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ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 401k Plan overview

Plan NameASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST
Plan identification number 501

ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST Benefits

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

401k Sponsoring company profile

OREGON-COLUMBIA CHAPTER AGC OF AMERICA, INC. has sponsored the creation of one or more 401k plans.

Company Name:OREGON-COLUMBIA CHAPTER AGC OF AMERICA, INC.
Employer identification number (EIN):237170147
NAIC Classification:238900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-04-01
5012021-04-01
5012020-04-01
5012019-04-01
5012018-04-01
5012017-04-01ALI GADBAUGH
5012016-04-01COLETTE EVERS
5012015-04-01COLETTE EVERS
5012015-04-01COLETTE EVERS
5012014-04-01COLETTE EVERS
5012013-04-01COLETTE EVERS
5012012-04-01COLETTE EVERS
5012011-04-01COLETTE EVERS NORMAN RUSSELL2012-10-09
5012010-04-01COLETTE EVERS
5012009-04-01COLETTE EVERS

Plan Statistics for ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST

401k plan membership statisitcs for ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST

Measure Date Value
2022: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2022 401k membership
Total participants, beginning-of-year2022-04-01813
Total number of active participants reported on line 7a of the Form 55002022-04-01779
Number of retired or separated participants receiving benefits2022-04-014
Number of other retired or separated participants entitled to future benefits2022-04-010
Total of all active and inactive participants2022-04-01783
2021: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2021 401k membership
Total participants, beginning-of-year2021-04-011,164
Total number of active participants reported on line 7a of the Form 55002021-04-01809
Number of retired or separated participants receiving benefits2021-04-014
Number of other retired or separated participants entitled to future benefits2021-04-010
Total of all active and inactive participants2021-04-01813
2020: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2020 401k membership
Total participants, beginning-of-year2020-04-01932
Total number of active participants reported on line 7a of the Form 55002020-04-011,154
Number of retired or separated participants receiving benefits2020-04-0110
Number of other retired or separated participants entitled to future benefits2020-04-010
Total of all active and inactive participants2020-04-011,164
2019: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2019 401k membership
Total participants, beginning-of-year2019-04-011,029
Total number of active participants reported on line 7a of the Form 55002019-04-01927
Number of retired or separated participants receiving benefits2019-04-015
Number of other retired or separated participants entitled to future benefits2019-04-010
Total of all active and inactive participants2019-04-01932
2018: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2018 401k membership
Total participants, beginning-of-year2018-04-011,134
Total number of active participants reported on line 7a of the Form 55002018-04-011,024
Number of retired or separated participants receiving benefits2018-04-015
Number of other retired or separated participants entitled to future benefits2018-04-010
Total of all active and inactive participants2018-04-011,029
2017: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2017 401k membership
Total participants, beginning-of-year2017-04-01996
Total number of active participants reported on line 7a of the Form 55002017-04-011,126
Number of retired or separated participants receiving benefits2017-04-018
Number of other retired or separated participants entitled to future benefits2017-04-010
Total of all active and inactive participants2017-04-011,134
2016: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2016 401k membership
Total participants, beginning-of-year2016-04-01755
Total number of active participants reported on line 7a of the Form 55002016-04-01989
Number of retired or separated participants receiving benefits2016-04-017
Number of other retired or separated participants entitled to future benefits2016-04-010
Total of all active and inactive participants2016-04-01996
2015: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2015 401k membership
Total participants, beginning-of-year2015-04-01795
Total number of active participants reported on line 7a of the Form 55002015-04-01750
Number of retired or separated participants receiving benefits2015-04-015
Number of other retired or separated participants entitled to future benefits2015-04-010
Total of all active and inactive participants2015-04-01755
2014: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2014 401k membership
Total participants, beginning-of-year2014-04-01906
Total number of active participants reported on line 7a of the Form 55002014-04-01790
Number of retired or separated participants receiving benefits2014-04-015
Number of other retired or separated participants entitled to future benefits2014-04-010
Total of all active and inactive participants2014-04-01795
2013: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2013 401k membership
Total participants, beginning-of-year2013-04-01977
Total number of active participants reported on line 7a of the Form 55002013-04-01899
Number of retired or separated participants receiving benefits2013-04-017
Number of other retired or separated participants entitled to future benefits2013-04-010
Total of all active and inactive participants2013-04-01906
2012: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2012 401k membership
Total participants, beginning-of-year2012-04-011,139
Total number of active participants reported on line 7a of the Form 55002012-04-01957
Number of retired or separated participants receiving benefits2012-04-0120
Number of other retired or separated participants entitled to future benefits2012-04-010
Total of all active and inactive participants2012-04-01977
2011: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2011 401k membership
Total participants, beginning-of-year2011-04-011,817
Total number of active participants reported on line 7a of the Form 55002011-04-011,126
Number of retired or separated participants receiving benefits2011-04-0113
Total of all active and inactive participants2011-04-011,139
2010: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2010 401k membership
Total participants, beginning-of-year2010-04-012,867
Total number of active participants reported on line 7a of the Form 55002010-04-011,817
Total of all active and inactive participants2010-04-011,817
2009: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2009 401k membership
Total participants, beginning-of-year2009-04-011,667
Total number of active participants reported on line 7a of the Form 55002009-04-011,579
Number of retired or separated participants receiving benefits2009-04-0137
Total of all active and inactive participants2009-04-011,616

Financial Data on ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST

Measure Date Value
2023 : ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-03-31$152,593
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-03-31$99,470
Total income from all sources (including contributions)2023-03-31$7,954,701
Total loss/gain on sale of assets2023-03-31$0
Total of all expenses incurred2023-03-31$7,980,760
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-03-31$7,442,529
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-03-31$7,971,558
Value of total assets at end of year2023-03-31$1,744,399
Value of total assets at beginning of year2023-03-31$1,717,335
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-03-31$538,231
Total interest from all sources2023-03-31$0
Total dividends received (eg from common stock, registered investment company shares)2023-03-31$23,495
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-03-31No
Total dividends received from registered investment company shares (eg mutual funds)2023-03-31$23,495
Administrative expenses professional fees incurred2023-03-31$29,419
Was this plan covered by a fidelity bond2023-03-31Yes
Value of fidelity bond cover2023-03-31$500,000
Were there any nonexempt tranactions with any party-in-interest2023-03-31No
Contributions received from participants2023-03-31$27,899
Value of other receiveables (less allowance for doubtful accounts) at end of year2023-03-31$4,697
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2023-03-31$0
Other income not declared elsewhere2023-03-31$441
Administrative expenses (other) incurred2023-03-31$320,609
Liabilities. Value of operating payables at end of year2023-03-31$102,920
Liabilities. Value of operating payables at beginning of year2023-03-31$74,084
Total non interest bearing cash at end of year2023-03-31$136,279
Total non interest bearing cash at beginning of year2023-03-31$524,582
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-03-31No
Value of net income/loss2023-03-31$-26,059
Value of net assets at end of year (total assets less liabilities)2023-03-31$1,591,806
Value of net assets at beginning of year (total assets less liabilities)2023-03-31$1,617,865
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-03-31No
Were any leases to which the plan was party in default or uncollectible2023-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2023-03-31$1,293,150
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2023-03-31$1,170,626
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-03-31$289,935
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2023-03-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2023-03-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2023-03-31$7,442,529
Net investment gain/loss from registered investment companies (e.g. mutual funds)2023-03-31$-40,793
