THE RAND CORPORATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan RETIREE GROUP MEDICAL BENEFITS PLAN
Measure | Date | Value |
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2022 : RETIREE GROUP MEDICAL BENEFITS PLAN 2022 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2022-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $61,259 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $97,908 |
Total income from all sources (including contributions) | 2022-12-31 | $-3,411,632 |
Total loss/gain on sale of assets | 2022-12-31 | $0 |
Total of all expenses incurred | 2022-12-31 | $1,294,645 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $1,233,295 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-12-31 | $214,748 |
Value of total assets at end of year | 2022-12-31 | $24,007,783 |
Value of total assets at beginning of year | 2022-12-31 | $28,750,709 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $61,350 |
Total interest from all sources | 2022-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2022-12-31 | $513,701 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2022-12-31 | $513,701 |
Was this plan covered by a fidelity bond | 2022-12-31 | Yes |
Value of fidelity bond cover | 2022-12-31 | $10,000,000 |
Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
Contributions received from participants | 2022-12-31 | $214,748 |
Participant contributions at end of year | 2022-12-31 | $400,443 |
Participant contributions at beginning of year | 2022-12-31 | $17,404 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-12-31 | $0 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-12-31 | $0 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2022-12-31 | $0 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2022-12-31 | $57,487 |
Liabilities. Value of operating payables at end of year | 2022-12-31 | $61,259 |
Liabilities. Value of operating payables at beginning of year | 2022-12-31 | $40,421 |
Total non interest bearing cash at end of year | 2022-12-31 | $492,723 |
Total non interest bearing cash at beginning of year | 2022-12-31 | $344,624 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
Value of net income/loss | 2022-12-31 | $-4,706,277 |
Value of net assets at end of year (total assets less liabilities) | 2022-12-31 | $23,946,524 |
Value of net assets at beginning of year (total assets less liabilities) | 2022-12-31 | $28,652,801 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
Investment advisory and management fees | 2022-12-31 | $61,350 |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-12-31 | $23,114,617 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-12-31 | $28,388,681 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2022-12-31 | $157,270 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-12-31 | $-4,140,081 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2022-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
Employer contributions (assets) at end of year | 2022-12-31 | $0 |
Employer contributions (assets) at beginning of year | 2022-12-31 | $0 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-12-31 | $1,076,025 |
Did the plan have assets held for investment | 2022-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
Accountancy firm name | 2022-12-31 | GREEN HASSON & JANKS LLP |
Accountancy firm EIN | 2022-12-31 | 951777440 |
2021 : RETIREE GROUP MEDICAL BENEFITS PLAN 2021 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2021-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $97,908 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $35,323 |
Total income from all sources (including contributions) | 2021-12-31 | $3,200,172 |
Total loss/gain on sale of assets | 2021-12-31 | $0 |
Total of all expenses incurred | 2021-12-31 | $1,339,042 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $1,282,712 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-12-31 | $214,409 |
Value of total assets at end of year | 2021-12-31 | $28,750,709 |
Value of total assets at beginning of year | 2021-12-31 | $26,826,994 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $56,330 |
Total interest from all sources | 2021-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2021-12-31 | $739,286 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2021-12-31 | $739,286 |
Was this plan covered by a fidelity bond | 2021-12-31 | Yes |
Value of fidelity bond cover | 2021-12-31 | $10,000,000 |
Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
Contributions received from participants | 2021-12-31 | $214,409 |
Participant contributions at end of year | 2021-12-31 | $17,404 |
Participant contributions at beginning of year | 2021-12-31 | $21,900 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-12-31 | $0 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-12-31 | $0 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2021-12-31 | $57,487 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2021-12-31 | $0 |
Liabilities. Value of operating payables at end of year | 2021-12-31 | $40,421 |
Liabilities. Value of operating payables at beginning of year | 2021-12-31 | $35,323 |
Total non interest bearing cash at end of year | 2021-12-31 | $344,624 |
Total non interest bearing cash at beginning of year | 2021-12-31 | $501,574 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
Value of net income/loss | 2021-12-31 | $1,861,130 |
Value of net assets at end of year (total assets less liabilities) | 2021-12-31 | $28,652,801 |
Value of net assets at beginning of year (total assets less liabilities) | 2021-12-31 | $26,791,671 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2021-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
Investment advisory and management fees | 2021-12-31 | $56,330 |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-12-31 | $28,388,681 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-12-31 | $26,303,520 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2021-12-31 | $207,012 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2021-12-31 | $2,246,477 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2021-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
Employer contributions (assets) at end of year | 2021-12-31 | $0 |
Employer contributions (assets) at beginning of year | 2021-12-31 | $0 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-12-31 | $1,075,700 |
Did the plan have assets held for investment | 2021-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
Accountancy firm name | 2021-12-31 | GREEN HASSON & JANKS LLP |
Accountancy firm EIN | 2021-12-31 | 951777440 |
2020 : RETIREE GROUP MEDICAL BENEFITS PLAN 2020 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2020-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $35,323 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $39,730 |
Total income from all sources (including contributions) | 2020-12-31 | $3,126,596 |
Total loss/gain on sale of assets | 2020-12-31 | $0 |
Total of all expenses incurred | 2020-12-31 | $1,218,845 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $1,157,225 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-12-31 | $215,041 |
Value of total assets at end of year | 2020-12-31 | $26,826,994 |
Value of total assets at beginning of year | 2020-12-31 | $24,923,650 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $61,620 |
