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LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 401k Plan overview

Plan NameLVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN
Plan identification number 506

LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision
  • Other welfare benefit cover

401k Sponsoring company profile

LVMH MOET HENNESSY LOUIS VUITTON, INC. has sponsored the creation of one or more 401k plans.

Company Name:LVMH MOET HENNESSY LOUIS VUITTON, INC.
Employer identification number (EIN):135371790
NAIC Classification:424800

Additional information about LVMH MOET HENNESSY LOUIS VUITTON, INC.

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 0905410

More information about LVMH MOET HENNESSY LOUIS VUITTON, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5062019-01-01PASCAL CARPENTIER2020-09-24
5062018-01-01PASCAL CARPENTIER2019-10-09
5062017-01-01
5062017-01-01
5062016-01-01
5062015-01-01
5062011-01-01PASCAL CARPENTIER
5062010-01-01PASCAL CARPENTIER PASCAL CARPENTIER2011-10-14
5062009-01-01PASCAL CARPENTIER PASCAL CARPENTIER2010-10-15
5062009-01-01PASCAL CARPENTIER PASCAL CARPENTIER2010-10-15

Plan Statistics for LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN

401k plan membership statisitcs for LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN

Measure Date Value
2019: LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-016,046
Total number of active participants reported on line 7a of the Form 55002019-01-016,053
Number of retired or separated participants receiving benefits2019-01-0167
Total of all active and inactive participants2019-01-016,120
2018: LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-015,029
Total number of active participants reported on line 7a of the Form 55002018-01-015,975
Number of retired or separated participants receiving benefits2018-01-0171
Total of all active and inactive participants2018-01-016,046
2017: LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-015,332
Total number of active participants reported on line 7a of the Form 55002017-01-014,957
Number of retired or separated participants receiving benefits2017-01-0172
Total of all active and inactive participants2017-01-015,029
2016: LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-015,424
Total number of active participants reported on line 7a of the Form 55002016-01-015,273
Number of retired or separated participants receiving benefits2016-01-0159
Total of all active and inactive participants2016-01-015,332
2015: LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-014,784
Total number of active participants reported on line 7a of the Form 55002015-01-015,348
Number of retired or separated participants receiving benefits2015-01-0176
Total of all active and inactive participants2015-01-015,424
2011: LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-014,559
Total number of active participants reported on line 7a of the Form 55002011-01-014,705
Number of retired or separated participants receiving benefits2011-01-0182
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-014,787
2010: LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-014,359
Total number of active participants reported on line 7a of the Form 55002010-01-014,559
Total of all active and inactive participants2010-01-014,559
Total participants2010-01-014,559
2009: LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-014,695
Total number of active participants reported on line 7a of the Form 55002009-01-014,359
Total of all active and inactive participants2009-01-014,359
Total participants2009-01-014,359