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-03-31Yes
Was there a failure to transmit to the plan any participant contributions2023-03-31No
Has the plan failed to provide any benefit when due under the plan2023-03-31No
Contributions received in cash from employer2023-03-31$7,943,659
Employer contributions (assets) at end of year2023-03-31$20,338
Employer contributions (assets) at beginning of year2023-03-31$22,127
Contract administrator fees2023-03-31$188,203
Liabilities. Value of benefit claims payable at end of year2023-03-31$49,673
Liabilities. Value of benefit claims payable at beginning of year2023-03-31$25,386
Did the plan have assets held for investment2023-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-03-31No
Opinion of an independent qualified public accountant for this plan2023-03-31Unqualified
Accountancy firm name2023-03-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2023-03-31410746749
2022 : ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-03-31$99,470
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-03-31$143,171
Total income from all sources (including contributions)2022-03-31$11,390,434
Total loss/gain on sale of assets2022-03-31$0
Total of all expenses incurred2022-03-31$10,897,713
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-03-31$10,202,692
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-03-31$10,893,531
Value of total assets at end of year2022-03-31$1,717,335
Value of total assets at beginning of year2022-03-31$1,268,315
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-03-31$695,021
Total interest from all sources2022-03-31$0
Total dividends received (eg from common stock, registered investment company shares)2022-03-31$42,256
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-03-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-03-31$42,256
Administrative expenses professional fees incurred2022-03-31$252,331
Was this plan covered by a fidelity bond2022-03-31Yes
Value of fidelity bond cover2022-03-31$500,000
Were there any nonexempt tranactions with any party-in-interest2022-03-31No
Contributions received from participants2022-03-31$64,679
Other income not declared elsewhere2022-03-31$479,420
Administrative expenses (other) incurred2022-03-31$352,369
Liabilities. Value of operating payables at end of year2022-03-31$74,084
Liabilities. Value of operating payables at beginning of year2022-03-31$43,274
Total non interest bearing cash at end of year2022-03-31$524,582
Total non interest bearing cash at beginning of year2022-03-31$86,037
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-03-31No
Value of net income/loss2022-03-31$492,721
Value of net assets at end of year (total assets less liabilities)2022-03-31$1,617,865
Value of net assets at beginning of year (total assets less liabilities)2022-03-31$1,125,144
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-03-31No
Were any leases to which the plan was party in default or uncollectible2022-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-03-31$1,170,626
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-03-31$1,153,143
Expenses. Payments to insurance carriers foe the provision of benefits2022-03-31$10,202,692
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-03-31$-24,773
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-03-31No
Was there a failure to transmit to the plan any participant contributions2022-03-31No
Has the plan failed to provide any benefit when due under the plan2022-03-31No
Contributions received in cash from employer2022-03-31$10,828,852
Employer contributions (assets) at end of year2022-03-31$22,127
Employer contributions (assets) at beginning of year2022-03-31$29,135
Contract administrator fees2022-03-31$90,321
Liabilities. Value of benefit claims payable at end of year2022-03-31$25,386
Liabilities. Value of benefit claims payable at beginning of year2022-03-31$99,897
Did the plan have assets held for investment2022-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-03-31No
Opinion of an independent qualified public accountant for this plan2022-03-31Unqualified
Accountancy firm name2022-03-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2022-03-31410746749
2021 : ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-03-31$143,171
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-03-31$192,321
Total income from all sources (including contributions)2021-03-31$11,324,632
Total loss/gain on sale of assets2021-03-31$0
Total of all expenses incurred2021-03-31$11,207,595
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-03-31$10,488,108
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-03-31$11,153,951
Value of total assets at end of year2021-03-31$1,268,315
Value of total assets at beginning of year2021-03-31$1,200,428
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-03-31$719,487
Total interest from all sources2021-03-31$27,403
Total dividends received (eg from common stock, registered investment company shares)2021-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-03-31No
Administrative expenses professional fees incurred2021-03-31$35,195
Was this plan covered by a fidelity bond2021-03-31Yes
Value of fidelity bond cover2021-03-31$500,000
Were there any nonexempt tranactions with any party-in-interest2021-03-31No
Contributions received from participants2021-03-31$93,660
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2021-03-31$1,310
Other income not declared elsewhere2021-03-31$201
Administrative expenses (other) incurred2021-03-31$447,195
Liabilities. Value of operating payables at end of year2021-03-31$43,274
Liabilities. Value of operating payables at beginning of year2021-03-31$51,726
Total non interest bearing cash at end of year2021-03-31$86,037
Total non interest bearing cash at beginning of year2021-03-31$95,899
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-03-31No
Value of net income/loss2021-03-31$117,037
Value of net assets at end of year (total assets less liabilities)2021-03-31$1,125,144
Value of net assets at beginning of year (total assets less liabilities)2021-03-31$1,008,107
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-03-31No
Were any leases to which the plan was party in default or uncollectible2021-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-03-31$1,153,143
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-03-31$1,082,664
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-03-31$27,403
Expenses. Payments to insurance carriers foe the provision of benefits2021-03-31$10,486,798
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-03-31$143,077
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-03-31Yes
Was there a failure to transmit to the plan any participant contributions2021-03-31No
Has the plan failed to provide any benefit when due under the plan2021-03-31No
Contributions received in cash from employer2021-03-31$11,060,291
Employer contributions (assets) at end of year2021-03-31$29,135
Employer contributions (assets) at beginning of year2021-03-31$21,865
Contract administrator fees2021-03-31$237,097
Liabilities. Value of benefit claims payable at end of year2021-03-31$99,897
Liabilities. Value of benefit claims payable at beginning of year2021-03-31$140,595
Did the plan have assets held for investment2021-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-03-31No
Opinion of an independent qualified public accountant for this plan2021-03-31Unqualified
Accountancy firm name2021-03-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2021-03-31410746749
2020 : ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-03-31$192,321
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-03-31$200,637
Total income from all sources (including contributions)2020-03-31$10,710,134
Total loss/gain on sale of assets2020-03-31$0
Total of all expenses incurred2020-03-31$10,779,119
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-03-31$10,095,585
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-03-31$10,719,379
Value of total assets at end of year2020-03-31$1,200,428
Value of total assets at beginning of year2020-03-31$1,277,729
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-03-31$683,534
Total interest from all sources2020-03-31$35,173
Total dividends received (eg from common stock, registered investment company shares)2020-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-03-31No
Administrative expenses professional fees incurred2020-03-31$18,739
Was this plan covered by a fidelity bond2020-03-31Yes
Value of fidelity bond cover2020-03-31$500,000
Were there any nonexempt tranactions with any party-in-interest2020-03-31No
Contributions received from participants2020-03-31$70,526
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-03-31$952
Other income not declared elsewhere2020-03-31$547
Administrative expenses (other) incurred2020-03-31$430,491
Liabilities. Value of operating payables at end of year2020-03-31$51,726
Liabilities. Value of operating payables at beginning of year2020-03-31$79,890
Total non interest bearing cash at end of year2020-03-31$95,899
Total non interest bearing cash at beginning of year2020-03-31$139,693
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-03-31No
Value of net income/loss2020-03-31$-68,985
Value of net assets at end of year (total assets less liabilities)2020-03-31$1,008,107
Value of net assets at beginning of year (total assets less liabilities)2020-03-31$1,077,092
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-03-31No
Were any leases to which the plan was party in default or uncollectible2020-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-03-31$1,082,664
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-03-31$1,092,456
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-03-31$35,173
Expenses. Payments to insurance carriers foe the provision of benefits2020-03-31$10,094,633
