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NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 401k Plan overview

Plan NameNETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH
Plan identification number 501

NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH Benefits

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

401k Sponsoring company profile

NETWORK MEDICAL MANAGEMENT, INC. has sponsored the creation of one or more 401k plans.

Company Name:NETWORK MEDICAL MANAGEMENT, INC.
Employer identification number (EIN):954472349
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Additional information about NETWORK MEDICAL MANAGEMENT, INC.

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 3129845

More information about NETWORK MEDICAL MANAGEMENT, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012018-02-01THOMAS LAM2020-01-03
5012017-02-01THOMAS LAM2020-01-03
5012016-02-01THOMAS LAM2020-01-03
5012015-02-01THOMAS LAM2020-01-03
5012014-02-01THOMAS LAM2020-01-03 THOMAS LAM2020-01-03
5012013-02-01THOMAS LAM2020-01-03 THOMAS LAM2020-01-03
5012012-02-01THOMAS LAM2020-01-03 THOMAS LAM2020-01-03
5012011-02-01THOMAS LAM2020-01-03 THOMAS LAM2020-01-03
5012010-02-01THOMAS LAM2020-01-03 THOMAS LAM2020-01-03
5012009-02-01THOMAS LAM2020-01-03 THOMAS LAM2020-01-03
5012009-02-01THOMAS LAM2020-01-03 THOMAS LAM2020-01-03
5012008-02-01THOMAS LAM2020-01-03 THOMAS LAM2020-01-03

Plan Statistics for NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH

401k plan membership statisitcs for NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH

Measure Date Value
2018: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2018 401k membership
Total participants, beginning-of-year2018-02-01412
Total number of active participants reported on line 7a of the Form 55002018-02-01412
Total of all active and inactive participants2018-02-01412
Total participants2018-02-01412
2017: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2017 401k membership
Total participants, beginning-of-year2017-02-01308
Total number of active participants reported on line 7a of the Form 55002017-02-01308
Total of all active and inactive participants2017-02-01308
Total participants2017-02-01308
2016: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2016 401k membership
Total participants, beginning-of-year2016-02-01265
Total number of active participants reported on line 7a of the Form 55002016-02-01265
Total of all active and inactive participants2016-02-01265
Total participants2016-02-01265
2015: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2015 401k membership
Total participants, beginning-of-year2015-02-01236
Total number of active participants reported on line 7a of the Form 55002015-02-01236
Total of all active and inactive participants2015-02-01236
Total participants2015-02-01236
2014: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2014 401k membership
Total participants, beginning-of-year2014-02-01183
Total number of active participants reported on line 7a of the Form 55002014-02-01183
Total of all active and inactive participants2014-02-01183
Total participants2014-02-01183
2013: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2013 401k membership
Total participants, beginning-of-year2013-02-01102
Total number of active participants reported on line 7a of the Form 55002013-02-01102
Total of all active and inactive participants2013-02-01102
Total participants2013-02-01102
2012: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2012 401k membership
Total participants, beginning-of-year2012-02-01100
Total number of active participants reported on line 7a of the Form 55002012-02-01100
Total of all active and inactive participants2012-02-01100
Total participants2012-02-01100
2011: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2011 401k membership
Total participants, beginning-of-year2011-02-0194
Total number of active participants reported on line 7a of the Form 55002011-02-0194
Total of all active and inactive participants2011-02-0194
Total participants2011-02-0194
2010: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2010 401k membership
Total participants, beginning-of-year2010-02-0195
Total number of active participants reported on line 7a of the Form 55002010-02-0195
Total of all active and inactive participants2010-02-0195
Total participants2010-02-0195
2009: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2009 401k membership
Total participants, beginning-of-year2009-02-0183
Total number of active participants reported on line 7a of the Form 55002009-02-0183
Total of all active and inactive participants2009-02-0183
Total participants2009-02-0183
2008: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2008 401k membership
Total participants, beginning-of-year2008-02-0183
Total number of active participants reported on line 7a of the Form 55002008-02-0183
Total of all active and inactive participants2008-02-0183
Total participants2008-02-0183

