,664
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$1,484,959
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31Yes
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$374,414
Contract administrator fees2020-12-31$3,955
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Aggregate proceeds on sale of assets2020-12-31$1,984,196
Aggregate carrying amount (costs) on sale of assets2020-12-31$2,034,233
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31BDO USA, LLP
Accountancy firm EIN2020-12-31135381590
2019 : MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$174,541
Total unrealized appreciation/depreciation of assets2019-12-31$174,541
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$589,943
Total loss/gain on sale of assets2019-12-31$-58,491
Total of all expenses incurred2019-12-31$2,477,571
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$2,467,452
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$0
Value of total assets at end of year2019-12-31$8,983,894
Value of total assets at beginning of year2019-12-31$10,871,522
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$10,119
Total interest from all sources2019-12-31$473,893
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Administrative expenses professional fees incurred2019-12-31$5,797
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Assets. Other investments not covered elsewhere at end of year2019-12-31$8,523,230
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$10,595,803
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$25,042
Administrative expenses (other) incurred2019-12-31$1,510
Total non interest bearing cash at end of year2019-12-31$0
Total non interest bearing cash at beginning of year2019-12-31$134,704
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$-1,887,628
Value of net assets at end of year (total assets less liabilities)2019-12-31$8,983,894
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$10,871,522
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Interest earned on other investments2019-12-31$473,893
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$460,664
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$141,015
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$141,015
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$2,055,985
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$386,425
Contract administrator fees2019-12-31$2,812
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Aggregate proceeds on sale of assets2019-12-31$2,620,289
Aggregate carrying amount (costs) on sale of assets2019-12-31$2,678,780
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31BDO USA, LLP
Accountancy firm EIN2019-12-31135381590
2018 : MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$-390,878
Total unrealized appreciation/depreciation of assets2018-12-31$-390,878
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$261,590
Total loss/gain on sale of assets2018-12-31$-26,748
Total of all expenses incurred2018-12-31$2,469,253
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$2,456,205
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$0
Value of total assets at end of year2018-12-31$10,871,522
Value of total assets at beginning of year2018-12-31$13,079,185
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$13,048
Total interest from all sources2018-12-31$544,512
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Administrative expenses professional fees incurred2018-12-31$5,986
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Assets. Other investments not covered elsewhere at end of year2018-12-31$10,595,803
Assets. Other investments not covered elsewhere at beginning of year2018-12-31$12,778,439
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$54,313
Other income not declared elsewhere2018-12-31$134,704
Administrative expenses (other) incurred2018-12-31$7,062
Total non interest bearing cash at end of year2018-12-31$134,704
Total non interest bearing cash at beginning of year2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-2,207,663
Value of net assets at end of year (total assets less liabilities)2018-12-31$10,871,522
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$13,079,185
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Interest earned on other investments2018-12-31$544,512
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$141,015
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$300,746
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$300,746
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$1,936,736
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31Yes
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$465,156
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Aggregate proceeds on sale of assets2018-12-31$1,791,138
Aggregate carrying amount (costs) on sale of assets2018-12-31$1,817,886
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31BDO USA, LLP
Accountancy firm EIN2018-12-31135381590
2017 : MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2017-12-31$73,285
Total unrealized appreciation/depreciation of assets2017-12-31$73,285
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$599,454
Total loss/gain on sale of assets2017-12-31$-66,864
Total of all expenses incurred2017-12-31$2,526,340
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$2,513,305
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$0
Value of total assets at end of year2017-12-31$13,079,185
Value of total assets at beginning of year2017-12-31$15,006,071
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$13,035
Total interest from all sources2017-12-31$593,033
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Administrative expenses professional fees incurred2017-12-31$1,716
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Assets. Other investments not covered elsewhere at end of year2017-12-31$12,778,439
Assets. Other investments not covered elsewhere at beginning of year2017-12-31$12,254,627
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-12-31$22,624
Administrative expenses (other) incurred2017-12-31$11,319
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-1,926,886
Value of net assets at end of year (total assets less liabilities)2017-12-31$13,079,185
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$15,006,071
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Interest earned on other investments2017-12-31$593,033
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$300,746
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$2,751,444
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$2,751,444
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$2,051,587
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31Yes
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$439,094
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Aggregate proceeds on sale of assets2017-12-31$1,432,046
Aggregate carrying amount (costs) on sale of assets2017-12-31$1,498,910
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31BDO USA, LLP
Accountancy firm EIN2017-12-31135381590