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-03-31$-44,965
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-03-31No
Was there a failure to transmit to the plan any participant contributions2020-03-31No
Has the plan failed to provide any benefit when due under the plan2020-03-31No
Contributions received in cash from employer2020-03-31$10,648,853
Employer contributions (assets) at end of year2020-03-31$21,865
Employer contributions (assets) at beginning of year2020-03-31$45,580
Contract administrator fees2020-03-31$234,304
Liabilities. Value of benefit claims payable at end of year2020-03-31$140,595
Liabilities. Value of benefit claims payable at beginning of year2020-03-31$120,747
Did the plan have assets held for investment2020-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-03-31No
Opinion of an independent qualified public accountant for this plan2020-03-31Unqualified
Accountancy firm name2020-03-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2020-03-31410746749
2019 : ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-03-31$200,637
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-03-31$180,150
Total income from all sources (including contributions)2019-03-31$12,313,037
Total loss/gain on sale of assets2019-03-31$0
Total of all expenses incurred2019-03-31$12,331,208
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-03-31$11,534,264
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-03-31$12,276,222
Value of total assets at end of year2019-03-31$1,277,729
Value of total assets at beginning of year2019-03-31$1,275,413
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-03-31$796,944
Total interest from all sources2019-03-31$31,235
Total dividends received (eg from common stock, registered investment company shares)2019-03-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-03-31No
Administrative expenses professional fees incurred2019-03-31$20,840
Was this plan covered by a fidelity bond2019-03-31Yes
Value of fidelity bond cover2019-03-31$500,000
Were there any nonexempt tranactions with any party-in-interest2019-03-31No
Contributions received from participants2019-03-31$87,183
Income. Received or receivable in cash from other sources (including rollovers)2019-03-31$8,400
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-03-31$1,788
Other income not declared elsewhere2019-03-31$606
Administrative expenses (other) incurred2019-03-31$896
Liabilities. Value of operating payables at end of year2019-03-31$79,890
Liabilities. Value of operating payables at beginning of year2019-03-31$78,037
Total non interest bearing cash at end of year2019-03-31$139,693
Total non interest bearing cash at beginning of year2019-03-31$210,875
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-03-31No
Value of net income/loss2019-03-31$-18,171
Value of net assets at end of year (total assets less liabilities)2019-03-31$1,077,092
Value of net assets at beginning of year (total assets less liabilities)2019-03-31$1,095,263
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-03-31No
Were any leases to which the plan was party in default or uncollectible2019-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-03-31$1,092,456
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-03-31$1,056,246
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-03-31$31,235
Expenses. Payments to insurance carriers foe the provision of benefits2019-03-31$11,532,476
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-03-31$4,974
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-03-31No
Was there a failure to transmit to the plan any participant contributions2019-03-31No
Has the plan failed to provide any benefit when due under the plan2019-03-31No
Contributions received in cash from employer2019-03-31$12,180,639
Employer contributions (assets) at end of year2019-03-31$45,580
Employer contributions (assets) at beginning of year2019-03-31$8,292
Contract administrator fees2019-03-31$775,208
Liabilities. Value of benefit claims payable at end of year2019-03-31$120,747
Liabilities. Value of benefit claims payable at beginning of year2019-03-31$102,113
Did the plan have assets held for investment2019-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-03-31No
Opinion of an independent qualified public accountant for this plan2019-03-31Unqualified
Accountancy firm name2019-03-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2019-03-31410746749
2018 : ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-03-31$180,150
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-03-31$124,801
Total income from all sources (including contributions)2018-03-31$10,680,728
Total loss/gain on sale of assets2018-03-31$0
Total of all expenses incurred2018-03-31$10,703,344
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-03-31$9,988,240
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-03-31$10,649,220
Value of total assets at end of year2018-03-31$1,275,413
Value of total assets at beginning of year2018-03-31$1,242,680
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-03-31$715,104
Total interest from all sources2018-03-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-03-31$17,081
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-03-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-03-31$17,081
Administrative expenses professional fees incurred2018-03-31$18,092
Was this plan covered by a fidelity bond2018-03-31Yes
Value of fidelity bond cover2018-03-31$500,000
Were there any nonexempt tranactions with any party-in-interest2018-03-31No
Contributions received from participants2018-03-31$64,905
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-03-31$1,757
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-03-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-03-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-03-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-03-31$0
Other income not declared elsewhere2018-03-31$2,939
Administrative expenses (other) incurred2018-03-31$5,369
Liabilities. Value of operating payables at end of year2018-03-31$78,037
Liabilities. Value of operating payables at beginning of year2018-03-31$45,941
Total non interest bearing cash at end of year2018-03-31$210,875
Total non interest bearing cash at beginning of year2018-03-31$56,862
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-03-31No
Value of net income/loss2018-03-31$-22,616
Value of net assets at end of year (total assets less liabilities)2018-03-31$1,095,263
Value of net assets at beginning of year (total assets less liabilities)2018-03-31$1,117,879
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-03-31No
Were any leases to which the plan was party in default or uncollectible2018-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-03-31$1,056,246
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-03-31$1,177,675
Expenses. Payments to insurance carriers foe the provision of benefits2018-03-31$9,986,483
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-03-31$11,488
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-03-31No
Was there a failure to transmit to the plan any participant contributions2018-03-31No
Has the plan failed to provide any benefit when due under the plan2018-03-31No
Contributions received in cash from employer2018-03-31$10,584,315
Employer contributions (assets) at end of year2018-03-31$8,292
Employer contributions (assets) at beginning of year2018-03-31$8,143
Contract administrator fees2018-03-31$691,643
Liabilities. Value of benefit claims payable at end of year2018-03-31$102,113
Liabilities. Value of benefit claims payable at beginning of year2018-03-31$78,860
Did the plan have assets held for investment2018-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-03-31No
Opinion of an independent qualified public accountant for this plan2018-03-31Unqualified
Accountancy firm name2018-03-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2018-03-31410746749
2017 : ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-03-31$124,801
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-03-31$129,318
Total income from all sources (including contributions)2017-03-31$8,447,755
Total loss/gain on sale of assets2017-03-31$0
Total of all expenses incurred2017-03-31$8,479,873
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-03-31$7,898,834
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-03-31$8,405,109
Value of total assets at end of year2017-03-31$1,242,680
Value of total assets at beginning of year2017-03-31$1,279,315
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-03-31$581,039
Total interest from all sources2017-03-31$0
Total dividends received (eg from common stock, registered investment company shares)2017-03-31$10,561
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-03-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-03-31$10,561
Administrative expenses professional fees incurred2017-03-31$35,833
Was this plan covered by a fidelity bond2017-03-31Yes
Value of fidelity bond cover2017-03-31$500,000
Were there any nonexempt tranactions with any party-in-interest2017-03-31No
Contributions received from participants2017-03-31$43,944
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-03-31$933
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-03-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-03-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-03-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-03-31$0
Other income not declared elsewhere2017-03-31$1,170
Administrative expenses (other) incurred2017-03-31$4,250
Liabilities. Value of operating payables at end of year2017-03-31$45,941
Liabilities. Value of operating payables at beginning of year2017-03-31$11,138
Total non interest bearing cash at end of year2017-03-31$56,862
Total non interest bearing cash at beginning of year2017-03-31$135,394