Form 5500 Responses for NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH

2018: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2018 form 5500 responses
2018-02-01Type of plan entitySingle employer plan
2018-02-01First time form 5500 has been submittedYes
2018-02-01Submission has been amendedNo
2018-02-01This submission is the final filingNo
2018-02-01This return/report is a short plan year return/report (less than 12 months)No
2018-02-01Plan is a collectively bargained planNo
2018-02-01Plan funding arrangement – InsuranceYes
2018-02-01Plan funding arrangement – General assets of the sponsorYes
2018-02-01Plan benefit arrangement – InsuranceYes
2018-02-01Plan benefit arrangement – General assets of the sponsorYes
2017: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2017 form 5500 responses
2017-02-01Type of plan entitySingle employer plan
2017-02-01First time form 5500 has been submittedYes
2017-02-01Submission has been amendedNo
2017-02-01This submission is the final filingNo
2017-02-01This return/report is a short plan year return/report (less than 12 months)No
2017-02-01Plan is a collectively bargained planNo
2017-02-01Plan funding arrangement – InsuranceYes
2017-02-01Plan funding arrangement – General assets of the sponsorYes
2017-02-01Plan benefit arrangement – InsuranceYes
2017-02-01Plan benefit arrangement – General assets of the sponsorYes
2016: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2016 form 5500 responses
2016-02-01Type of plan entitySingle employer plan
2016-02-01First time form 5500 has been submittedYes
2016-02-01Submission has been amendedNo
2016-02-01This submission is the final filingNo
2016-02-01This return/report is a short plan year return/report (less than 12 months)No
2016-02-01Plan is a collectively bargained planNo
2016-02-01Plan funding arrangement – InsuranceYes
2016-02-01Plan funding arrangement – General assets of the sponsorYes
2016-02-01Plan benefit arrangement – InsuranceYes
2016-02-01Plan benefit arrangement – General assets of the sponsorYes
2015: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2015 form 5500 responses
2015-02-01Type of plan entitySingle employer plan
2015-02-01First time form 5500 has been submittedYes
2015-02-01Submission has been amendedNo
2015-02-01This submission is the final filingNo
2015-02-01This return/report is a short plan year return/report (less than 12 months)No
2015-02-01Plan is a collectively bargained planNo
2015-02-01Plan funding arrangement – InsuranceYes
2015-02-01Plan funding arrangement – General assets of the sponsorYes
2015-02-01Plan benefit arrangement – InsuranceYes
2015-02-01Plan benefit arrangement – General assets of the sponsorYes
2014: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2014 form 5500 responses
2014-02-01Type of plan entitySingle employer plan
2014-02-01First time form 5500 has been submittedYes
2014-02-01Submission has been amendedNo
2014-02-01This submission is the final filingNo
2014-02-01This return/report is a short plan year return/report (less than 12 months)No
2014-02-01Plan is a collectively bargained planNo
2014-02-01Plan funding arrangement – InsuranceYes
2014-02-01Plan funding arrangement – General assets of the sponsorYes
2014-02-01Plan benefit arrangement – InsuranceYes
2014-02-01Plan benefit arrangement – General assets of the sponsorYes
2013: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2013 form 5500 responses
2013-02-01Type of plan entitySingle employer plan
2013-02-01First time form 5500 has been submittedYes
2013-02-01Submission has been amendedNo
2013-02-01This submission is the final filingNo
2013-02-01This return/report is a short plan year return/report (less than 12 months)No
2013-02-01Plan is a collectively bargained planNo
2013-02-01Plan funding arrangement – InsuranceYes
2013-02-01Plan funding arrangement – General assets of the sponsorYes
2013-02-01Plan benefit arrangement – InsuranceYes
2013-02-01Plan benefit arrangement – General assets of the sponsorYes
2012: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2012 form 5500 responses
2012-02-01Type of plan entitySingle employer plan
2012-02-01First time form 5500 has been submittedYes
2012-02-01Submission has been amendedNo
2012-02-01This submission is the final filingNo
2012-02-01This return/report is a short plan year return/report (less than 12 months)No
2012-02-01Plan is a collectively bargained planNo
2012-02-01Plan funding arrangement – InsuranceYes
2012-02-01Plan funding arrangement – General assets of the sponsorYes
2012-02-01Plan benefit arrangement – InsuranceYes
2012-02-01Plan benefit arrangement – General assets of the sponsorYes
2011: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2011 form 5500 responses
2011-02-01Type of plan entitySingle employer plan
2011-02-01First time form 5500 has been submittedYes
2011-02-01Submission has been amendedNo
2011-02-01This submission is the final filingNo
2011-02-01This return/report is a short plan year return/report (less than 12 months)No
2011-02-01Plan is a collectively bargained planNo
2011-02-01Plan funding arrangement – InsuranceYes
2011-02-01Plan funding arrangement – General assets of the sponsorYes
2011-02-01Plan benefit arrangement – InsuranceYes
2011-02-01Plan benefit arrangement – General assets of the sponsorYes
2010: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2010 form 5500 responses
2010-02-01Type of plan entitySingle employer plan
2010-02-01First time form 5500 has been submittedYes
2010-02-01Submission has been amendedNo
2010-02-01This submission is the final filingNo
2010-02-01This return/report is a short plan year return/report (less than 12 months)No
2010-02-01Plan is a collectively bargained planNo
2010-02-01Plan funding arrangement – InsuranceYes
2010-02-01Plan funding arrangement – General assets of the sponsorYes
2010-02-01Plan benefit arrangement – InsuranceYes
2010-02-01Plan benefit arrangement – General assets of the sponsorYes
