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CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 401k Plan overview

Plan NameCAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN
Plan identification number 514

CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN Benefits

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

401k Sponsoring company profile

CAMPBELL SOUP COMPANY has sponsored the creation of one or more 401k plans.

Company Name:CAMPBELL SOUP COMPANY
Employer identification number (EIN):210419870
NAIC Classification:311900
NAIC Description: Other Food Manufacturing

Additional information about CAMPBELL SOUP COMPANY

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 2169131

More information about CAMPBELL SOUP COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5142022-01-01WILLIAM REMPHREY2023-10-16 RANDALL CHERKAS2023-10-16
5142021-01-01WILLIAM REMPHREY2022-10-17 RANDALL CHERKAS2022-10-17
5142020-01-01WILLIAM REMPHREY2021-10-08 RANDALL CHERKAS2021-10-08
5142019-01-01WILLIAM REMPHREY2020-10-14 RANDALL CHERKAS2020-10-14
5142018-01-01KEVIN KAISER2019-10-01 RANDALL CHERKAS2019-10-01
5142017-01-01
5142016-01-01KEVIN KAISER DONALD SHANIN2017-10-12
5142015-01-01KEVIN KAISER DONALD SHANIN2016-10-13
5142014-01-01KEVIN D. KAISER DONALD B. SHANIN2015-07-27
5142013-01-01KEVIN D. KAISER DONALD B. SHANIN2014-10-06

Plan Statistics for CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN

401k plan membership statisitcs for CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN

Measure Date Value
2022: CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-016,043
Number of retired or separated participants receiving benefits2022-01-015,685
Number of other retired or separated participants entitled to future benefits2022-01-01449
Total of all active and inactive participants2022-01-016,134
2021: CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-015,933
Number of retired or separated participants receiving benefits2021-01-015,622
Number of other retired or separated participants entitled to future benefits2021-01-01421
Total of all active and inactive participants2021-01-016,043
2020: CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-015,743
Number of retired or separated participants receiving benefits2020-01-015,468
Number of other retired or separated participants entitled to future benefits2020-01-01465
Total of all active and inactive participants2020-01-015,933
2019: CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-016,548
Number of retired or separated participants receiving benefits2019-01-015,120
Number of other retired or separated participants entitled to future benefits2019-01-01623
Total of all active and inactive participants2019-01-015,743
2018: CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-016,333
Number of retired or separated participants receiving benefits2018-01-014,768
Number of other retired or separated participants entitled to future benefits2018-01-011,780
Total of all active and inactive participants2018-01-016,548
2017: CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-015,023
Number of retired or separated participants receiving benefits2017-01-016,333
Total of all active and inactive participants2017-01-016,333
2016: CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-015,736
Number of retired or separated participants receiving benefits2016-01-015,023
Total of all active and inactive participants2016-01-015,023
2015: CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-015,734
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-015,736
Total of all active and inactive participants2015-01-015,736
2014: CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-015,067
Total number of active participants reported on line 7a of the Form 55002014-01-010
Number of retired or separated participants receiving benefits2014-01-015,272
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-015,272
2013: CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-014,631
Total number of active participants reported on line 7a of the Form 55002013-01-010
Number of retired or separated participants receiving benefits2013-01-013,826
Number of other retired or separated participants entitled to future benefits2013-01-011,243
Total of all active and inactive participants2013-01-015,069