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-03-31No
Value of net income/loss2017-03-31$-32,118
Value of net assets at end of year (total assets less liabilities)2017-03-31$1,117,879
Value of net assets at beginning of year (total assets less liabilities)2017-03-31$1,149,997
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-03-31No
Were any leases to which the plan was party in default or uncollectible2017-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-03-31$1,177,675
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-03-31$1,136,199
Expenses. Payments to insurance carriers foe the provision of benefits2017-03-31$7,897,901
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-03-31$30,915
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-03-31No
Was there a failure to transmit to the plan any participant contributions2017-03-31No
Has the plan failed to provide any benefit when due under the plan2017-03-31No
Contributions received in cash from employer2017-03-31$8,361,165
Employer contributions (assets) at end of year2017-03-31$8,143
Employer contributions (assets) at beginning of year2017-03-31$7,722
Contract administrator fees2017-03-31$540,956
Liabilities. Value of benefit claims payable at end of year2017-03-31$78,860
Liabilities. Value of benefit claims payable at beginning of year2017-03-31$118,180
Did the plan have assets held for investment2017-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-03-31No
Opinion of an independent qualified public accountant for this plan2017-03-31Unqualified
Accountancy firm name2017-03-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2017-03-31410746749
2016 : ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-03-31$129,318
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-03-31$130,312
Total income from all sources (including contributions)2016-03-31$8,307,031
Total loss/gain on sale of assets2016-03-31$0
Total of all expenses incurred2016-03-31$8,531,164
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-03-31$7,920,049
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-03-31$8,296,210
Value of total assets at end of year2016-03-31$1,279,315
Value of total assets at beginning of year2016-03-31$1,504,442
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-03-31$611,115
Total interest from all sources2016-03-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-03-31$21,302
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-03-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-03-31$21,302
Administrative expenses professional fees incurred2016-03-31$73,396
Was this plan covered by a fidelity bond2016-03-31Yes
Value of fidelity bond cover2016-03-31$500,000
Were there any nonexempt tranactions with any party-in-interest2016-03-31No
Amount of non-exempt transactions with any party-in-interest2016-03-31$500
Contributions received from participants2016-03-31$35,574
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-03-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-03-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-03-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-03-31$0
Other income not declared elsewhere2016-03-31$2,664
Administrative expenses (other) incurred2016-03-31$7,874
Liabilities. Value of operating payables at end of year2016-03-31$11,138
Liabilities. Value of operating payables at beginning of year2016-03-31$11,137
Total non interest bearing cash at end of year2016-03-31$135,394
Total non interest bearing cash at beginning of year2016-03-31$177,217
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-03-31No
Value of net income/loss2016-03-31$-224,133
Value of net assets at end of year (total assets less liabilities)2016-03-31$1,149,997
Value of net assets at beginning of year (total assets less liabilities)2016-03-31$1,374,130
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-03-31No
Were any leases to which the plan was party in default or uncollectible2016-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-03-31$1,136,199
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-03-31$1,323,042
Expenses. Payments to insurance carriers foe the provision of benefits2016-03-31$7,920,049
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-03-31$-13,145
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-03-31No
Was there a failure to transmit to the plan any participant contributions2016-03-31No
Has the plan failed to provide any benefit when due under the plan2016-03-31No
Contributions received in cash from employer2016-03-31$8,260,636
Employer contributions (assets) at end of year2016-03-31$7,722
Employer contributions (assets) at beginning of year2016-03-31$4,183
Contract administrator fees2016-03-31$529,845
Liabilities. Value of benefit claims payable at end of year2016-03-31$118,180
Liabilities. Value of benefit claims payable at beginning of year2016-03-31$119,175
Did the plan have assets held for investment2016-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-03-31No
Opinion of an independent qualified public accountant for this plan2016-03-31Unqualified
Accountancy firm name2016-03-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2016-03-31410746749
2015 : ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-03-31$130,312
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-03-31$142,552
Total income from all sources (including contributions)2015-03-31$8,516,591
Total loss/gain on sale of assets2015-03-31$0
Total of all expenses incurred2015-03-31$8,628,371
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-03-31$8,044,060
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-03-31$8,463,019
Value of total assets at end of year2015-03-31$1,504,442
Value of total assets at beginning of year2015-03-31$1,628,462
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-03-31$584,311
Total interest from all sources2015-03-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-03-31$28,908
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-03-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-03-31$28,908
Administrative expenses professional fees incurred2015-03-31$20,139
Was this plan covered by a fidelity bond2015-03-31Yes
Value of fidelity bond cover2015-03-31$500,000
Were there any nonexempt tranactions with any party-in-interest2015-03-31No
Contributions received from participants2015-03-31$104,223
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-03-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-03-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-03-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-03-31$0
Administrative expenses (other) incurred2015-03-31$580
Liabilities. Value of operating payables at end of year2015-03-31$11,137
Liabilities. Value of operating payables at beginning of year2015-03-31$17,202
Total non interest bearing cash at end of year2015-03-31$177,217
Total non interest bearing cash at beginning of year2015-03-31$131,365
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-03-31No
Value of net income/loss2015-03-31$-111,780
Value of net assets at end of year (total assets less liabilities)2015-03-31$1,374,130
Value of net assets at beginning of year (total assets less liabilities)2015-03-31$1,485,910
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-03-31No
Were any leases to which the plan was party in default or uncollectible2015-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-03-31$1,323,042
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-03-31$1,464,470
Expenses. Payments to insurance carriers foe the provision of benefits2015-03-31$8,044,060
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-03-31$24,664
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-03-31No
Was there a failure to transmit to the plan any participant contributions2015-03-31No
Has the plan failed to provide any benefit when due under the plan2015-03-31No
Contributions received in cash from employer2015-03-31$8,358,796
Employer contributions (assets) at end of year2015-03-31$4,183
Employer contributions (assets) at beginning of year2015-03-31$32,627
Contract administrator fees2015-03-31$563,592
Liabilities. Value of benefit claims payable at end of year2015-03-31$119,175
Liabilities. Value of benefit claims payable at beginning of year2015-03-31$125,350
Did the plan have assets held for investment2015-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-03-31No
Opinion of an independent qualified public accountant for this plan2015-03-31Unqualified
Accountancy firm name2015-03-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2015-03-31410746749
2014 : ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-03-31$142,552
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-03-31$90,957
Total income from all sources (including contributions)2014-03-31$8,563,325
Total loss/gain on sale of assets2014-03-31$0
Total of all expenses incurred2014-03-31$8,493,979
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-03-31$7,998,045
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-03-31$8,490,927
Value of total assets at end of year2014-03-31$1,628,462
Value of total assets at beginning of year2014-03-31$1,507,521
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-03-31$495,934
Total interest from all sources2014-03-31$0
Total dividends received (eg from common stock, registered investment company shares)2014-03-31$9,658
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-03-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-03-31$9,658
Administrative expenses professional fees incurred2014-03-31$32,887
Was this plan covered by a fidelity bond2014-03-31Yes
Value of fidelity bond cover2014-03-31$500,000
Were there any nonexempt tranactions with any party-in-interest2014-03-31No
Contributions received from participants2014-03-31$122,778