2016 : MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2016-12-31$-512,777
Total unrealized appreciation/depreciation of assets2016-12-31$-512,777
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$2,265,411
Total loss/gain on sale of assets2016-12-31$-119,483
Total of all expenses incurred2016-12-31$3,034,451
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$3,029,067
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$0
Value of total assets at end of year2016-12-31$15,006,071
Value of total assets at beginning of year2016-12-31$15,775,111
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$5,384
Total interest from all sources2016-12-31$625,622
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$5,384
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Assets. Other investments not covered elsewhere at end of year2016-12-31$12,254,627
Assets. Other investments not covered elsewhere at beginning of year2016-12-31$13,430,801
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-12-31$668,691
Other income not declared elsewhere2016-12-31$2,272,049
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-769,040
Value of net assets at end of year (total assets less liabilities)2016-12-31$15,006,071
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$15,775,111
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Interest earned on other investments2016-12-31$625,622
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$2,751,444
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$2,344,310
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$2,344,310
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$1,851,219
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31Yes
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$509,157
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Aggregate proceeds on sale of assets2016-12-31$3,736,245
Aggregate carrying amount (costs) on sale of assets2016-12-31$3,855,728
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31BDO USA, LLP
Accountancy firm EIN2016-12-31135381590
2015 : MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2015-12-31$-135,808
Total unrealized appreciation/depreciation of assets2015-12-31$-135,808
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$2,525,409
Total loss/gain on sale of assets2015-12-31$-92,508
Total of all expenses incurred2015-12-31$3,279,373
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$3,277,360
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$0
Value of total assets at end of year2015-12-31$15,775,111
Value of total assets at beginning of year2015-12-31$16,529,075
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$2,013
Total interest from all sources2015-12-31$680,726
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$2,013
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Assets. Other investments not covered elsewhere at end of year2015-12-31$13,430,801
Assets. Other investments not covered elsewhere at beginning of year2015-12-31$12,913,444
Other income not declared elsewhere2015-12-31$2,072,999
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-753,964
Value of net assets at end of year (total assets less liabilities)2015-12-31$15,775,111
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$16,529,075
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Interest earned on other investments2015-12-31$680,726
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$2,344,310
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$3,615,631
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$3,615,631
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$2,031,549
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31Yes
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$1,245,811
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Aggregate proceeds on sale of assets2015-12-31$3,327,048
Aggregate carrying amount (costs) on sale of assets2015-12-31$3,419,556
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31BDO USA, LLP
Accountancy firm EIN2015-12-31135381590
2014 : MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-12-31$559,959
Total unrealized appreciation/depreciation of assets2014-12-31$559,959
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$5,928,361
Total loss/gain on sale of assets2014-12-31$-77,713
Total of all expenses incurred2014-12-31$4,083,594
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$4,083,594
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$0
Value of total assets at end of year2014-12-31$16,529,075
Value of total assets at beginning of year2014-12-31$14,684,308
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$0
Total interest from all sources2014-12-31$624,242
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$5,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Assets. Other investments not covered elsewhere at end of year2014-12-31$12,913,444
Assets. Other investments not covered elsewhere at beginning of year2014-12-31$13,872,438
Other income not declared elsewhere2014-12-31$4,821,873
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$1,844,767
Value of net assets at end of year (total assets less liabilities)2014-12-31$16,529,075
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$14,684,308
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Interest earned on other investments2014-12-31$624,242
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$3,615,631
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$811,870
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$811,870
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$2,627,420
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$1,456,174
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Aggregate proceeds on sale of assets2014-12-31$8,865,384
Aggregate carrying amount (costs) on sale of assets2014-12-31$8,943,097
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31BDO USA, LLP
Accountancy firm EIN2014-12-31135381590
2013 : MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$-885,920
Total unrealized appreciation/depreciation of assets2013-12-31$-885,920
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$1,688,662
Total loss/gain on sale of assets2013-12-31$-138,888
Total of all expenses incurred2013-12-31$5,153,901
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$5,153,901
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$2,000,000
Value of total assets at end of year2013-12-31$14,684,308
Value of total assets at beginning of year2013-12-31$18,149,547
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$0
Total interest from all sources2013-12-31$713,470
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$5,000,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Assets. Other investments not covered elsewhere at end of year2013-12-31$13,872,438
Assets. Other investments not covered elsewhere at beginning of year2013-12-31$16,747,198
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-3,465,239
Value of net assets at end of year (total assets less liabilities)2013-12-31$14,684,308
