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FDSA/FSSA GROUP BENEFITS PLAN 401k Plan overview

Plan NameFDSA/FSSA GROUP BENEFITS PLAN
Plan identification number 501

FDSA/FSSA GROUP BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

FRESNO DEPUTY SHERIFFS ASSOC., INC. has sponsored the creation of one or more 401k plans.

Company Name:FRESNO DEPUTY SHERIFFS ASSOC., INC.
Employer identification number (EIN):237377560
NAIC Classification:722410
NAIC Description:Drinking Places (Alcoholic Beverages)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FDSA/FSSA GROUP BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01ERIC SCHMIDT, PRESIDENT
5012016-01-01ERIC SCHMIDT, PRESIDENT
5012015-01-01ERIC SCHMIDT, PRESIDENT
5012014-01-01ERIC SCHMIDT, PRESIDENT
5012013-01-01ERIC SCHMIDT, PRESIDENT
5012012-01-01ERIC SCHMIDT, PRESIDENT
5012011-01-01ERIC SCHMIDT PRESIDENT
5012009-01-01ERIC SCHMIDT PRESIDENT

Plan Statistics for FDSA/FSSA GROUP BENEFITS PLAN

401k plan membership statisitcs for FDSA/FSSA GROUP BENEFITS PLAN

Measure Date Value
2022: FDSA/FSSA GROUP BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01704
Total number of active participants reported on line 7a of the Form 55002022-01-01744
Number of retired or separated participants receiving benefits2022-01-01224
Number of other retired or separated participants entitled to future benefits2022-01-012
Total of all active and inactive participants2022-01-01970
Total participants2022-01-01970
2021: FDSA/FSSA GROUP BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01798
Total number of active participants reported on line 7a of the Form 55002021-01-01557
Number of retired or separated participants receiving benefits2021-01-01147
Total of all active and inactive participants2021-01-01704
Total participants2021-01-01704
2020: FDSA/FSSA GROUP BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01718
Total number of active participants reported on line 7a of the Form 55002020-01-01569
Number of retired or separated participants receiving benefits2020-01-01227
Number of other retired or separated participants entitled to future benefits2020-01-012
Total of all active and inactive participants2020-01-01798
Total participants2020-01-01798
2019: FDSA/FSSA GROUP BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01653
Total number of active participants reported on line 7a of the Form 55002019-01-01511
Number of retired or separated participants receiving benefits2019-01-01207
Total of all active and inactive participants2019-01-01718
Total participants2019-01-01718
2018: FDSA/FSSA GROUP BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01707
Total number of active participants reported on line 7a of the Form 55002018-01-01561
Number of retired or separated participants receiving benefits2018-01-0192
Total of all active and inactive participants2018-01-01653
Total participants2018-01-01653
2017: FDSA/FSSA GROUP BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01669
Total number of active participants reported on line 7a of the Form 55002017-01-01494
Number of retired or separated participants receiving benefits2017-01-01213
Total of all active and inactive participants2017-01-01707
Total participants2017-01-01707
2016: FDSA/FSSA GROUP BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01615
Total number of active participants reported on line 7a of the Form 55002016-01-01464
Number of retired or separated participants receiving benefits2016-01-01205
Total of all active and inactive participants2016-01-01669
Total participants2016-01-01669
2015: FDSA/FSSA GROUP BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-010
Total number of active participants reported on line 7a of the Form 55002015-01-01536
Number of retired or separated participants receiving benefits2015-01-0179
Total of all active and inactive participants2015-01-01615
Total participants2015-01-010
2014: FDSA/FSSA GROUP BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01614
Total number of active participants reported on line 7a of the Form 55002014-01-011,249
Number of retired or separated participants receiving benefits2014-01-01106
Total of all active and inactive participants2014-01-011,355
Total participants2014-01-010
2013: FDSA/FSSA GROUP BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01573
Total number of active participants reported on line 7a of the Form 55002013-01-01522
Number of retired or separated participants receiving benefits2013-01-0192
Total of all active and inactive participants2013-01-01614
Total participants2013-01-010
2012: FDSA/FSSA GROUP BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01647
Total number of active participants reported on line 7a of the Form 55002012-01-01473
Number of retired or separated participants receiving benefits2012-01-0195
Number of other retired or separated participants entitled to future benefits2012-01-015
Total of all active and inactive participants2012-01-01573
Total participants2012-01-010
2011: FDSA/FSSA GROUP BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01673
Total number of active participants reported on line 7a of the Form 55002011-01-01461
Number of retired or separated participants receiving benefits2011-01-01160
Number of other retired or separated participants entitled to future benefits2011-01-014
Total of all active and inactive participants2011-01-01625
Total participants2011-01-01625
2009: FDSA/FSSA GROUP BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01640
Total number of active participants reported on line 7a of the Form 55002009-01-01518
Number of retired or separated participants receiving benefits2009-01-0174
Total of all active and inactive participants2009-01-01592
Total participants2009-01-01592