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-03-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-03-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-03-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-03-31$0
Other income not declared elsewhere2014-03-31$4,165
Administrative expenses (other) incurred2014-03-31$710
Liabilities. Value of operating payables at end of year2014-03-31$17,202
Liabilities. Value of operating payables at beginning of year2014-03-31$7,319
Total non interest bearing cash at end of year2014-03-31$131,365
Total non interest bearing cash at beginning of year2014-03-31$91,106
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-03-31No
Value of net income/loss2014-03-31$69,346
Value of net assets at end of year (total assets less liabilities)2014-03-31$1,485,910
Value of net assets at beginning of year (total assets less liabilities)2014-03-31$1,416,564
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-03-31No
Were any leases to which the plan was party in default or uncollectible2014-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-03-31$1,464,470
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-03-31$1,396,237
Expenses. Payments to insurance carriers foe the provision of benefits2014-03-31$7,998,045
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-03-31$58,575
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-03-31No
Was there a failure to transmit to the plan any participant contributions2014-03-31No
Has the plan failed to provide any benefit when due under the plan2014-03-31No
Contributions received in cash from employer2014-03-31$8,368,149
Employer contributions (assets) at end of year2014-03-31$32,627
Employer contributions (assets) at beginning of year2014-03-31$20,178
Contract administrator fees2014-03-31$462,337
Liabilities. Value of benefit claims payable at end of year2014-03-31$125,350
Liabilities. Value of benefit claims payable at beginning of year2014-03-31$83,638
Did the plan have assets held for investment2014-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-03-31No
Opinion of an independent qualified public accountant for this plan2014-03-31Unqualified
Accountancy firm name2014-03-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2014-03-31410746749
2013 : ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-03-31$90,957
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-03-31$151,601
Total income from all sources (including contributions)2013-03-31$8,589,378
Total loss/gain on sale of assets2013-03-31$0
Total of all expenses incurred2013-03-31$8,571,927
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-03-31$7,901,952
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-03-31$8,520,367
Value of total assets at end of year2013-03-31$1,507,521
Value of total assets at beginning of year2013-03-31$1,550,714
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-03-31$669,975
Total interest from all sources2013-03-31$0
Total dividends received (eg from common stock, registered investment company shares)2013-03-31$13,354
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-03-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-03-31$13,354
Administrative expenses professional fees incurred2013-03-31$41,658
Was this plan covered by a fidelity bond2013-03-31Yes
Value of fidelity bond cover2013-03-31$500,000
Were there any nonexempt tranactions with any party-in-interest2013-03-31No
Contributions received from participants2013-03-31$107,165
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-03-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-03-31$674
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-03-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-03-31$0
Other income not declared elsewhere2013-03-31$9,631
Administrative expenses (other) incurred2013-03-31$2,586
Liabilities. Value of operating payables at end of year2013-03-31$7,319
Liabilities. Value of operating payables at beginning of year2013-03-31$19,067
Total non interest bearing cash at end of year2013-03-31$91,106
Total non interest bearing cash at beginning of year2013-03-31$195,781
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-03-31No
Value of net income/loss2013-03-31$17,451
Value of net assets at end of year (total assets less liabilities)2013-03-31$1,416,564
Value of net assets at beginning of year (total assets less liabilities)2013-03-31$1,399,113
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-03-31No
Were any leases to which the plan was party in default or uncollectible2013-03-31No
Investment advisory and management fees2013-03-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-03-31$1,396,237
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-03-31$1,336,182
Expenses. Payments to insurance carriers foe the provision of benefits2013-03-31$7,901,952
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-03-31$46,026
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-03-31No
Was there a failure to transmit to the plan any participant contributions2013-03-31No
Has the plan failed to provide any benefit when due under the plan2013-03-31No
Contributions received in cash from employer2013-03-31$8,413,202
Employer contributions (assets) at end of year2013-03-31$20,178
Employer contributions (assets) at beginning of year2013-03-31$18,077
Contract administrator fees2013-03-31$625,731
Liabilities. Value of benefit claims payable at end of year2013-03-31$83,638
Liabilities. Value of benefit claims payable at beginning of year2013-03-31$132,534
Did the plan have assets held for investment2013-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-03-31No
Opinion of an independent qualified public accountant for this plan2013-03-31Unqualified
Accountancy firm name2013-03-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2013-03-31410746749
2012 : ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-03-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-03-31$151,601
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-03-31$155,350
Total income from all sources (including contributions)2012-03-31$10,842,380
Total loss/gain on sale of assets2012-03-31$-12,324
Total of all expenses incurred2012-03-31$10,749,620
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-03-31$9,897,519
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-03-31$10,710,597
Value of total assets at end of year2012-03-31$1,550,714
Value of total assets at beginning of year2012-03-31$1,461,703
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-03-31$852,101
Total interest from all sources2012-03-31$0
Total dividends received (eg from common stock, registered investment company shares)2012-03-31$30,307
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-03-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-03-31$30,307
Administrative expenses professional fees incurred2012-03-31$37,493
Was this plan covered by a fidelity bond2012-03-31Yes
Value of fidelity bond cover2012-03-31$500,000
If this is an individual account plan, was there a blackout period2012-03-31No
Were there any nonexempt tranactions with any party-in-interest2012-03-31No
Contributions received from participants2012-03-31$126,007
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-03-31$674
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-03-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-03-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-03-31$0
Other income not declared elsewhere2012-03-31$86,777
Administrative expenses (other) incurred2012-03-31$2,612
Liabilities. Value of operating payables at end of year2012-03-31$19,067
Liabilities. Value of operating payables at beginning of year2012-03-31$18,191
Total non interest bearing cash at end of year2012-03-31$195,781
Total non interest bearing cash at beginning of year2012-03-31$169,853
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-03-31No
Value of net income/loss2012-03-31$92,760
Value of net assets at end of year (total assets less liabilities)2012-03-31$1,399,113
Value of net assets at beginning of year (total assets less liabilities)2012-03-31$1,306,353
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-03-31No
Were any leases to which the plan was party in default or uncollectible2012-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-03-31$1,336,182
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-03-31$1,291,850
Expenses. Payments to insurance carriers foe the provision of benefits2012-03-31$9,897,519
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-03-31$27,023
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-03-31No
Was there a failure to transmit to the plan any participant contributions2012-03-31No
Has the plan failed to provide any benefit when due under the plan2012-03-31No
Contributions received in cash from employer2012-03-31$10,584,590
Employer contributions (assets) at end of year2012-03-31$18,077
Contract administrator fees2012-03-31$811,996
Liabilities. Value of benefit claims payable at end of year2012-03-31$132,534
Liabilities. Value of benefit claims payable at beginning of year2012-03-31$137,159
Did the plan have assets held for investment2012-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-03-31No
Aggregate proceeds on sale of assets2012-03-31$65,287
Aggregate carrying amount (costs) on sale of assets2012-03-31$77,611
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-03-31No
Opinion of an independent qualified public accountant for this plan2012-03-31Unqualified
Accountancy firm name2012-03-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2012-03-31410746749
2011 : ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-03-31$155,350
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-03-31$123,816
Total income from all sources (including contributions)2011-03-31$11,604,567
Total of all expenses incurred2011-03-31$11,588,206
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-03-31$10,614,976