Financial Data on LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN

Measure Date Value
2019 : LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$5,223,044
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$5,121,153
Total income from all sources (including contributions)2019-12-31$81,176,668
Total of all expenses incurred2019-12-31$73,239,566
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$68,206,869
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$76,422,847
Value of total assets at end of year2019-12-31$42,566,578
Value of total assets at beginning of year2019-12-31$34,527,585
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$5,032,697
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Administrative expenses professional fees incurred2019-12-31$382,599
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$851,295
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$60,384,808
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$42,566,578
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$34,527,585
Other income not declared elsewhere2019-12-31$4,753,821
Administrative expenses (other) incurred2019-12-31$1,636,494
Liabilities. Value of operating payables at end of year2019-12-31$64,772
Liabilities. Value of operating payables at beginning of year2019-12-31$73,157
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$7,937,102
Value of net assets at end of year (total assets less liabilities)2019-12-31$37,343,534
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$29,406,432
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$7,690,904
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$75,571,552
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$131,157
Contract administrator fees2019-12-31$3,013,604
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31No
Liabilities. Value of benefit claims payable at end of year2019-12-31$5,158,272
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$5,047,996
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31BUCHBINDER TUNICK & CO. LLP
Accountancy firm EIN2019-12-31131578842
2018 : LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$5,121,153
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$4,811,209
Total income from all sources (including contributions)2018-12-31$74,078,463
Total of all expenses incurred2018-12-31$66,906,312
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$62,554,950
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$70,070,666
Value of total assets at end of year2018-12-31$34,527,585
Value of total assets at beginning of year2018-12-31$27,045,490
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$4,351,362
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Administrative expenses professional fees incurred2018-12-31$358,698
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$1,157,932
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$55,010,523
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$34,527,585
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$27,045,490
Other income not declared elsewhere2018-12-31$4,007,797
Administrative expenses (other) incurred2018-12-31$1,151,670
Liabilities. Value of operating payables at end of year2018-12-31$73,157
Liabilities. Value of operating payables at beginning of year2018-12-31$19,054
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$7,172,151
Value of net assets at end of year (total assets less liabilities)2018-12-31$29,406,432
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$22,234,281
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$7,375,854
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$68,912,734
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$168,573
Contract administrator fees2018-12-31$2,840,994
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Liabilities. Value of benefit claims payable at end of year2018-12-31$5,047,996
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$4,792,155
Did the plan have assets held for investment2018-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31BUCHBINDER TUNICK & CO. LLP
Accountancy firm EIN2018-12-31131578842
2017 : LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$4,811,209
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$5,452,029
Total income from all sources (including contributions)2017-12-31$75,370,873
Total of all expenses incurred2017-12-31$62,555,311
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$58,047,812
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$70,393,853
Value of total assets at end of year2017-12-31$26,815,120
Value of total assets at beginning of year2017-12-31$14,640,378
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$4,507,499
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Administrative expenses professional fees incurred2017-12-31$617,415
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$1,255,021
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-12-31$50,931,463
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$26,815,120
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$14,640,378
Other income not declared elsewhere2017-12-31$4,977,020
Administrative expenses (other) incurred2017-12-31$1,012,449
Liabilities. Value of operating payables at end of year2017-12-31$19,054
Liabilities. Value of operating payables at beginning of year2017-12-31$289,245
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$12,815,562
Value of net assets at end of year (total assets less liabilities)2017-12-31$22,003,911
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$9,188,349
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$6,955,781
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$69,138,832
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$160,568
Contract administrator fees2017-12-31$2,877,635
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Liabilities. Value of benefit claims payable at end of year2017-12-31$4,792,155
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$5,162,784
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31BUCHBINDER TUNICK & CO. LLP
Accountancy firm EIN2017-12-31131578842
2016 : LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$5,452,029
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$5,753,646
Total income from all sources (including contributions)2016-12-31$78,243,635
Total of all expenses incurred2016-12-31$68,658,537
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$63,950,055
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$75,271,280
Value of total assets at end of year2016-12-31$14,640,378
Value of total assets at beginning of year2016-12-31$5,356,897
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$4,708,482
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$575,726
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$890,046
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-12-31$56,705,605
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$14,640,378
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$5,356,897
Other income not declared elsewhere2016-12-31$2,972,355
Administrative expenses (other) incurred2016-12-31$1,040,372