Financial Data on CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN

Measure Date Value
2022 : CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$613,550
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$613,838
Total income from all sources (including contributions)2022-12-31$14,938,755
Total of all expenses incurred2022-12-31$14,687,827
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$14,333,123
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$14,938,755
Value of total assets at end of year2022-12-31$1,012,592
Value of total assets at beginning of year2022-12-31$761,952
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$354,704
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$25,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$1,576,267
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$154,057
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$156,482
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$613,550
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$605,470
Administrative expenses (other) incurred2022-12-31$354,704
Liabilities. Value of operating payables at end of year2022-12-31$0
Liabilities. Value of operating payables at beginning of year2022-12-31$8,368
Total non interest bearing cash at end of year2022-12-31$858,535
Total non interest bearing cash at beginning of year2022-12-31$605,470
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$250,928
Value of net assets at end of year (total assets less liabilities)2022-12-31$399,042
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$148,114
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$13,362,488
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$14,333,123
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-12-31No
Did the plan have assets held for investment2022-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31BAKER TILLY US, LLP
Accountancy firm EIN2022-12-31390859910
2021 : CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$613,838
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$25,546
Total income from all sources (including contributions)2021-12-31$16,934,551
Total of all expenses incurred2021-12-31$16,858,707
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$16,583,813
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$16,934,551
Value of total assets at end of year2021-12-31$761,952
Value of total assets at beginning of year2021-12-31$97,816
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$274,894
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$25,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$1,626,148
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$156,482
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$97,816
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$605,470
Administrative expenses (other) incurred2021-12-31$274,894
Liabilities. Value of operating payables at end of year2021-12-31$8,368
Liabilities. Value of operating payables at beginning of year2021-12-31$25,546
Total non interest bearing cash at end of year2021-12-31$605,470
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$75,844
Value of net assets at end of year (total assets less liabilities)2021-12-31$148,114
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$72,270
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$15,308,403
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$16,583,813
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-12-31No
Did the plan have assets held for investment2021-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31BAKER TILLY US, LLP
Accountancy firm EIN2021-12-31390859910
2020 : CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$25,546
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$19,629
Total income from all sources (including contributions)2020-12-31$15,956,334
Total of all expenses incurred2020-12-31$16,467,186
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$16,145,725
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$15,956,334
Value of total assets at end of year2020-12-31$97,816
Value of total assets at beginning of year2020-12-31$602,751
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$321,461
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$25,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$75,658
Assets. Other investments not covered elsewhere at beginning of year2020-12-31$497,955
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$97,816
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$104,796
Administrative expenses (other) incurred2020-12-31$321,461
Liabilities. Value of operating payables at end of year2020-12-31$25,546
Liabilities. Value of operating payables at beginning of year2020-12-31$19,629
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$-510,852
Value of net assets at end of year (total assets less liabilities)2020-12-31$72,270
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$583,122
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$15,880,676
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$16,145,725
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-12-31No
Did the plan have assets held for investment2020-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31BAKER TILLY US, LLP
Accountancy firm EIN2020-12-31390859910
2019 : CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$19,629
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$63,342
Total income from all sources (including contributions)2019-12-31$20,107,932
Total of all expenses incurred2019-12-31$19,953,960
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$19,579,347
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$20,107,932
Value of total assets at end of year2019-12-31$602,751
Value of total assets at beginning of year2019-12-31$492,492
Value of total assets at beginning of year2019-12-31$492,492
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$374,613
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$25,000,000
Value of fidelity bond cover2019-12-31$25,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
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
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$83,268
Participant contributions at end of year2019-12-31$0
Participant contributions at beginning of year2019-12-31$7,606
Participant contributions at beginning of year2019-12-31$7,606
Assets. Other investments not covered elsewhere at end of year2019-12-31$497,955
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$104,796
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$484,886
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$484,886
Administrative expenses (other) incurred2019-12-31$374,613
Liabilities. Value of operating payables at end of year2019-12-31$19,629
Liabilities. Value of operating payables at beginning of year2019-12-31$63,342
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
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$153,972
Value of net assets at end of year (total assets less liabilities)2019-12-31$583,122
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$429,150
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
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 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
Were any leases to which the plan was party in default or uncollectible2019-12-31No
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
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
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$20,024,664
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$19,579,347
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
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
Did the plan have assets held for investment2019-12-31No
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
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
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 name2019-12-31BAKER TILLY US, LLP
Accountancy firm EIN2019-12-31390859910
2018 : CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$63,342
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$48,326
Total income from all sources (including contributions)2018-12-31$22,544,930
Total of all expenses incurred2018-12-31$22,774,439
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$22,170,625
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$22,544,930
Value of total assets at end of year2018-12-31$492,492
Value of total assets at beginning of year2018-12-31$706,985
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$603,814
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$25,000,000
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$591,991
Participant contributions at end of year2018-12-31$7,606
Participant contributions at beginning of year2018-12-31$177,039
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$484,886
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$529,946
Administrative expenses (other) incurred2018-12-31$603,814
Liabilities. Value of operating payables at end of year2018-12-31$63,342
Liabilities. Value of operating payables at beginning of year2018-12-31$48,326
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-229,509
Value of net assets at end of year (total assets less liabilities)2018-12-31$429,150
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$658,659
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
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$21,952,939
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$22,170,625
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
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 name2018-12-31BAKER TILLY VIRCHOW KRAUSE LLP
Accountancy firm EIN2018-12-31390859910
2017 : CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$48,326
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$511,803
Total income from all sources (including contributions)2017-12-31$22,688,090
Total of all expenses incurred2017-12-31$23,244,695
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$22,058,577
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$22,688,090
Value of total assets at end of year2017-12-31$706,985
Value of total assets at beginning of year2017-12-31$1,727,067
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$1,186,118
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$250,000
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$2,144,240
Participant contributions at end of year2017-12-31$177,039
Participant contributions at beginning of year2017-12-31$261,660
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$529,946
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$1,465,407
Administrative expenses (other) incurred2017-12-31$1,186,118
Liabilities. Value of operating payables at end of year2017-12-31$48,326
Liabilities. Value of operating payables at beginning of year2017-12-31$511,803
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-556,605
Value of net assets at end of year (total assets less liabilities)2017-12-31$658,659
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$1,215,264
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$1,498,025
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$20,543,850
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$20,560,552
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
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 name2017-12-31BAKER TILLY VIRCHOW KRAUSE LLP
Accountancy firm EIN2017-12-31390859910
2016 : CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$511,803
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$347,862
Total income from all sources (including contributions)2016-12-31$32,049,670
Total of all expenses incurred2016-12-31$31,911,825
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$29,502,090
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$32,049,670
Value of total assets at end of year2016-12-31$1,727,067
Value of total assets at beginning of year2016-12-31$1,425,281
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$2,409,735
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
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$3,788,126
Participant contributions at end of year2016-12-31$261,660
Participant contributions at beginning of year2016-12-31$282,976
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$1,465,407
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$1,101,628
Administrative expenses (other) incurred2016-12-31$2,409,735
Liabilities. Value of operating payables at end of year2016-12-31$511,803
Liabilities. Value of operating payables at beginning of year2016-12-31$347,862
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$137,845
Value of net assets at end of year (total assets less liabilities)2016-12-31$1,215,264
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$1,077,419
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$40,677
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$40,677
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$3,977,021
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$28,261,544
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$25,525,069
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
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 name2016-12-31BAKER TILLY VIRCHOW KRAUSE LLP
Accountancy firm EIN2016-12-31390859910
2015 : CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$347,862
Total income from all sources (including contributions)2015-12-31$29,265,645
Total of all expenses incurred2015-12-31$28,188,226
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$25,741,187
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$29,265,397
Value of total assets at end of year2015-12-31$1,425,281
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$2,447,039
Total interest from all sources2015-12-31$248
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
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$3,917,795
Participant contributions at end of year2015-12-31$282,976
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$1,101,628
Administrative expenses (other) incurred2015-12-31$2,447,039
Liabilities. Value of operating payables at end of year2015-12-31$347,862
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$1,077,419
Value of net assets at end of year (total assets less liabilities)2015-12-31$1,077,419
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
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$40,677
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$248
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$3,056,006
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$25,347,602
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$22,685,181
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
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 name2015-12-31BAKER TILLY VIRCHOW KRAUSE LLP
Accountancy firm EIN2015-12-31390859910