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-03-31$11,573,116
Value of total assets at end of year2011-03-31$1,461,703
Value of total assets at beginning of year2011-03-31$1,413,808
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-03-31$973,230
Total dividends received (eg from common stock, registered investment company shares)2011-03-31$21,059
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-03-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-03-31$21,059
Administrative expenses professional fees incurred2011-03-31$58,335
Was this plan covered by a fidelity bond2011-03-31Yes
Value of fidelity bond cover2011-03-31$500,000
If this is an individual account plan, was there a blackout period2011-03-31No
Were there any nonexempt tranactions with any party-in-interest2011-03-31No
Contributions received from participants2011-03-31$256,125
Income. Received or receivable in cash from other sources (including rollovers)2011-03-31$1,635
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-03-31$53,954
Other income not declared elsewhere2011-03-31$-32,726
Administrative expenses (other) incurred2011-03-31$8,720
Liabilities. Value of operating payables at end of year2011-03-31$18,191
Liabilities. Value of operating payables at beginning of year2011-03-31$19,383
Total non interest bearing cash at end of year2011-03-31$169,853
Total non interest bearing cash at beginning of year2011-03-31$9,579
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-03-31No
Value of net income/loss2011-03-31$16,361
Value of net assets at end of year (total assets less liabilities)2011-03-31$1,306,353
Value of net assets at beginning of year (total assets less liabilities)2011-03-31$1,289,992
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-03-31No
Were any leases to which the plan was party in default or uncollectible2011-03-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-03-31$1,291,850
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-03-31$1,350,275
Expenses. Payments to insurance carriers foe the provision of benefits2011-03-31$10,614,976
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-03-31$43,118
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-03-31No
Was there a failure to transmit to the plan any participant contributions2011-03-31No
Has the plan failed to provide any benefit when due under the plan2011-03-31No
Contributions received in cash from employer2011-03-31$11,315,356
Contract administrator fees2011-03-31$906,175
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-03-31No
Liabilities. Value of benefit claims payable at end of year2011-03-31$137,159
Liabilities. Value of benefit claims payable at beginning of year2011-03-31$104,433
Did the plan have assets held for investment2011-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-03-31No
Opinion of an independent qualified public accountant for this plan2011-03-31Unqualified
Accountancy firm name2011-03-31MOSS ADAMS LLP
Accountancy firm EIN2011-03-31910189318

Form 5500 Responses for ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST

2022: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2022 form 5500 responses
2022-04-01Type of plan entityMulitple employer plan
2022-04-01Submission has been amendedNo
2022-04-01This submission is the final filingNo
2022-04-01This return/report is a short plan year return/report (less than 12 months)No
2022-04-01Plan is a collectively bargained planNo
2022-04-01Plan funding arrangement – TrustYes
2022-04-01Plan benefit arrangement – InsuranceYes
2021: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2021 form 5500 responses
2021-04-01Type of plan entityMulitple employer plan
2021-04-01Submission has been amendedNo
2021-04-01This submission is the final filingNo
2021-04-01This return/report is a short plan year return/report (less than 12 months)No
2021-04-01Plan is a collectively bargained planNo
2021-04-01Plan funding arrangement – TrustYes
2021-04-01Plan benefit arrangement – InsuranceYes
2020: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2020 form 5500 responses
2020-04-01Type of plan entityMulitple employer plan
2020-04-01Submission has been amendedNo
2020-04-01This submission is the final filingNo
2020-04-01This return/report is a short plan year return/report (less than 12 months)No
2020-04-01Plan is a collectively bargained planNo
2020-04-01Plan funding arrangement – TrustYes
2020-04-01Plan benefit arrangement – InsuranceYes
2019: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2019 form 5500 responses
2019-04-01Type of plan entityMulitple employer plan
2019-04-01Submission has been amendedNo
2019-04-01This submission is the final filingNo
2019-04-01This return/report is a short plan year return/report (less than 12 months)No
2019-04-01Plan is a collectively bargained planNo
2019-04-01Plan funding arrangement – TrustYes
2019-04-01Plan benefit arrangement – InsuranceYes
2018: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2018 form 5500 responses
2018-04-01Type of plan entityMulitple employer plan
2018-04-01Submission has been amendedNo
2018-04-01This submission is the final filingNo
2018-04-01This return/report is a short plan year return/report (less than 12 months)No
2018-04-01Plan is a collectively bargained planNo
2018-04-01Plan funding arrangement – TrustYes
2018-04-01Plan benefit arrangement – InsuranceYes
2017: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2017 form 5500 responses
2017-04-01Type of plan entityMulitple employer plan
2017-04-01Submission has been amendedNo
2017-04-01This submission is the final filingNo
2017-04-01This return/report is a short plan year return/report (less than 12 months)No
2017-04-01Plan is a collectively bargained planNo
2017-04-01Plan funding arrangement – TrustYes
2017-04-01Plan benefit arrangement – InsuranceYes
2016: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2016 form 5500 responses
2016-04-01Type of plan entityMulitple employer plan
2016-04-01Submission has been amendedNo
2016-04-01This submission is the final filingNo
2016-04-01This return/report is a short plan year return/report (less than 12 months)No
2016-04-01Plan is a collectively bargained planNo
2016-04-01Plan funding arrangement – TrustYes
2016-04-01Plan benefit arrangement – InsuranceYes
2015: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2015 form 5500 responses
2015-04-01Type of plan entityMulitple employer plan
2015-04-01Submission has been amendedNo
2015-04-01This submission is the final filingNo
2015-04-01This return/report is a short plan year return/report (less than 12 months)No
2015-04-01Plan is a collectively bargained planNo
2015-04-01Plan funding arrangement – TrustYes
2015-04-01Plan benefit arrangement – InsuranceYes
2014: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2014 form 5500 responses
2014-04-01Type of plan entityMulitple employer plan
2014-04-01Submission has been amendedNo
2014-04-01This submission is the final filingNo
2014-04-01This return/report is a short plan year return/report (less than 12 months)No
2014-04-01Plan is a collectively bargained planNo
2014-04-01Plan funding arrangement – TrustYes
2014-04-01Plan benefit arrangement – InsuranceYes
2013: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2013 form 5500 responses
2013-04-01Type of plan entityMulitple employer plan
2013-04-01Submission has been amendedNo
2013-04-01This submission is the final filingNo
2013-04-01This return/report is a short plan year return/report (less than 12 months)No
2013-04-01Plan is a collectively bargained planNo
2013-04-01Plan funding arrangement – TrustYes
2013-04-01Plan benefit arrangement – InsuranceYes
2012: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2012 form 5500 responses
2012-04-01Type of plan entityMulitple employer plan
2012-04-01Submission has been amendedNo
2012-04-01This submission is the final filingNo
2012-04-01This return/report is a short plan year return/report (less than 12 months)No
2012-04-01Plan is a collectively bargained planNo
2012-04-01Plan funding arrangement – TrustYes
2012-04-01Plan benefit arrangement – InsuranceYes
2011: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2011 form 5500 responses
2011-04-01Type of plan entityMulitple employer plan
2011-04-01Submission has been amendedNo
2011-04-01This submission is the final filingNo
2011-04-01This return/report is a short plan year return/report (less than 12 months)No
2011-04-01Plan is a collectively bargained planNo
2011-04-01Plan funding arrangement – TrustYes
2011-04-01Plan benefit arrangement – InsuranceYes
2010: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2010 form 5500 responses
2010-04-01Type of plan entityMulitple employer plan
2010-04-01Plan funding arrangement – TrustYes
2010-04-01Plan benefit arrangement – InsuranceYes
2009: ASSOCIATED GENERAL CONTRACTORS HEALTH BENEFIT TRUST 2009 form 5500 responses
2009-04-01Type of plan entityMulitple employer plan
2009-04-01This submission is the final filingNo
2009-04-01Plan funding arrangement – TrustYes
2009-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number309287
Policy instance 4
Insurance contract or identification number309287
Number of Individuals Covered780
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD & D
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 $23,790
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 number8390000
Policy instance 3
Insurance contract or identification number8390000
Number of Individuals Covered1589
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $7,197,616
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number753399
Policy instance 2
Insurance contract or identification number753399
Number of Individuals Covered462
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number753399D
Policy instance 1
Insurance contract or identification number753399D
Number of Individuals Covered206