Liabilities. Value of operating payables at end of year2016-12-31$289,245
Liabilities. Value of operating payables at beginning of year2016-12-31$375,257
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$9,585,098
Value of net assets at end of year (total assets less liabilities)2016-12-31$9,188,349
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$-396,749
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$7,098,197
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$74,381,234
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$146,253
Contract administrator fees2016-12-31$3,092,384
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Liabilities. Value of benefit claims payable at end of year2016-12-31$5,162,784
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$5,378,389
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31BUCHBINDER TUNICK & CO. LLP
Accountancy firm EIN2016-12-31131578842
2015 : LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$5,753,646
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$4,875,339
Total income from all sources (including contributions)2015-12-31$67,177,788
Total of all expenses incurred2015-12-31$69,746,318
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$65,285,331
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$66,127,223
Value of total assets at end of year2015-12-31$5,356,897
Value of total assets at beginning of year2015-12-31$7,047,120
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$4,460,987
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$355,409
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$691,777
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-12-31$58,803,276
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$5,356,897
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$7,047,120
Other income not declared elsewhere2015-12-31$1,050,565
Administrative expenses (other) incurred2015-12-31$1,006,959
Liabilities. Value of operating payables at end of year2015-12-31$375,257
Liabilities. Value of operating payables at beginning of year2015-12-31$376,770
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-2,568,530
Value of net assets at end of year (total assets less liabilities)2015-12-31$-396,749
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$2,171,781
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$6,332,301
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$65,435,446
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$149,754
Contract administrator fees2015-12-31$3,098,619
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
Liabilities. Value of benefit claims payable at end of year2015-12-31$5,378,389
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$4,498,569
Did the plan have assets held for investment2015-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31BUCHBINDER TUNICK & CO LLP
Accountancy firm EIN2015-12-31131578842
2011 : LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$3,106,400
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$3,017,231
Total income from all sources (including contributions)2011-12-31$44,509,703
Total of all expenses incurred2011-12-31$38,297,434
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$35,646,141
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$43,152,989
Value of total assets at end of year2011-12-31$10,815,536
Value of total assets at beginning of year2011-12-31$4,514,098
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$2,651,293
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$234,691
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$761,887
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-12-31$31,058,932
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$10,815,536
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$4,514,098
Other income not declared elsewhere2011-12-31$1,356,714
Administrative expenses (other) incurred2011-12-31$559,457
Liabilities. Value of operating payables at end of year2011-12-31$19,400
Liabilities. Value of operating payables at beginning of year2011-12-31$31,231
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$6,212,269
Value of net assets at end of year (total assets less liabilities)2011-12-31$7,709,136
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$1,496,867
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
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$4,426,155
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
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$42,391,102
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$161,054
Contract administrator fees2011-12-31$1,857,145
Liabilities. Value of benefit claims payable at end of year2011-12-31$3,087,000
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$2,986,000
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
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31BUCHBINDER TUNICK & CO. LLP
Accountancy firm EIN2011-12-31131578842
2010 : LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2010 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$3,017,231
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$2,742,885
Total income from all sources (including contributions)2010-12-31$35,486,262
Total of all expenses incurred2010-12-31$36,214,619
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$31,148,483
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$35,485,167
Value of total assets at end of year2010-12-31$5,871,962
Value of total assets at beginning of year2010-12-31$6,325,973
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$5,066,136
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$334,996
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$500,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$1,052,678
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$1,000,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$31,231
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$60,885
Other income not declared elsewhere2010-12-31$1,095
Administrative expenses (other) incurred2010-12-31$57,519
Total non interest bearing cash at end of year2010-12-31$5,871,962
Total non interest bearing cash at beginning of year2010-12-31$6,325,973
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-728,357
Value of net assets at end of year (total assets less liabilities)2010-12-31$2,854,731
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$3,583,088
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
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
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$33,432,489
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$31,148,483
Contract administrator fees2010-12-31$4,673,621
Liabilities. Value of benefit claims payable at end of year2010-12-31$2,986,000
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$2,682,000
Did the plan have assets held for investment2010-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party 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
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31SPIELMAN, KOENIGSBERG & PARKER, LLP
Accountancy firm EIN2010-12-31133367751