2009: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2009 form 5500 responses
2009-02-01Type of plan entitySingle employer plan
2009-02-01First time form 5500 has been submittedYes
2009-02-01Submission has been amendedNo
2009-02-01This submission is the final filingNo
2009-02-01This return/report is a short plan year return/report (less than 12 months)No
2009-02-01Plan is a collectively bargained planNo
2009-02-01Plan funding arrangement – InsuranceYes
2009-02-01Plan funding arrangement – General assets of the sponsorYes
2009-02-01Plan benefit arrangement – InsuranceYes
2009-02-01Plan benefit arrangement – General assets of the sponsorYes
2008: NETWORK MEDICAL MANAGEMENT INC WELFARE BENEFITS PLAN HEALTH 2008 form 5500 responses
2008-02-01Type of plan entitySingle employer plan
2008-02-01First time form 5500 has been submittedYes
2008-02-01Submission has been amendedNo
2008-02-01This submission is the final filingNo
2008-02-01This return/report is a short plan year return/report (less than 12 months)No
2008-02-01Plan is a collectively bargained planNo
2008-02-01Plan funding arrangement – InsuranceYes
2008-02-01Plan funding arrangement – General assets of the sponsorYes
2008-02-01Plan benefit arrangement – InsuranceYes
2008-02-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHEALTH HMO
Policy instance 1
Insurance contract or identification numberHEALTH HMO
Number of Individuals Covered236
Insurance policy start date2015-02-01
Insurance policy end date2016-01-31
Total amount of commissions paid to insurance brokerUSD $70,231
Total amount of fees paid to insurance companyUSD $31,569
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,363,211
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees64585
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $167,189
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHEALTH HMO
Policy instance 1
Insurance contract or identification numberHEALTH HMO
Number of Individuals Covered308
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $100,652
Total amount of fees paid to insurance companyUSD $45,504
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,965,436
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHEALTH HMO
Policy instance 1
Insurance contract or identification numberHEALTH HMO
Number of Individuals Covered183
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Total amount of commissions paid to insurance brokerUSD $35,087
Total amount of fees paid to insurance companyUSD $15,683
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $294,235
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,087
Insurance broker organization code?3
Amount paid for insurance broker fees15683
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHEALTH HMO
Policy instance 1
Insurance contract or identification numberHEALTH HMO
Number of Individuals Covered102
Insurance policy start date2013-02-01
Insurance policy end date2014-01-31
Total amount of commissions paid to insurance brokerUSD $26,258
Total amount of fees paid to insurance companyUSD $12,651
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $487,704
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees12651
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $26,258
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHEALTH HMO
Policy instance 1
Insurance contract or identification numberHEALTH HMO
Number of Individuals Covered100
Insurance policy start date2012-02-01
Insurance policy end date2013-01-31
Total amount of commissions paid to insurance brokerUSD $26,828
Total amount of fees paid to insurance companyUSD $9,884
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $491,602
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees9884
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $26,828
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHEALTH HMO
Policy instance 1
Insurance contract or identification numberHEALTH HMO
Number of Individuals Covered94
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Total amount of commissions paid to insurance brokerUSD $29,478
Total amount of fees paid to insurance companyUSD $11,131
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $464,045
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees11131
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $14,563
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHEALTH HMO
Policy instance 1
Insurance contract or identification numberHEALTH HMO
Number of Individuals Covered95
Insurance policy start date2010-02-01
Insurance policy end date2011-01-31
Total amount of commissions paid to insurance brokerUSD $26,410
Total amount of fees paid to insurance companyUSD $834
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $405,685
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees834
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $26,410
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHEALTH HMO
Policy instance 1
Insurance contract or identification numberHEALTH HMO
Number of Individuals Covered92
Insurance policy start date2009-02-01
Insurance policy end date2010-01-31
Total amount of commissions paid to insurance brokerUSD $23,551
Total amount of fees paid to insurance companyUSD $8,830
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $360,456
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees8830
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $23,551
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHEALTH HMO
Policy instance 1
Insurance contract or identification numberHEALTH HMO
Number of Individuals Covered83
Insurance policy start date2008-02-01
Insurance policy end date2009-01-31
Total amount of commissions paid to insurance brokerUSD $1,671
Total amount of fees paid to insurance companyUSD $624
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $24,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees624
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $1,671

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