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
Dental Insurance Welfare BenefitYes
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number753399D
Policy instance 2
Insurance contract or identification number753399D
Number of Individuals Covered222
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
Dental Insurance Welfare BenefitYes
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number753399V
Policy instance 3
Insurance contract or identification number753399V
Number of Individuals Covered530
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberOR300267
Policy instance 4
Insurance contract or identification numberOR300267
Number of Individuals Covered1172
Insurance policy start date2021-04-01
Insurance policy end date2021-09-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D, VOLUNATARY ACCIDENT
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 $18,920
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 number8390000
Policy instance 5
Insurance contract or identification number8390000
Number of Individuals Covered1657
Insurance policy start date2021-10-01
Insurance policy end date2022-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $4,112,159
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 number309287
Policy instance 6
Insurance contract or identification number309287
Number of Individuals Covered881
Insurance policy start date2021-10-01
Insurance policy end date2022-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD & D
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 $12,752
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 )
Policy contract number800000016
Policy instance 1
Insurance contract or identification number800000016
Number of Individuals Covered2159
Insurance policy start date2021-01-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $6,612
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $8,604,796
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2488
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberOR300267
Policy instance 4
Insurance contract or identification numberOR300267
Number of Individuals Covered1066
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $34,166
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number753399V
Policy instance 3
Insurance contract or identification number753399V
Number of Individuals Covered600
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number753399D
Policy instance 2
Insurance contract or identification number753399D
Number of Individuals Covered312
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
Dental Insurance Welfare BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 )
Policy contract number800000016
Policy instance 1
Insurance contract or identification number800000016
Number of Individuals Covered1957
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $4,443
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $9,523,039
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1380
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number753399V
Policy instance 3
Insurance contract or identification number753399V
Number of Individuals Covered411
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number753399D
Policy instance 2
Insurance contract or identification number753399D
Number of Individuals Covered292
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
Dental Insurance Welfare BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 )
Policy contract number800000016
Policy instance 1
Insurance contract or identification number800000016
Number of Individuals Covered1556
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 $4,318
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $10,076,708
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees640
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $0
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberOR300267
Policy instance 4
Insurance contract or identification numberOR300267
Number of Individuals Covered873
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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 $35,079
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number753399D
Policy instance 2
Insurance contract or identification number753399D
Number of Individuals Covered337
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
Dental Insurance Welfare BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 )
Policy contract number800000016
Policy instance 1
Insurance contract or identification number800000016
Number of Individuals Covered2261
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $3,040
Total amount of fees paid to insurance companyUSD $11,957
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
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 $11,177,043
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2040
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $1,760
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number753399V
Policy instance 3
Insurance contract or identification number753399V
Number of Individuals Covered400
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberOR300267
Policy instance 4
Insurance contract or identification numberOR300267
Number of Individuals Covered1005
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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 $40,064
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberOR300267
Policy instance 4
Insurance contract or identification numberOR300267
Number of Individuals Covered1120
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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 $38,890
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number753399V
Policy instance 3
Insurance contract or identification number753399V
Number of Individuals Covered536
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 )
Policy contract number800000016
Policy instance 1
Insurance contract or identification number800000016
Number of Individuals Covered2672
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 $2,100
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
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 $9,144,227
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees560
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameCRAVINHO & JAEGER FINANCIAL SVS INC
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number753399D
Policy instance 2
Insurance contract or identification number753399D
Number of Individuals Covered370
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
Dental Insurance Welfare BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number30346-02
Policy instance 3
Insurance contract or identification number30346-02
Number of Individuals Covered550
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
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 $26,315
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberOR300267
Policy instance 6
Insurance contract or identification numberOR300267
Number of Individuals Covered934
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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 $29,917
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number30346-04
Policy instance 5
Insurance contract or identification number30346-04
Number of Individuals Covered54
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
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 $2,535
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 )
Policy contract number800000016
Policy instance 1
Insurance contract or identification number800000016
Number of Individuals Covered750
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $574
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 BenefitYes
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 $7,693,533
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees406
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameDEBRA BRAILSFORD
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number30346-03
Policy instance 4
Insurance contract or identification number30346-03
Number of Individuals Covered121
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
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 $8,274
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number30346-01
Policy instance 2
Insurance contract or identification number30346-01
Number of Individuals Covered294
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
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 $11,425
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number30346-02
Policy instance 3
Insurance contract or identification number30346-02
Number of Individuals Covered558
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
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 $29,739
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number30346-03
Policy instance 4
Insurance contract or identification number30346-03
Number of Individuals Covered131
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
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 $11,813
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number30346-01
Policy instance 2
Insurance contract or identification number30346-01
Number of Individuals Covered224
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
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 $9,703
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number30346-04
Policy instance 5
Insurance contract or identification number30346-04
Number of Individuals Covered0
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
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 $3,673
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberOR300267
Policy instance 6
Insurance contract or identification numberOR300267
Number of Individuals Covered836