Total interest from all sources | 2020-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2020-12-31 | $488,473 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2020-12-31 | $488,473 |
Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
Value of fidelity bond cover | 2020-12-31 | $10,000,000 |
Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
Contributions received from participants | 2020-12-31 | $215,041 |
Participant contributions at end of year | 2020-12-31 | $21,900 |
Participant contributions at beginning of year | 2020-12-31 | $14,992 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-12-31 | $0 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-12-31 | $0 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2020-12-31 | $0 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-12-31 | $0 |
Liabilities. Value of operating payables at end of year | 2020-12-31 | $35,323 |
Liabilities. Value of operating payables at beginning of year | 2020-12-31 | $39,730 |
Total non interest bearing cash at end of year | 2020-12-31 | $501,574 |
Total non interest bearing cash at beginning of year | 2020-12-31 | $285,368 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
Value of net income/loss | 2020-12-31 | $1,907,751 |
Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $26,791,671 |
Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $24,883,920 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
Investment advisory and management fees | 2020-12-31 | $61,620 |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-12-31 | $26,303,520 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-12-31 | $24,623,290 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2020-12-31 | $185,598 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2020-12-31 | $2,423,082 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
Contributions received in cash from employer | 2020-12-31 | $0 |
Employer contributions (assets) at end of year | 2020-12-31 | $0 |
Employer contributions (assets) at beginning of year | 2020-12-31 | $0 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-12-31 | $971,627 |
Did the plan have assets held for investment | 2020-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Unqualified |
Accountancy firm name | 2020-12-31 | GREEN HASSON & JANKS LLP |
Accountancy firm EIN | 2020-12-31 | 951777440 |
2019 : RETIREE GROUP MEDICAL BENEFITS PLAN 2019 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2019-12-31 | $0 |
Total unrealized appreciation/depreciation of assets | 2019-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $39,730 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $39,730 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $-76 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $-76 |
Total income from all sources (including contributions) | 2019-12-31 | $4,532,195 |
Total income from all sources (including contributions) | 2019-12-31 | $4,532,195 |
Total loss/gain on sale of assets | 2019-12-31 | $0 |
Total loss/gain on sale of assets | 2019-12-31 | $0 |
Total of all expenses incurred | 2019-12-31 | $958,415 |
Total of all expenses incurred | 2019-12-31 | $958,415 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $896,583 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $896,583 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $478,559 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $478,559 |
Value of total assets at end of year | 2019-12-31 | $24,923,650 |
Value of total assets at end of year | 2019-12-31 | $24,923,650 |
Value of total assets at beginning of year | 2019-12-31 | $21,310,064 |
Value of total assets at beginning of year | 2019-12-31 | $21,310,064 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $61,832 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $61,832 |
Total interest from all sources | 2019-12-31 | $0 |
Total interest from all sources | 2019-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2019-12-31 | $631,323 |
Total dividends received (eg from common stock, registered investment company shares) | 2019-12-31 | $631,323 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2019-12-31 | $631,323 |
Total dividends received from registered investment company shares (eg mutual funds) | 2019-12-31 | $631,323 |
Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
Value of fidelity bond cover | 2019-12-31 | $1,000,000 |
Value of fidelity bond cover | 2019-12-31 | $1,000,000 |
Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
Contributions received from participants | 2019-12-31 | $165,093 |
Contributions received from participants | 2019-12-31 | $165,093 |
Participant contributions at end of year | 2019-12-31 | $14,992 |
Participant contributions at end of year | 2019-12-31 | $14,992 |
Participant contributions at beginning of year | 2019-12-31 | $27,680 |
Participant contributions at beginning of year | 2019-12-31 | $27,680 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-12-31 | $0 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-12-31 | $0 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $0 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $0 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2019-12-31 | $0 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2019-12-31 | $0 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2019-12-31 | $0 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2019-12-31 | $0 |
Other income not declared elsewhere | 2019-12-31 | $658 |
Liabilities. Value of operating payables at end of year | 2019-12-31 | $39,730 |
Liabilities. Value of operating payables at end of year | 2019-12-31 | $39,730 |
Liabilities. Value of operating payables at beginning of year | 2019-12-31 | $-76 |
Liabilities. Value of operating payables at beginning of year | 2019-12-31 | $-76 |
Total non interest bearing cash at end of year | 2019-12-31 | $285,368 |
Total non interest bearing cash at end of year | 2019-12-31 | $285,368 |
Total non interest bearing cash at beginning of year | 2019-12-31 | $286,799 |
Total non interest bearing cash at beginning of year | 2019-12-31 | $286,799 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
Value of net income/loss | 2019-12-31 | $3,573,780 |
Value of net income/loss | 2019-12-31 | $3,573,780 |
Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $24,883,920 |
Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $24,883,920 |
Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $21,310,140 |
Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $21,310,140 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
Investment advisory and management fees | 2019-12-31 | $61,832 |
Investment advisory and management fees | 2019-12-31 | $61,832 |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-12-31 | $24,623,290 |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-12-31 | $24,623,290 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-12-31 | $20,891,096 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-12-31 | $20,891,096 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $225,239 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $225,239 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2019-12-31 | $3,422,313 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2019-12-31 | $3,422,313 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | No |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