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$18,149,547
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Interest earned on other investments2013-12-31$713,470
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$811,870
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$1,402,349
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$1,402,349
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$3,885,308
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31Yes
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$2,000,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$1,268,593
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31No
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Aggregate proceeds on sale of assets2013-12-31$3,742,722
Aggregate carrying amount (costs) on sale of assets2013-12-31$3,881,610
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31BDO USA, LLP
Accountancy firm EIN2013-12-31135381590
2012 : MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$291,718
Total unrealized appreciation/depreciation of assets2012-12-31$291,718
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$3,293,665
Total loss/gain on sale of assets2012-12-31$181,000
Total of all expenses incurred2012-12-31$5,030,576
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$5,030,576
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$2,000,000
Value of total assets at end of year2012-12-31$18,149,547
Value of total assets at beginning of year2012-12-31$19,886,458
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$0
Total interest from all sources2012-12-31$820,947
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$5,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Assets. Other investments not covered elsewhere at end of year2012-12-31$16,747,198
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$16,721,056
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-12-31$42,873
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-1,736,911
Value of net assets at end of year (total assets less liabilities)2012-12-31$18,149,547
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$19,886,458
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Interest earned on other investments2012-12-31$820,947
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$1,402,349
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$3,165,402
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$3,165,402
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$3,658,994
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31Yes
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$2,000,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$1,328,709
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31No
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Aggregate proceeds on sale of assets2012-12-31$2,209,629
Aggregate carrying amount (costs) on sale of assets2012-12-31$2,028,629
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31BDO USA, LLP
Accountancy firm EIN2012-12-31135381590
2011 : MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$1,027,067
Total unrealized appreciation/depreciation of assets2011-12-31$1,027,067
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$4,727,450
Total loss/gain on sale of assets2011-12-31$-42,604
Total of all expenses incurred2011-12-31$5,276,533
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$5,276,533
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$2,800,000
Value of total assets at end of year2011-12-31$19,886,458
Value of total assets at beginning of year2011-12-31$20,435,541
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$0
Total interest from all sources2011-12-31$942,987
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$5,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Assets. Other investments not covered elsewhere at end of year2011-12-31$16,721,056
Assets. Other investments not covered elsewhere at beginning of year2011-12-31$17,992,401
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-12-31$14,175
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-549,083
Value of net assets at end of year (total assets less liabilities)2011-12-31$19,886,458
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$20,435,541
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Interest earned on other investments2011-12-31$942,987
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$3,165,402
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$2,443,140
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$2,443,140
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$3,878,646
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$2,800,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$1,383,712
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Aggregate proceeds on sale of assets2011-12-31$1,576,150
Aggregate carrying amount (costs) on sale of assets2011-12-31$1,618,754
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31BDO USA, LLP
Accountancy firm EIN2011-12-31135381590
2010 : MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$-441,069
Total unrealized appreciation/depreciation of assets2010-12-31$-441,069
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$2,707,252
Total loss/gain on sale of assets2010-12-31$88,861
Total of all expenses incurred2010-12-31$6,143,388
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$6,143,388
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$2,000,000
Value of total assets at end of year2010-12-31$20,435,541
Value of total assets at beginning of year2010-12-31$23,871,677
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$0
Total interest from all sources2010-12-31$1,059,460
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$5,000,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Assets. Other investments not covered elsewhere at end of year2010-12-31$17,992,401
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$21,488,385
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$39,799
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-3,436,136
Value of net assets at end of year (total assets less liabilities)2010-12-31$20,435,541
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$23,871,677
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Interest earned on other investments2010-12-31$1,059,403
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$2,443,140
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$2,383,292
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$2,383,292
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$57
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$4,091,439
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$2,000,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$2,012,150
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$13,828,239
Aggregate carrying amount (costs) on sale of assets2010-12-31$13,739,378
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31BDO USA, LLP
Accountancy firm EIN2010-12-31135381590

Form 5500 Responses for MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC.

