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GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN 401k Plan overview

Plan NameGENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN
Plan identification number 566

GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN Benefits

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

401k Sponsoring company profile

GENERAL DYNAMICS CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:GENERAL DYNAMICS CORPORATION
Employer identification number (EIN):131673581
NAIC Classification:334200

Additional information about GENERAL DYNAMICS CORPORATION

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 0453929

More information about GENERAL DYNAMICS CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5662016-01-01JOHN OHRNBERGER
5662015-01-01JOHN OHRNBERGER
5662014-01-01JOHN OHRNBERGER
5662013-01-01HENRY EICKELBERG
5662012-01-01HENRY C. EICKELBERG
5662011-01-01HENRY C. EICKELBERG
5662010-01-01HENRY C. EICKELBERG
5662009-01-01HENRY C. EICKELBERG

Plan Statistics for GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN

401k plan membership statisitcs for GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN

Measure Date Value
2016: GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01411
Total number of active participants reported on line 7a of the Form 55002016-01-010
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-010
2015: GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01434
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-01224
Number of other retired or separated participants entitled to future benefits2015-01-01187
Total of all active and inactive participants2015-01-01411
2014: GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01594
Total number of active participants reported on line 7a of the Form 55002014-01-010
Number of retired or separated participants receiving benefits2014-01-01248
Number of other retired or separated participants entitled to future benefits2014-01-01159
Total of all active and inactive participants2014-01-01407
2013: GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01379
Total number of active participants reported on line 7a of the Form 55002013-01-010
Number of retired or separated participants receiving benefits2013-01-01299
Number of other retired or separated participants entitled to future benefits2013-01-0127
Total of all active and inactive participants2013-01-01326
2012: GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01366
Total number of active participants reported on line 7a of the Form 55002012-01-010
Number of retired or separated participants receiving benefits2012-01-01291
Number of other retired or separated participants entitled to future benefits2012-01-01114
Total of all active and inactive participants2012-01-01405
2011: GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01306
Total number of active participants reported on line 7a of the Form 55002011-01-010
Number of retired or separated participants receiving benefits2011-01-01255
Number of other retired or separated participants entitled to future benefits2011-01-0185
Total of all active and inactive participants2011-01-01340
2010: GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01281
Total number of active participants reported on line 7a of the Form 55002010-01-010
Number of retired or separated participants receiving benefits2010-01-01231
Number of other retired or separated participants entitled to future benefits2010-01-0175
Total of all active and inactive participants2010-01-01306
2009: GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01266
Total number of active participants reported on line 7a of the Form 55002009-01-010
Number of retired or separated participants receiving benefits2009-01-01218
Number of other retired or separated participants entitled to future benefits2009-01-0162
Total of all active and inactive participants2009-01-01280

Financial Data on GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN

Measure Date Value
2011 : GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$-377
Total unrealized appreciation/depreciation of assets2011-12-31$-377
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$995,748
Total income from all sources (including contributions)2011-12-31$1,848,789
Total loss/gain on sale of assets2011-12-31$-19,972
Total of all expenses incurred2011-12-31$2,272,389
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$2,076,717
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$1,198,111
Value of total assets at end of year2011-12-31$0
Value of total assets at beginning of year2011-12-31$1,419,348
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$195,672
Total interest from all sources2011-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$13,816
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Administrative expenses professional fees incurred2011-12-31$56,218
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$75,000,000
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$1,073,870
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$31,529
Other income not declared elsewhere2011-12-31$656,643
Administrative expenses (other) incurred2011-12-31$15,266
Liabilities. Value of operating payables at end of year2011-12-31$0
Liabilities. Value of operating payables at beginning of year2011-12-31$995,748
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-423,600
Value of net assets at end of year (total assets less liabilities)2011-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$423,600
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Investment advisory and management fees2011-12-31$7,795
Value of interest in common/collective trusts at end of year2011-12-31$0
Value of interest in common/collective trusts at beginning of year2011-12-31$275,954
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$10,101
Net investment gain or loss from common/collective trusts2011-12-31$568
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$124,241
Employer contributions (assets) at end of year2011-12-31$0
Employer contributions (assets) at beginning of year2011-12-31$459,736
Income. Dividends from common stock2011-12-31$13,816
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$2,066,616
Contract administrator fees2011-12-31$116,393
Assets. Corporate common stocks other than exployer securities at end of year2011-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2011-12-31$652,129
Did the plan have assets held for investment2011-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Aggregate proceeds on sale of assets2011-12-31$1,761,195
Aggregate carrying amount (costs) on sale of assets2011-12-31$1,781,167
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31KPMG LLP
Accountancy firm EIN2011-12-31135565207
2010 : GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$68,946
Total unrealized appreciation/depreciation of assets2010-12-31$68,946
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$995,748
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$1,510,973
Total income from all sources (including contributions)2010-12-31$1,736,011
Total loss/gain on sale of assets2010-12-31$-54,709
Total of all expenses incurred2010-12-31$2,127,767
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$1,943,386
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$1,699,815
Value of total assets at end of year2010-12-31$1,419,348
Value of total assets at beginning of year2010-12-31$2,326,329
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$184,381
Total interest from all sources2010-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$21,454
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Administrative expenses professional fees incurred2010-12-31$54,698
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$75,000,000
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$1,174,263
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$31,529
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$33,644
Administrative expenses (other) incurred2010-12-31$12,522
Liabilities. Value of operating payables at end of year2010-12-31$995,748
Liabilities. Value of operating payables at beginning of year2010-12-31$1,510,973
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-391,756
Value of net assets at end of year (total assets less liabilities)2010-12-31$423,600
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$815,356
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Investment advisory and management fees2010-12-31$6,012
Value of interest in common/collective trusts at end of year2010-12-31$275,954
Value of interest in common/collective trusts at beginning of year2010-12-31$241,147
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$9,011
Net investment gain or loss from common/collective trusts2010-12-31$505
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$525,552
Employer contributions (assets) at end of year2010-12-31$459,736
Employer contributions (assets) at beginning of year2010-12-31$7,000
Income. Dividends from common stock2010-12-31$21,454
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$1,934,375
Contract administrator fees2010-12-31$111,149
Assets. Corporate common stocks other than exployer securities at end of year2010-12-31$652,129
Assets. Corporate common stocks other than exployer securities at beginning of year2010-12-31$2,044,538
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$1,978,447
Aggregate carrying amount (costs) on sale of assets2010-12-31$2,033,156
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31KPMG LLP
Accountancy firm EIN2010-12-31135565207

Form 5500 Responses for GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN

2016: GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingYes
2016-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedYes
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: GENERAL DYNAMICS DECISION SYSTEMS, INC. POST-EMPLOYMENT HEALTH BENEFITS PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number104212
Policy instance 1
Insurance contract or identification number104212
Number of Individuals Covered453
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare 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 $1,689,912
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number104212
Policy instance 1
Insurance contract or identification number104212
Number of Individuals Covered471
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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 $2,029,689
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number104212
Policy instance 1
Insurance contract or identification number104212
Number of Individuals Covered831
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare 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 $2,545,945
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number3276
Policy instance 1
Insurance contract or identification number3276
Number of Individuals Covered1
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $4,344
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number104212
Policy instance 2
Insurance contract or identification number104212
Number of Individuals Covered879
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,993,706
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number12577-1
Policy instance 1
Insurance contract or identification number12577-1
Number of Individuals Covered2
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $10,101
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number12577-1
Policy instance 1
Insurance contract or identification number12577-1
Number of Individuals Covered5
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $19,898
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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