Financial Data on FDSA/FSSA GROUP BENEFITS PLAN

Measure Date Value
2022 : FDSA/FSSA GROUP BENEFITS PLAN 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$-367,283
Total unrealized appreciation/depreciation of assets2022-12-31$-367,283
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$17,285
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$24,323
Total income from all sources (including contributions)2022-12-31$9,315,431
Total loss/gain on sale of assets2022-12-31$-8,271
Total of all expenses incurred2022-12-31$9,681,770
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$9,549,671
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$9,583,975
Value of total assets at end of year2022-12-31$2,173,891
Value of total assets at beginning of year2022-12-31$2,547,268
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$132,099
Total interest from all sources2022-12-31$146
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$54,588
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$54,588
Was this plan covered by a fidelity bond2022-12-31No
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$3,102,188
Participant contributions at end of year2022-12-31$93,325
Participant contributions at beginning of year2022-12-31$120,578
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$17,285
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$24,323
Other income not declared elsewhere2022-12-31$52,276
Administrative expenses (other) incurred2022-12-31$108,681
Total non interest bearing cash at end of year2022-12-31$235,517
Total non interest bearing cash at beginning of year2022-12-31$320,247
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-366,339
Value of net assets at end of year (total assets less liabilities)2022-12-31$2,156,606
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$2,522,945
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$23,418
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$1,491,808
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$1,836,004
Value of interest in pooled separate accounts at end of year2022-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$85,322
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$44,501
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$44,501
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$146
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$9,549,671
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$6,481,787
Employer contributions (assets) at end of year2022-12-31$267,919
Employer contributions (assets) at beginning of year2022-12-31$225,938
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-12-31No
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Aggregate proceeds on sale of assets2022-12-31$126,995
Aggregate carrying amount (costs) on sale of assets2022-12-31$135,266
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31HILLS RENAUT HOMEN & HUGHES
Accountancy firm EIN2022-12-31942463125
2021 : FDSA/FSSA GROUP BENEFITS PLAN 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2021-12-31$148,723
Total unrealized appreciation/depreciation of assets2021-12-31$148,723
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$24,323
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$16,964
Total income from all sources (including contributions)2021-12-31$9,801,968
Total loss/gain on sale of assets2021-12-31$7,541
Total of all expenses incurred2021-12-31$9,764,401
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$9,662,353
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$9,522,613
Value of total assets at end of year2021-12-31$2,547,268
Value of total assets at beginning of year2021-12-31$2,502,342
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$102,048
Total interest from all sources2021-12-31$43
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$70,907
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$70,907
Was this plan covered by a fidelity bond2021-12-31No
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$3,639,045
Participant contributions at end of year2021-12-31$120,578
Participant contributions at beginning of year2021-12-31$118,536
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$24,323
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$16,964
Other income not declared elsewhere2021-12-31$52,141
Administrative expenses (other) incurred2021-12-31$75,634
Total non interest bearing cash at end of year2021-12-31$320,247
Total non interest bearing cash at beginning of year2021-12-31$475,990
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$37,567
Value of net assets at end of year (total assets less liabilities)2021-12-31$2,522,945
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$2,485,378
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$26,414
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$1,836,004
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$1,636,659
Value of interest in pooled separate accounts at end of year2021-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$44,501
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$44,163
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$44,163
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$43
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$9,662,353
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$5,883,568
Employer contributions (assets) at end of year2021-12-31$225,938
Employer contributions (assets) at beginning of year2021-12-31$226,994
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-12-31No
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Aggregate proceeds on sale of assets2021-12-31$21,001
Aggregate carrying amount (costs) on sale of assets2021-12-31$13,460
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31HILLS RENAUT HOMEN & HUGHES
Accountancy firm EIN2021-12-31942463125
2020 : FDSA/FSSA GROUP BENEFITS PLAN 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2020-12-31$177,433
Total unrealized appreciation/depreciation of assets2020-12-31$177,433
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$16,964
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$17,506
Total income from all sources (including contributions)2020-12-31$9,423,739
Total loss/gain on sale of assets2020-12-31$-7,226
Total of all expenses incurred2020-12-31$9,304,885
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$9,195,254
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$9,152,455
Value of total assets at end of year2020-12-31$2,502,342
Value of total assets at beginning of year2020-12-31$2,384,030
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$109,631
Total interest from all sources2020-12-31$136
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$47,992
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31No
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$3,545,483
Participant contributions at end of year2020-12-31$118,536