2022: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC. 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number05454
Policy instance 2
Insurance contract or identification number05454
Number of Individuals Covered106
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $87,364
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 numberVARIOUS
Policy instance 1
Insurance contract or identification numberVARIOUS
Number of Individuals Covered91
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $957,794
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 number05454
Policy instance 2
Insurance contract or identification number05454
Number of Individuals Covered112
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $99,941
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 numberVARIOUS
Policy instance 1
Insurance contract or identification numberVARIOUS
Number of Individuals Covered103
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,222,733
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 number05454
Policy instance 2
Insurance contract or identification number05454
Number of Individuals Covered122
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $115,012
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 numberVARIOUS
Policy instance 1
Insurance contract or identification numberVARIOUS
Number of Individuals Covered111
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,369,947
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 numberVARIOUS
Policy instance 1
Insurance contract or identification numberVARIOUS
Number of Individuals Covered121
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,657,460
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 number05454
Policy instance 2
Insurance contract or identification number05454
Number of Individuals Covered138
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $128,439
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 numberVARIOUS
Policy instance 3
Insurance contract or identification numberVARIOUS
Number of Individuals Covered0
Insurance policy start date2019-01-01
Insurance policy end date2019-06-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $270,086
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 numberVARIOUS
Policy instance 1
Insurance contract or identification numberVARIOUS
Number of Individuals Covered150
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,333,365
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 number05454
Policy instance 2
Insurance contract or identification number05454
Number of Individuals Covered141
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $117,116
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 numberVARIOUS
Policy instance 3
Insurance contract or identification numberVARIOUS
Number of Individuals Covered105
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $486,255
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 numberVARIOUS
Policy instance 3
Insurance contract or identification numberVARIOUS
Number of Individuals Covered117
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $469,234
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 number8781
Policy instance 2
Insurance contract or identification number8781
Number of Individuals Covered126
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $126,001
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 numberVARIOUS
Policy instance 1
Insurance contract or identification numberVARIOUS
Number of Individuals Covered335
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,456,352
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 numberVARIOUS
Policy instance 1
Insurance contract or identification numberVARIOUS
Number of Individuals Covered380
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,821,551
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 number8781
Policy instance 2
Insurance contract or identification number8781
Number of Individuals Covered380
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $209,998
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 numberVARIOUS
Policy instance 1
Insurance contract or identification numberVARIOUS
Number of Individuals Covered425
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,223,318
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 number8781
Policy instance 2
Insurance contract or identification number8781
Number of Individuals Covered164
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $333,617
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 numberVARIOUS
Policy instance 1
Insurance contract or identification numberVARIOUS
Number of Individuals Covered203
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,544,458
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 number8781
Policy instance 2
Insurance contract or identification number8781
Number of Individuals Covered153
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $340,850
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 number8781
Policy instance 2
Insurance contract or identification number8781
Number of Individuals Covered160
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $238,487
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 numberVARIOUS
Policy instance 1
Insurance contract or identification numberVARIOUS
Number of Individuals Covered210
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,420,507
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 number8781
Policy instance 2
Insurance contract or identification number8781
Number of Individuals Covered168
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $272,538
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 numberVARIOUS
Policy instance 1
Insurance contract or identification numberVARIOUS
Number of Individuals Covered224
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,606,108
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 numberVARIOUS
Policy instance 1
Insurance contract or identification numberVARIOUS
Number of Individuals Covered265
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,484,591
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 number8781
Policy instance 2
Insurance contract or identification number8781
Number of Individuals Covered185
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $585,963
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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