Contributions received in cash from employer | 2019-12-31 | $313,466 |
Contributions received in cash from employer | 2019-12-31 | $313,466 |
Employer contributions (assets) at end of year | 2019-12-31 | $0 |
Employer contributions (assets) at end of year | 2019-12-31 | $0 |
Employer contributions (assets) at beginning of year | 2019-12-31 | $104,489 |
Employer contributions (assets) at beginning of year | 2019-12-31 | $104,489 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $671,344 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $671,344 |
Did the plan have assets held for investment | 2019-12-31 | Yes |
Did the plan have assets held for investment | 2019-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Unqualified |
Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Unqualified |
Accountancy firm name | 2019-12-31 | GREEN HASSON & JANKS LLP |
Accountancy firm name | 2019-12-31 | GREEN HASSON & JANKS LLP |
Accountancy firm EIN | 2019-12-31 | 951777440 |
Accountancy firm EIN | 2019-12-31 | 951777440 |
2018 : RETIREE GROUP MEDICAL BENEFITS PLAN 2018 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2018-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $-76 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $2,657 |
Total income from all sources (including contributions) | 2018-12-31 | $-918,984 |
Total loss/gain on sale of assets | 2018-12-31 | $0 |
Total of all expenses incurred | 2018-12-31 | $788,809 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $748,788 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $668,151 |
Value of total assets at end of year | 2018-12-31 | $21,310,064 |
Value of total assets at beginning of year | 2018-12-31 | $23,020,590 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $40,021 |
Total interest from all sources | 2018-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2018-12-31 | $686,715 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2018-12-31 | $686,715 |
Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
Value of fidelity bond cover | 2018-12-31 | $10,000,000 |
Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
Contributions received from participants | 2018-12-31 | $192,984 |
Participant contributions at end of year | 2018-12-31 | $27,680 |
Participant contributions at beginning of year | 2018-12-31 | $0 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-12-31 | $0 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-12-31 | $0 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2018-12-31 | $0 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2018-12-31 | $438 |
Liabilities. Value of operating payables at end of year | 2018-12-31 | $-76 |
Liabilities. Value of operating payables at beginning of year | 2018-12-31 | $2,219 |
Total non interest bearing cash at end of year | 2018-12-31 | $286,799 |
Total non interest bearing cash at beginning of year | 2018-12-31 | $248,810 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
Value of net income/loss | 2018-12-31 | $-1,707,793 |
Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $21,310,140 |
Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $23,017,933 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
Investment advisory and management fees | 2018-12-31 | $40,021 |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2018-12-31 | $20,891,096 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2018-12-31 | $22,648,220 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $139,445 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2018-12-31 | $-2,273,850 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2018-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
Contributions received in cash from employer | 2018-12-31 | $475,167 |
Employer contributions (assets) at end of year | 2018-12-31 | $104,489 |
Employer contributions (assets) at beginning of year | 2018-12-31 | $123,560 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-12-31 | $609,343 |
Did the plan have assets held for investment | 2018-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Unqualified |
Accountancy firm name | 2018-12-31 | GREEN HASSON & JANKS LLP |
Accountancy firm EIN | 2018-12-31 | 951777440 |
2017 : RETIREE GROUP MEDICAL BENEFITS PLAN 2017 401k financial data |
---|
Total unrealized appreciation/depreciation of assets | 2017-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $2,657 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $487,730 |
Total income from all sources (including contributions) | 2017-12-31 | $4,865,416 |
Total loss/gain on sale of assets | 2017-12-31 | $0 |
Total of all expenses incurred | 2017-12-31 | $745,309 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $712,273 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $897,666 |
Value of total assets at end of year | 2017-12-31 | $23,020,590 |
Value of total assets at beginning of year | 2017-12-31 | $19,385,556 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $33,036 |
Total interest from all sources | 2017-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2017-12-31 | $578,763 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2017-12-31 | $578,763 |
Was this plan covered by a fidelity bond | 2017-12-31 | Yes |
Value of fidelity bond cover | 2017-12-31 | $2,000,000 |
Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
Contributions received from participants | 2017-12-31 | $104,335 |
Participant contributions at end of year | 2017-12-31 | $0 |
Participant contributions at beginning of year | 2017-12-31 | $58,285 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-12-31 | $0 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-12-31 | $0 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2017-12-31 | $438 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2017-12-31 | $453,849 |
Liabilities. Value of operating payables at end of year | 2017-12-31 | $2,219 |
Liabilities. Value of operating payables at beginning of year | 2017-12-31 | $33,881 |
Total non interest bearing cash at end of year | 2017-12-31 | $248,810 |
Total non interest bearing cash at beginning of year | 2017-12-31 | $205,696 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
Value of net income/loss | 2017-12-31 | $4,120,107 |
Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $23,017,933 |
Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $18,897,826 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
Investment advisory and management fees | 2017-12-31 | $33,036 |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2017-12-31 | $22,648,220 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2017-12-31 | $18,898,318 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $159,012 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2017-12-31 | $3,388,987 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2017-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
Contributions received in cash from employer | 2017-12-31 | $793,331 |
Employer contributions (assets) at end of year | 2017-12-31 | $123,560 |
Employer contributions (assets) at beginning of year | 2017-12-31 | $223,257 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-12-31 | $553,261 |
Did the plan have assets held for investment | 2017-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Unqualified |