Form 5500 Responses for LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN

2019: LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2011: LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
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: LVMH MOET HENNESSY LOUIS VUITTON, INC & AFFILIATES MEDICAL AND DENTAL BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
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

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0109798
Policy instance 4
Insurance contract or identification number0109798
Number of Individuals Covered2091
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $77
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $528,077
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees77
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number80325
Policy instance 1
Insurance contract or identification number80325
Number of Individuals Covered432
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,408,228
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 number601004
Policy instance 2
Insurance contract or identification number601004
Number of Individuals Covered480
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,612,692
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 number227970
Policy instance 3
Insurance contract or identification number227970
Number of Individuals Covered181
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $808,992
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number819123
Policy instance 5
Insurance contract or identification number819123
Number of Individuals Covered5505
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $22,401
Welfare Benefit Premiums Paid to CarrierUSD $1,120,054
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees22401
Additional information about fees paid to insurance brokerOTHER COMMISSION OVERRIDE
Insurance broker organization code?3
UNITED BEHAVIORAL HEALTH DBA OPTUM (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number47419
Policy instance 6
Insurance contract or identification number47419
Number of Individuals Covered6997
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PLAN
Welfare Benefit Premiums Paid to CarrierUSD $142,583
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12221067
Policy instance 7
Insurance contract or identification number12221067
Number of Individuals Covered4560
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $900,773
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12221067
Policy instance 7
Insurance contract or identification number12221067
Number of Individuals Covered4306
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $844,285
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 number80325
Policy instance 1
Insurance contract or identification number80325
Number of Individuals Covered397
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
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 number601004
Policy instance 2
Insurance contract or identification number601004
Number of Individuals Covered460
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,829,029
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 number227970
Policy instance 3
Insurance contract or identification number227970
Number of Individuals Covered193
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,096,623
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0109798
Policy instance 4
Insurance contract or identification number0109798
Number of Individuals Covered2177
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $90
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $622,675
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees90
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number819123
Policy instance 5
Insurance contract or identification number819123
Number of Individuals Covered5285
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $18,903
Welfare Benefit Premiums Paid to CarrierUSD $945,165
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees18903
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
UNITED BEHAVIORAL HEALTH DBA OPTUM (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number47419
Policy instance 6
Insurance contract or identification number47419
Number of Individuals Covered6788
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PLAN
Welfare Benefit Premiums Paid to CarrierUSD $145,032
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 number227970
Policy instance 3
Insurance contract or identification number227970
Number of Individuals Covered146
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $758,808
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0109798
Policy instance 4
Insurance contract or identification number0109798
Number of Individuals Covered3578
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $499
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $892,052
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees420
Additional information about fees paid to insurance brokerADMIN FEES - DENTAL
Insurance broker organization code?3
Insurance broker nameAON CONSULTING, INC
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number947-4584
Policy instance 5
Insurance contract or identification number947-4584
Number of Individuals Covered5008
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $25,315
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $843,823
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,315
Insurance broker organization code?3
Insurance broker nameAON CONSULTING, INC
UNITED BEHAVIORAL HEALTH DBA OPTUM (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number47419
Policy instance 6
Insurance contract or identification number47419
Number of Individuals Covered6466
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PLAN
Welfare Benefit Premiums Paid to CarrierUSD $117,851
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12221067
Policy instance 7
Insurance contract or identification number12221067
Number of Individuals Covered4088
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $812,625
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 number601004
Policy instance 2
Insurance contract or identification number601004
Number of Individuals Covered476
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,254,258
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 number80325
Policy instance 1
Insurance contract or identification number80325
Number of Individuals Covered360
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
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 number601004
Policy instance 2
Insurance contract or identification number601004
Number of Individuals Covered468
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,193,736
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 number227970
Policy instance 3
Insurance contract or identification number227970
Number of Individuals Covered143
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $706,174
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0109798
Policy instance 4
Insurance contract or identification number0109798
Number of Individuals Covered3699
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,589
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $863,423
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2549
Additional information about fees paid to insurance brokerADMIN FEES
Insurance broker organization code?3
Insurance broker nameAON CONSULTING, INC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number819123
Policy instance 5
Insurance contract or identification number819123
Number of Individuals Covered5110
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $18,164
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $846,997
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,164
Insurance broker organization code?3
Insurance broker nameAON CONSULTING, INC
UNITED BEHAVIORAL HEALTH DBA OPTUM (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number47419
Policy instance 6
Insurance contract or identification number47419
Number of Individuals Covered6405
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PLAN
Welfare Benefit Premiums Paid to CarrierUSD $141,329
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12221067
Policy instance 7
Insurance contract or identification number12221067
Number of Individuals Covered4162
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
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 number80325
Policy instance 1
Insurance contract or identification number80325
Number of Individuals Covered377
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number810189
Policy instance 3
Insurance contract or identification number810189
Number of Individuals Covered4063
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
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $359,141
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED BEHAVIORAL HEALTH DBA OPTUM (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number47419
Policy instance 7
Insurance contract or identification number47419
Number of Individuals Covered4821
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
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedEMPLOYEE ASSISTANCE PLAN
Welfare Benefit Premiums Paid to CarrierUSD $112,030
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0109798
Policy instance 1
Insurance contract or identification number0109798
Number of Individuals Covered3482
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,178
Total amount of fees paid to insurance companyUSD $1,196
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $755,882
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 number80325
Policy instance 6
Insurance contract or identification number80325
Number of Individuals Covered299
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
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $1,124,741
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 number227970
Policy instance 5
Insurance contract or identification number227970
Number of Individuals Covered95
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $240
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $411,706
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12221067
Policy instance 2
Insurance contract or identification number12221067
Number of Individuals Covered3067
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
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
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 number601004
Policy instance 4
Insurance contract or identification number601004
Number of Individuals Covered367
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $137
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,423,347
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 number227970
Policy instance 5
Insurance contract or identification number227970
Number of Individuals Covered66
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $2,299
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $345,359
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0109798
Policy instance 1
Insurance contract or identification number0109798
Number of Individuals Covered3231
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $8,791
Total amount of fees paid to insurance companyUSD $5,612
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $679,716
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12221067
Policy instance 2
Insurance contract or identification number12221067
Number of Individuals Covered2816
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $19,428
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number601004
Policy instance 4
Insurance contract or identification number601004
Number of Individuals Covered189
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $8,959
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,298,346
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number710325
Policy instance 3
Insurance contract or identification number710325
Number of Individuals Covered3847
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
Welfare Benefit Premiums Paid to CarrierUSD $310,296
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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