Participant contributions at beginning of year2020-12-31$123,155
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$16,964
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$17,506
Other income not declared elsewhere2020-12-31$52,949
Administrative expenses (other) incurred2020-12-31$71,571
Total non interest bearing cash at end of year2020-12-31$475,990
Total non interest bearing cash at beginning of year2020-12-31$542,545
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$118,854
Value of net assets at end of year (total assets less liabilities)2020-12-31$2,485,378
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$2,366,524
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Investment advisory and management fees2020-12-31$38,060
Value of interest in pooled separate accounts at end of year2020-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$44,163
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$43,956
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$43,956
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$136
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$9,195,254
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$5,606,972
Employer contributions (assets) at end of year2020-12-31$226,994
Employer contributions (assets) at beginning of year2020-12-31$217,720
Income. Dividends from common stock2020-12-31$47,992
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-12-31No
Assets. Corporate common stocks other than exployer securities at end of year2020-12-31$1,636,659
Assets. Corporate common stocks other than exployer securities at beginning of year2020-12-31$1,456,654
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Aggregate proceeds on sale of assets2020-12-31$239,602
Aggregate carrying amount (costs) on sale of assets2020-12-31$246,828
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31HILLS RENAUT HOMEN & HUGHES
Accountancy firm EIN2020-12-31942463125
2019 : FDSA/FSSA GROUP BENEFITS PLAN 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$197,295
Total unrealized appreciation/depreciation of assets2019-12-31$197,295
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$17,506
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$17,190
Total income from all sources (including contributions)2019-12-31$8,990,815
Total loss/gain on sale of assets2019-12-31$35,250
Total of all expenses incurred2019-12-31$8,741,346
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$8,649,896
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$8,656,649
Value of total assets at end of year2019-12-31$2,384,030
Value of total assets at beginning of year2019-12-31$2,134,245
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$91,450
Total interest from all sources2019-12-31$488
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$48,527
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$3,336,831
Participant contributions at end of year2019-12-31$123,155
Participant contributions at beginning of year2019-12-31$109,567
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$17,506
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$17,190
Other income not declared elsewhere2019-12-31$52,606
Administrative expenses (other) incurred2019-12-31$71,699
Total non interest bearing cash at end of year2019-12-31$542,545
Total non interest bearing cash at beginning of year2019-12-31$580,820
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$249,469
Value of net assets at end of year (total assets less liabilities)2019-12-31$2,366,524
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$2,117,055
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$19,751
Value of interest in pooled separate accounts at end of year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$43,956
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$43,016
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$43,016
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$488
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$8,649,896
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$5,319,818
Employer contributions (assets) at end of year2019-12-31$217,720
Employer contributions (assets) at beginning of year2019-12-31$205,057
Income. Dividends from common stock2019-12-31$48,527
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31No
Assets. Corporate common stocks other than exployer securities at end of year2019-12-31$1,456,654
Assets. Corporate common stocks other than exployer securities at beginning of year2019-12-31$1,195,785
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Aggregate proceeds on sale of assets2019-12-31$644,409
Aggregate carrying amount (costs) on sale of assets2019-12-31$609,159
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31HILLS RENAUT HOMEN & HUGHES
Accountancy firm EIN2019-12-31942463125
2018 : FDSA/FSSA GROUP BENEFITS PLAN 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$-140,645
Total unrealized appreciation/depreciation of assets2018-12-31$-140,645
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$17,190
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$13,520
Total income from all sources (including contributions)2018-12-31$8,040,639
Total loss/gain on sale of assets2018-12-31$-1,963
Total of all expenses incurred2018-12-31$8,127,513
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$8,039,156
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$8,081,279
Value of total assets at end of year2018-12-31$2,134,245
Value of total assets at beginning of year2018-12-31$2,217,449
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$88,357
Total interest from all sources2018-12-31$485
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$48,896
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31No
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$3,139,082
Participant contributions at end of year2018-12-31$109,567
Participant contributions at beginning of year2018-12-31$80,122
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$17,190
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$13,520
Other income not declared elsewhere2018-12-31$52,587
Administrative expenses (other) incurred2018-12-31$67,075
Total non interest bearing cash at end of year2018-12-31$580,820
Total non interest bearing cash at beginning of year2018-12-31$601,562
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-86,874
Value of net assets at end of year (total assets less liabilities)2018-12-31$2,117,055
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$2,203,929
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Investment advisory and management fees2018-12-31$21,282
Value of interest in pooled separate accounts at end of year2018-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$43,016
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$43,245
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$43,245