Accountancy firm name | 2017-12-31 | GREEN HASSON & JANKS LLP |
Accountancy firm EIN | 2017-12-31 | 951777440 |
2016 : RETIREE GROUP MEDICAL BENEFITS PLAN 2016 401k financial data |
---|
Total unrealized appreciation/depreciation of assets | 2016-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $487,730 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $2,747 |
Total income from all sources (including contributions) | 2016-12-31 | $2,974,075 |
Total loss/gain on sale of assets | 2016-12-31 | $0 |
Total of all expenses incurred | 2016-12-31 | $1,200,398 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $1,175,028 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $1,622,880 |
Value of total assets at end of year | 2016-12-31 | $19,385,556 |
Value of total assets at beginning of year | 2016-12-31 | $17,126,896 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $25,370 |
Total interest from all sources | 2016-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2016-12-31 | $479,614 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2016-12-31 | $479,614 |
Was this plan covered by a fidelity bond | 2016-12-31 | Yes |
Value of fidelity bond cover | 2016-12-31 | $2,000,000 |
Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
Contributions received from participants | 2016-12-31 | $538,267 |
Participant contributions at end of year | 2016-12-31 | $58,285 |
Participant contributions at beginning of year | 2016-12-31 | $19,388 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-12-31 | $0 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-12-31 | $0 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2016-12-31 | $453,849 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2016-12-31 | $0 |
Liabilities. Value of operating payables at end of year | 2016-12-31 | $33,881 |
Liabilities. Value of operating payables at beginning of year | 2016-12-31 | $2,747 |
Total non interest bearing cash at end of year | 2016-12-31 | $205,696 |
Total non interest bearing cash at beginning of year | 2016-12-31 | $162,588 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
Value of net income/loss | 2016-12-31 | $1,773,677 |
Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $18,897,826 |
Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $17,124,149 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
Investment advisory and management fees | 2016-12-31 | $25,370 |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2016-12-31 | $18,898,318 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2016-12-31 | $16,657,801 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $445,140 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2016-12-31 | $871,581 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
Contributions received in cash from employer | 2016-12-31 | $1,084,613 |
Employer contributions (assets) at end of year | 2016-12-31 | $223,257 |
Employer contributions (assets) at beginning of year | 2016-12-31 | $287,119 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-12-31 | $729,888 |
Did the plan have assets held for investment | 2016-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Unqualified |
Accountancy firm name | 2016-12-31 | GREEN HASSON & JANKS LLP |
Accountancy firm EIN | 2016-12-31 | 951777440 |
2015 : RETIREE GROUP MEDICAL BENEFITS PLAN 2015 401k financial data |
---|
Total unrealized appreciation/depreciation of assets | 2015-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $2,747 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $2,107 |
Total income from all sources (including contributions) | 2015-12-31 | $1,276,413 |
Total loss/gain on sale of assets | 2015-12-31 | $0 |
Total of all expenses incurred | 2015-12-31 | $1,147,347 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $1,119,444 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-12-31 | $1,515,635 |
Value of total assets at end of year | 2015-12-31 | $17,126,896 |
Value of total assets at beginning of year | 2015-12-31 | $16,997,190 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $27,903 |
Total interest from all sources | 2015-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2015-12-31 | $615,071 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2015-12-31 | $615,071 |
Was this plan covered by a fidelity bond | 2015-12-31 | Yes |
Value of fidelity bond cover | 2015-12-31 | $2,000,000 |
Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
Contributions received from participants | 2015-12-31 | $510,298 |
Participant contributions at end of year | 2015-12-31 | $19,388 |
Participant contributions at beginning of year | 2015-12-31 | $15,065 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-12-31 | $0 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-12-31 | $0 |
Liabilities. Value of operating payables at end of year | 2015-12-31 | $2,747 |
Liabilities. Value of operating payables at beginning of year | 2015-12-31 | $2,107 |
Total non interest bearing cash at end of year | 2015-12-31 | $162,588 |
Total non interest bearing cash at beginning of year | 2015-12-31 | $118,606 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
Value of net income/loss | 2015-12-31 | $129,066 |
Value of net assets at end of year (total assets less liabilities) | 2015-12-31 | $17,124,149 |
Value of net assets at beginning of year (total assets less liabilities) | 2015-12-31 | $16,995,083 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
Investment advisory and management fees | 2015-12-31 | $27,903 |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2015-12-31 | $16,657,801 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2015-12-31 | $16,624,113 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2015-12-31 | $515,284 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2015-12-31 | $-854,293 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2015-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
Contributions received in cash from employer | 2015-12-31 | $1,005,337 |
Employer contributions (assets) at end of year | 2015-12-31 | $287,119 |
Employer contributions (assets) at beginning of year | 2015-12-31 | $239,406 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-12-31 | $604,160 |
Did the plan have assets held for investment | 2015-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2015-12-31 | Unqualified |
Accountancy firm name | 2015-12-31 | GREEN HASSON & JANKS LLP |
Accountancy firm EIN | 2015-12-31 | 951777440 |
2014 : RETIREE GROUP MEDICAL BENEFITS PLAN 2014 401k financial data |
---|
Total unrealized appreciation/depreciation of assets | 2014-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $2,107 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $2,107 |
Total income from all sources (including contributions) | 2014-12-31 | $2,125,471 |
Total loss/gain on sale of assets | 2014-12-31 | $0 |
Total of all expenses incurred | 2014-12-31 | $1,197,053 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $1,180,953 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-12-31 | $1,591,078 |
Value of total assets at end of year | 2014-12-31 | $16,997,190 |
Value of total assets at beginning of year | 2014-12-31 | $16,068,772 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $16,100 |