Form 5500 Responses for CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN

2022: CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement - TrustYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement - TrustYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement - TrustYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement - TrustYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement - TrustYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: CAMPBELL SOUP COMPANY RETIREE MEDICAL 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 benefit arrangement – InsuranceYes
2013: CAMPBELL SOUP COMPANY RETIREE MEDICAL PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01First time form 5500 has been submittedYes
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

Insurance Providers Used on plan

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number603501
Policy instance 3
Insurance contract or identification number603501
Number of Individuals Covered5
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
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,896
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number5777
Policy instance 2
Insurance contract or identification number5777
Number of Individuals Covered12
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
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number403235
Policy instance 1
Insurance contract or identification number403235
Number of Individuals Covered4
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
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $121,885
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 number603501
Policy instance 3
Insurance contract or identification number603501
Number of Individuals Covered55
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $666
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $316,558
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $666
Insurance broker organization code?3
Insurance broker nameHEWITT ASSOCIATES
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number5777
Policy instance 2
Insurance contract or identification number5777
Number of Individuals Covered267
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $22
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,760,055
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22
Insurance broker nameHEWITT ASSOCIATES LLC
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number403235
Policy instance 1
Insurance contract or identification number403235
Number of Individuals Covered91
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
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $687,579
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 number603501
Policy instance 3
Insurance contract or identification number603501
Number of Individuals Covered86
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,360
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 $675,562
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,360
Insurance broker organization code?3
Insurance broker nameHEWITT ASSOCIATES
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number*SEE BELOW
Policy instance 2
Insurance contract or identification number*SEE BELOW
Number of Individuals Covered194
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 BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,835,599
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number*SEE BELOW
Policy instance 1
Insurance contract or identification number*SEE BELOW
Number of Individuals Covered77
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 $593,000
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 number603501
Policy instance 3
Insurance contract or identification number603501
Number of Individuals Covered88
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,823
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 $618,101
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,823
Insurance broker organization code?3
Insurance broker nameHEWITT ASSOCIATES
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number*SEE BELOW
Policy instance 2
Insurance contract or identification number*SEE BELOW
Number of Individuals Covered201
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,368,884
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number*SEE BELOW
Policy instance 1
Insurance contract or identification number*SEE BELOW
Number of Individuals Covered78
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 $637,806
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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