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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 $25,466
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 )
Policy contract number800000016
Policy instance 1
Insurance contract or identification number800000016
Number of Individuals Covered773
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
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 $8,003,961
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberOR300267
Policy instance 6
Insurance contract or identification numberOR300267
Number of Individuals Covered769
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $25,464
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 )
Policy contract number800000016
Policy instance 1
Insurance contract or identification number800000016
Number of Individuals Covered1691
Insurance policy start date2014-01-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $4,943
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 BenefitYes
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 $7,924,762
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1208
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameMARTIN KNUTSEN & SON
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number30346-01
Policy instance 2
Insurance contract or identification number30346-01
Number of Individuals Covered243
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
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 $8,937
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number30346-02
Policy instance 3
Insurance contract or identification number30346-02
Number of Individuals Covered614
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
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 $25,671
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number30346-03
Policy instance 4
Insurance contract or identification number30346-03
Number of Individuals Covered131
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
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 $10,061
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number30346-04
Policy instance 5
Insurance contract or identification number30346-04
Number of Individuals Covered39
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
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 $3,168
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number30625-04
Policy instance 11
Insurance contract or identification number30625-04
Number of Individuals Covered36
Insurance policy start date2012-08-01
Insurance policy end date2012-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
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 $332
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number30625-02
Policy instance 9
Insurance contract or identification number30625-02
Number of Individuals Covered31
Insurance policy start date2012-08-01
Insurance policy end date2012-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
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 $707
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00431772
Policy instance 8
Insurance contract or identification number00431772
Number of Individuals Covered355
Insurance policy start date2012-04-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $2,509
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 BenefitNo
Dental Insurance Welfare BenefitYes
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 $220,600
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,509
Insurance broker organization code?3
Insurance broker nameWILLIS OF OREGON INC
HEALTHNET (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number10179
Policy instance 7
Insurance contract or identification number10179
Number of Individuals Covered1078
Insurance policy start date2012-04-01
Insurance policy end date2012-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $5,776,148
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number30346-04
Policy instance 6
Insurance contract or identification number30346-04
Number of Individuals Covered42
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
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 $3,272
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 )
Policy contract number800000016
Policy instance 1
Insurance contract or identification number800000016
Number of Individuals Covered1767
Insurance policy start date2013-01-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $28,410
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 BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,923,259
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees15500
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameLARRY SHERWOOD & ASSOCIATES
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number30346-02
Policy instance 5
Insurance contract or identification number30346-02
Number of Individuals Covered492
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
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 $27,003
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number30625-01
Policy instance 4
Insurance contract or identification number30625-01
Number of Individuals Covered15
Insurance policy start date2012-08-01
Insurance policy end date2012-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
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 $745
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberOR300267
Policy instance 3
Insurance contract or identification numberOR300267
Number of Individuals Covered964
Insurance policy start date2013-01-01
Insurance policy end date2013-03-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $5,848
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number30346-01
Policy instance 2
Insurance contract or identification number30346-01
Number of Individuals Covered331
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
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 $14,838
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number30346-03
Policy instance 10
Insurance contract or identification number30346-03
Number of Individuals Covered54
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
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 $2,624
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number10179
Policy instance 2
Insurance contract or identification number10179
Number of Individuals Covered60
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
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 $186,399
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number12322
Policy instance 7
Insurance contract or identification number12322
Number of Individuals Covered15
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
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 $59,616
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00431772
Policy instance 6
Insurance contract or identification number00431772
Number of Individuals Covered312
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,614
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 BenefitNo
Dental Insurance Welfare BenefitYes
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 $403,097
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFEWISE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 94188 )
Policy contract numberOR-101615-0000
Policy instance 3
Insurance contract or identification numberOR-101615-0000
Number of Individuals Covered304
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $12,975
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number12331
Policy instance 4
Insurance contract or identification number12331
Number of Individuals Covered13
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $19,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number12329
Policy instance 1
Insurance contract or identification number12329
Number of Individuals Covered42
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
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 $28,213
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 number10179
Policy instance 5
Insurance contract or identification number10179
Number of Individuals Covered1132
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
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 $8,503,197
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHNET (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number10179
Policy instance 2
Insurance contract or identification number10179
Number of Individuals Covered1517
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
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
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,412,662
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number10179 ET AL
Policy instance 3
Insurance contract or identification number10179 ET AL
Number of Individuals Covered256
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
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
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $707,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFEWISE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 94188 )
Policy contract numberOR-101615-0000
Policy instance 4
Insurance contract or identification numberOR-101615-0000
Number of Individuals Covered409
Insurance policy start date2010-04-01
Insurance policy end date2011-03-30
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
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $16,742
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number431772
Policy instance 1
Insurance contract or identification number431772
Number of Individuals Covered620
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,186
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $403,103
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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