Total interest from all sources | 2014-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2014-12-31 | $550,260 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2014-12-31 | $550,260 |
Was this plan covered by a fidelity bond | 2014-12-31 | Yes |
Value of fidelity bond cover | 2014-12-31 | $2,000,000 |
Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
Contributions received from participants | 2014-12-31 | $572,839 |
Participant contributions at end of year | 2014-12-31 | $15,065 |
Participant contributions at beginning of year | 2014-12-31 | $12,586 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-12-31 | $0 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-12-31 | $0 |
Liabilities. Value of operating payables at end of year | 2014-12-31 | $2,107 |
Liabilities. Value of operating payables at beginning of year | 2014-12-31 | $2,107 |
Total non interest bearing cash at end of year | 2014-12-31 | $118,606 |
Total non interest bearing cash at beginning of year | 2014-12-31 | $563,981 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
Value of net income/loss | 2014-12-31 | $928,418 |
Value of net assets at end of year (total assets less liabilities) | 2014-12-31 | $16,995,083 |
Value of net assets at beginning of year (total assets less liabilities) | 2014-12-31 | $16,066,665 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
Investment advisory and management fees | 2014-12-31 | $16,100 |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2014-12-31 | $16,624,113 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2014-12-31 | $15,232,594 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2014-12-31 | $545,495 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2014-12-31 | $-15,867 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2014-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
Contributions received in cash from employer | 2014-12-31 | $1,018,239 |
Employer contributions (assets) at end of year | 2014-12-31 | $239,406 |
Employer contributions (assets) at beginning of year | 2014-12-31 | $259,611 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-12-31 | $635,458 |
Did the plan have assets held for investment | 2014-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2014-12-31 | Unqualified |
Accountancy firm name | 2014-12-31 | GREEN HASSON & JANKS LLP |
Accountancy firm EIN | 2014-12-31 | 951777440 |
2013 : RETIREE GROUP MEDICAL BENEFITS PLAN 2013 401k financial data |
---|
Total unrealized appreciation/depreciation of assets | 2013-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $2,107 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $6,200 |
Total income from all sources (including contributions) | 2013-12-31 | $3,999,805 |
Total loss/gain on sale of assets | 2013-12-31 | $0 |
Total of all expenses incurred | 2013-12-31 | $1,113,670 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $1,099,876 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-12-31 | $1,739,260 |
Value of total assets at end of year | 2013-12-31 | $16,068,772 |
Value of total assets at beginning of year | 2013-12-31 | $13,186,730 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $13,794 |
Total interest from all sources | 2013-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2013-12-31 | $382,571 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2013-12-31 | $382,571 |
Was this plan covered by a fidelity bond | 2013-12-31 | Yes |
Value of fidelity bond cover | 2013-12-31 | $2,000,000 |
Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
Contributions received from participants | 2013-12-31 | $594,330 |
Participant contributions at end of year | 2013-12-31 | $12,586 |
Participant contributions at beginning of year | 2013-12-31 | $4,004 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-12-31 | $0 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-12-31 | $1,614,632 |
Liabilities. Value of operating payables at end of year | 2013-12-31 | $2,107 |
Liabilities. Value of operating payables at beginning of year | 2013-12-31 | $6,200 |
Total non interest bearing cash at end of year | 2013-12-31 | $563,981 |
Total non interest bearing cash at beginning of year | 2013-12-31 | $121,744 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
Value of net income/loss | 2013-12-31 | $2,886,135 |
Value of net assets at end of year (total assets less liabilities) | 2013-12-31 | $16,066,665 |
Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $13,180,530 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
Investment advisory and management fees | 2013-12-31 | $13,794 |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2013-12-31 | $15,232,594 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2013-12-31 | $11,151,244 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2013-12-31 | $509,907 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2013-12-31 | $1,877,974 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2013-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
Contributions received in cash from employer | 2013-12-31 | $1,144,930 |
Employer contributions (assets) at end of year | 2013-12-31 | $259,611 |
Employer contributions (assets) at beginning of year | 2013-12-31 | $295,106 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-12-31 | $589,969 |
Did the plan have assets held for investment | 2013-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2013-12-31 | Unqualified |
Accountancy firm name | 2013-12-31 | GREEN HASSON & JANKS LLP |
Accountancy firm EIN | 2013-12-31 | 951777440 |
2012 : RETIREE GROUP MEDICAL BENEFITS PLAN 2012 401k financial data |
---|
Total unrealized appreciation/depreciation of assets | 2012-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $6,200 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $2,107 |
Total income from all sources (including contributions) | 2012-12-31 | $3,533,529 |
Total loss/gain on sale of assets | 2012-12-31 | $0 |
Total of all expenses incurred | 2012-12-31 | $1,123,542 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $1,111,004 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $2,147,061 |
Value of total assets at end of year | 2012-12-31 | $13,186,730 |
Value of total assets at beginning of year | 2012-12-31 | $10,772,650 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $12,538 |
Total interest from all sources | 2012-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2012-12-31 | $332,530 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2012-12-31 | $332,530 |
Was this plan covered by a fidelity bond | 2012-12-31 | Yes |
Value of fidelity bond cover | 2012-12-31 | $2,000,000 |
Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
Contributions received from participants | 2012-12-31 | $500,173 |
Participant contributions at end of year | 2012-12-31 | $4,004 |
Participant contributions at beginning of year | 2012-12-31 | $49,193 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-12-31 | $1,614,632 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-12-31 | $622,225 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2012-12-31 | $2,107 |
Liabilities. Value of operating payables at end of year | 2012-12-31 | $6,200 |
Total non interest bearing cash at end of year | 2012-12-31 | $121,744 |
Total non interest bearing cash at beginning of year | 2012-12-31 | $203,506 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
Value of net income/loss | 2012-12-31 | $2,409,987 |
Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $13,180,530 |
Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $10,770,543 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
Investment advisory and management fees | 2012-12-31 | $12,538 |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2012-12-31 | $11,151,244 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2012-12-31 | $9,447,132 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2012-12-31 | $499,004 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2012-12-31 | $1,053,938 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
Contributions received in cash from employer | 2012-12-31 | $1,646,888 |
Employer contributions (assets) at end of year | 2012-12-31 | $295,106 |
Employer contributions (assets) at beginning of year | 2012-12-31 | $450,594 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $612,000 |
Did the plan have assets held for investment | 2012-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Unqualified |
Accountancy firm name | 2012-12-31 | GREEN HASSON & JANKS LLP |
Accountancy firm EIN | 2012-12-31 | 951777440 |
2011 : RETIREE GROUP MEDICAL BENEFITS PLAN 2011 401k financial data |
---|
Total unrealized appreciation/depreciation of assets | 2011-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $2,107 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $2,248 |
Total income from all sources (including contributions) | 2011-12-31 | $2,149,650 |
Total loss/gain on sale of assets | 2011-12-31 | $0 |
Total of all expenses incurred | 2011-12-31 | $1,186,011 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $1,171,914 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $2,162,323 |
Value of total assets at end of year | 2011-12-31 | $10,772,650 |
Value of total assets at beginning of year | 2011-12-31 | $9,809,152 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $14,097 |
Total interest from all sources | 2011-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2011-12-31 | $253,359 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2011-12-31 | $253,359 |
Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
Value of fidelity bond cover | 2011-12-31 | $2,000,000 |
Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
Contributions received from participants | 2011-12-31 | $527,149 |
Participant contributions at end of year | 2011-12-31 | $49,193 |
Participant contributions at beginning of year | 2011-12-31 | $48,874 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-12-31 | $622,225 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2011-12-31 | $2,107 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2011-12-31 | $2,248 |
Total non interest bearing cash at end of year | 2011-12-31 | $203,506 |
Total non interest bearing cash at beginning of year | 2011-12-31 | $143,232 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
Value of net income/loss | 2011-12-31 | $963,639 |
Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $10,770,543 |
Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $9,806,904 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
Investment advisory and management fees | 2011-12-31 | $14,097 |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2011-12-31 | $9,447,132 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2011-12-31 | $9,222,186 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2011-12-31 | $545,294 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2011-12-31 | $-266,032 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
Contributions received in cash from employer | 2011-12-31 | $1,635,174 |
Employer contributions (assets) at end of year | 2011-12-31 | $450,594 |
Employer contributions (assets) at beginning of year | 2011-12-31 | $394,860 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $626,620 |
Did the plan have assets held for investment | 2011-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Unqualified |
Accountancy firm name | 2011-12-31 | GREEN HASSON & JANKS LLP |
Accountancy firm EIN | 2011-12-31 | 951777440 |
2010 : RETIREE GROUP MEDICAL BENEFITS PLAN 2010 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2010-12-31 | $684,647 |
Total unrealized appreciation/depreciation of assets | 2010-12-31 | $684,647 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $2,248 |
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 | $2,790,488 |
Total loss/gain on sale of assets | 2010-12-31 | $0 |
Total of all expenses incurred | 2010-12-31 | $1,094,820 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $1,082,362 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $1,886,980 |
Value of total assets at end of year | 2010-12-31 | $9,809,152 |
Value of total assets at beginning of year | 2010-12-31 | $8,111,236 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $12,458 |
Total interest from all sources | 2010-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2010-12-31 | $218,861 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2010-12-31 | $218,861 |
Was this plan covered by a fidelity bond | 2010-12-31 | Yes |
Value of fidelity bond cover | 2010-12-31 | $2,000,000 |
Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
Contributions received from participants | 2010-12-31 | $520,221 |
Participant contributions at end of year | 2010-12-31 | $48,874 |
Participant contributions at beginning of year | 2010-12-31 | $47,568 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2010-12-31 | $2,248 |
Administrative expenses (other) incurred | 2010-12-31 | $12,458 |
Total non interest bearing cash at end of year | 2010-12-31 | $143,232 |
Total non interest bearing cash at beginning of year | 2010-12-31 | $85,440 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
Value of net income/loss | 2010-12-31 | $1,695,668 |
Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $9,806,904 |
Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $8,111,236 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2010-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2010-12-31 | $9,222,186 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2010-12-31 | $7,654,262 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2010-12-31 | $472,552 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
Contributions received in cash from employer | 2010-12-31 | $1,366,759 |
Employer contributions (assets) at end of year | 2010-12-31 | $394,860 |
Employer contributions (assets) at beginning of year | 2010-12-31 | $323,966 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2010-12-31 | $609,810 |
Did the plan have assets held for investment | 2010-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Unqualified |
Accountancy firm name | 2010-12-31 | GREEN HASSON & JANKS LLP |
Accountancy firm EIN | 2010-12-31 | 951777440 |
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 0072727-0 |
Policy instance | 3 |
Insurance contract or identification number | 0072727-0 | Number of Individuals Covered | 4 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $286 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $4,769 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 286 | Additional information about fees paid to insurance broker | SERVICE FEE | Insurance broker organization code? | 4 |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 101555-001 |
Policy instance | 2 |
Insurance contract or identification number | 101555-001 | Number of Individuals Covered | 7 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $708 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $52,098 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $708 | Insurance broker organization code? | 4 |
|
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 ) |
Policy contract number | 8087 |
Policy instance | 1 |
Insurance contract or identification number | 8087 | Number of Individuals Covered | 2 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $246 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $11,441 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $246 | Insurance broker organization code? | 4 |
|
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 ) |
Policy contract number | 8087 |
Policy instance | 1 |
Insurance contract or identification number | 8087 | Number of Individuals Covered | 4 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $328 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $23,135 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $328 | Insurance broker organization code? | 4 |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 101555-003 |
Policy instance | 2 |
Insurance contract or identification number | 101555-003 | Number of Individuals Covered | 11 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $1,170 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $85,742 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,170 | Insurance broker organization code? | 4 |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | C21787 |
Policy instance | 3 |
Insurance contract or identification number | C21787 | Number of Individuals Covered | 6 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | C21787 |
Policy instance | 3 |
Insurance contract or identification number | C21787 | Number of Individuals Covered | 9 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $4,643 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 ) |
Policy contract number | 8087 |
Policy instance | 1 |
Insurance contract or identification number | 8087 | Number of Individuals Covered | 2 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $390 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $11,845 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $390 | Insurance broker organization code? | 4 |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 101555-003 |
Policy instance | 2 |
Insurance contract or identification number | 101555-003 | Number of Individuals Covered | 20 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $1,803 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $110,662 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,803 | Insurance broker organization code? | 4 |
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ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | C21787 |
Policy instance | 3 |
Insurance contract or identification number | C21787 | Number of Individuals Covered | 5 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $2,629 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 101555-001 |
Policy instance | 2 |
Insurance contract or identification number | 101555-001 | Number of Individuals Covered | 20 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $1,586 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $115,696 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,586 | Insurance broker organization code? | 4 |
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KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 ) |
Policy contract number | 8087 |
Policy instance | 1 |
Insurance contract or identification number | 8087 | Number of Individuals Covered | 3 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $588 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $15,284 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $588 | Insurance broker organization code? | 4 |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 101555-001 |
Policy instance | 2 |
Insurance contract or identification number | 101555-001 | Number of Individuals Covered | 22 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $3,089 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $118,689 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,089 | Insurance broker organization code? | 4 |
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KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 ) |
Policy contract number | 8087 |
Policy instance | 1 |
Insurance contract or identification number | 8087 | Number of Individuals Covered | 5 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $973 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $29,791 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $973 | Insurance broker organization code? | 4 |
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ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | C21787 |
Policy instance | 3 |
Insurance contract or identification number | C21787 | Number of Individuals Covered | 11 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $4,613 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 101555-001 |
Policy instance | 2 |
Insurance contract or identification number | 101555-001 | Number of Individuals Covered | 12 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,550 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $59,514 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,550 | Insurance broker organization code? | 4 | Insurance broker name | TOWERS WATSON DELAWARE INC. |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 67575-0 |
Policy instance | 3 |
Insurance contract or identification number | 67575-0 | Number of Individuals Covered | 10 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $217 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $4,340 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 217 | Additional information about fees paid to insurance broker | SERVICE FEE | Insurance broker organization code? | 4 | Insurance broker name | TOWERS WATSON DELAWARE INC. |
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KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 ) |
Policy contract number | 8087 |
Policy instance | 1 |
Insurance contract or identification number | 8087 | Number of Individuals Covered | 2 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $388 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $10,060 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $388 | Insurance broker organization code? | 4 | Insurance broker name | TOWERS WATSON DELAWARE INC. |
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KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 ) |
Policy contract number | 8087 |
Policy instance | 1 |
Insurance contract or identification number | 8087 | Number of Individuals Covered | 22 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $3,097 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $88,809 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,097 | Insurance broker organization code? | 4 | Insurance broker name | TOWERS WATSON DELAWARE INC. |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 101555-001 |
Policy instance | 2 |
Insurance contract or identification number | 101555-001 | Number of Individuals Covered | 112 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $10,294 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $452,489 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,294 | Insurance broker organization code? | 4 | Insurance broker name | TOWERS WATSON DELAWARE INC. |
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ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | C21787 |
Policy instance | 3 |
Insurance contract or identification number | C21787 | Number of Individuals Covered | 102 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 67575-0 |
Policy instance | 4 |
Insurance contract or identification number | 67575-0 | Number of Individuals Covered | 102 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $1,194 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $23,872 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1194 | Additional information about fees paid to insurance broker | SERVICE FEE | Insurance broker organization code? | 4 | Insurance broker name | TOWERS WATSON DELAWARE INC. |
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ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | C21787 |
Policy instance | 3 |
Insurance contract or identification number | C21787 | Number of Individuals Covered | 106 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 101555-001 |
Policy instance | 2 |
Insurance contract or identification number | 101555-001 | Number of Individuals Covered | 119 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $5,566 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $310,078 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,566 | Insurance broker organization code? | 4 | Insurance broker name | TOWERS WATSON DELAWARE INC. |
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KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 ) |
Policy contract number | 8087 |
Policy instance | 1 |
Insurance contract or identification number | 8087 | Number of Individuals Covered | 23 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $1,743 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $96,797 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,743 | Insurance broker organization code? | 4 | Insurance broker name | TOWERS WATSON DELAWARE INC. |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 67575-0 |
Policy instance | 4 |
Insurance contract or identification number | 67575-0 | Number of Individuals Covered | 106 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $2,341 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $46,813 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 2341 | Additional information about fees paid to insurance broker | SERVICE FEE | Insurance broker organization code? | 4 | Insurance broker name | TOWERS WATSON DELAWARE INC. |
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ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | C21787 |
Policy instance | 3 |
Insurance contract or identification number | C21787 | Number of Individuals Covered | 89 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 ) |
Policy contract number | 8087 |
Policy instance | 1 |
Insurance contract or identification number | 8087 | Number of Individuals Covered | 18 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $1,335 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $67,837 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,335 | Insurance broker organization code? | 4 | Insurance broker name | TOWERS WATSON DELAWARE INC. |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 101555-001 |
Policy instance | 2 |
Insurance contract or identification number | 101555-001 | Number of Individuals Covered | 119 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $4,532 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $302,232 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,532 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 4 | Insurance broker name | TOWERS WATSON DELAWARE INC. |
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
Policy contract number | 67575-0 |
Policy instance | 4 |
Insurance contract or identification number | 67575-0 | Number of Individuals Covered | 89 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $1,704 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $87,794 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 1704 | Additional information about fees paid to insurance broker | SERVICE FEE | Insurance broker organization code? | 3 | Insurance broker name | TOWERS WATSON DELAWARE INC. |
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BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | C24661 |
Policy instance | 1 |
Insurance contract or identification number | C24661 | Number of Individuals Covered | 4 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,803 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 101555-001 |
Policy instance | 3 |
Insurance contract or identification number | 101555-001 | Number of Individuals Covered | 114 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $5,691 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $288,662 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,691 | Insurance broker organization code? | 4 | Insurance broker name | TOWERS WATSON DELAWARE INC. |
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KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 ) |
Policy contract number | 8087 |
Policy instance | 2 |
Insurance contract or identification number | 8087 | Number of Individuals Covered | 1 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 ) |
Policy contract number | 8087-12,13 |
Policy instance | 3 |
Insurance contract or identification number | 8087-12,13 | Number of Individuals Covered | 3 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $428 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $29,353 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | C24661 |
Policy instance | 1 |
Insurance contract or identification number | C24661 | Number of Individuals Covered | 4 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $17,127 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 101555-0001 |
Policy instance | 2 |
Insurance contract or identification number | 101555-0001 | Number of Individuals Covered | 100 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $1,761 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $231,733 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 ) |
Policy contract number | 8087-9,12,13 |
Policy instance | 3 |
Insurance contract or identification number | 8087-9,12,13 | Number of Individuals Covered | 27 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $230 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $91,321 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 101555-0001 |
Policy instance | 2 |
Insurance contract or identification number | 101555-0001 | Number of Individuals Covered | 100 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $3,316 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $238,810 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | C24661 |
Policy instance | 1 |
Insurance contract or identification number | C24661 | Number of Individuals Covered | 0 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,049 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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