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$485
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$8,039,156
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$4,942,197
Employer contributions (assets) at end of year2018-12-31$205,057
Employer contributions (assets) at beginning of year2018-12-31$183,815
Income. Dividends from common stock2018-12-31$48,896
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Assets. Corporate common stocks other than exployer securities at end of year2018-12-31$1,195,785
Assets. Corporate common stocks other than exployer securities at beginning of year2018-12-31$1,308,705
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Aggregate proceeds on sale of assets2018-12-31$13,215
Aggregate carrying amount (costs) on sale of assets2018-12-31$15,178
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31HILLS RENAUT HOMEN & HUGHES
Accountancy firm EIN2018-12-31942463125
2017 : FDSA/FSSA GROUP BENEFITS PLAN 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2017-12-31$167,187
Total unrealized appreciation/depreciation of assets2017-12-31$167,187
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$13,520
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$12,784
Total income from all sources (including contributions)2017-12-31$8,032,705
Total loss/gain on sale of assets2017-12-31$-1,227
Total of all expenses incurred2017-12-31$7,864,709
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$7,778,649
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$7,767,746
Value of total assets at end of year2017-12-31$2,217,449
Value of total assets at beginning of year2017-12-31$2,048,717
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$86,060
Total interest from all sources2017-12-31$476
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$47,878
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31No
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$3,263,578
Participant contributions at end of year2017-12-31$80,122
Participant contributions at beginning of year2017-12-31$111,245
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$13,520
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$12,784
Other income not declared elsewhere2017-12-31$50,645
Administrative expenses (other) incurred2017-12-31$68,068
Total non interest bearing cash at end of year2017-12-31$601,562
Total non interest bearing cash at beginning of year2017-12-31$628,867
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$167,996
Value of net assets at end of year (total assets less liabilities)2017-12-31$2,203,929
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$2,035,933
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Investment advisory and management fees2017-12-31$17,992
Value of interest in common/collective trusts at end of year2017-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$43,245
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$42,675
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$42,675
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$476
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$7,778,649
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$4,504,168
Employer contributions (assets) at end of year2017-12-31$183,815
Employer contributions (assets) at beginning of year2017-12-31$152,055
Income. Dividends from common stock2017-12-31$47,878
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Assets. Corporate common stocks other than exployer securities at end of year2017-12-31$1,308,705
Assets. Corporate common stocks other than exployer securities at beginning of year2017-12-31$1,113,875
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Aggregate proceeds on sale of assets2017-12-31$11,792
Aggregate carrying amount (costs) on sale of assets2017-12-31$13,019
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31HILLS RENAUT HOMEN & HUGHES
Accountancy firm EIN2017-12-31942463125
2016 : FDSA/FSSA GROUP BENEFITS PLAN 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2016-12-31$59,364
Total unrealized appreciation/depreciation of assets2016-12-31$59,364
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$12,784
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$624,542
Total income from all sources (including contributions)2016-12-31$8,082,974
Total loss/gain on sale of assets2016-12-31$-684
Total of all expenses incurred2016-12-31$8,021,266
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$7,939,446
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$7,945,182
Value of total assets at end of year2016-12-31$2,048,717
Value of total assets at beginning of year2016-12-31$2,598,767
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$81,820
Total interest from all sources2016-12-31$472
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$28,401
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31No
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$3,976,532
Participant contributions at end of year2016-12-31$111,245
Participant contributions at beginning of year2016-12-31$122,461
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$12,784
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$624,542
Other income not declared elsewhere2016-12-31$50,239
Administrative expenses (other) incurred2016-12-31$65,569
Total non interest bearing cash at end of year2016-12-31$628,867
Total non interest bearing cash at beginning of year2016-12-31$1,240,780
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$61,708
Value of net assets at end of year (total assets less liabilities)2016-12-31$2,035,933
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$1,974,225
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Investment advisory and management fees2016-12-31$16,251
Value of interest in common/collective trusts at end of year2016-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$42,675
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$42,013
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$42,013
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$472
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$7,939,446
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$3,968,650
Employer contributions (assets) at end of year2016-12-31$152,055
Employer contributions (assets) at beginning of year2016-12-31$150,184
Income. Dividends from common stock2016-12-31$28,401
Assets. Corporate common stocks other than exployer securities at end of year2016-12-31$1,113,875
Assets. Corporate common stocks other than exployer securities at beginning of year2016-12-31$1,043,329
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Aggregate proceeds on sale of assets2016-12-31$10,561
Aggregate carrying amount (costs) on sale of assets2016-12-31$11,245
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31HILLS RENAUT HOMEN & HUGHES
Accountancy firm EIN2016-12-31942463125
2015 : FDSA/FSSA GROUP BENEFITS PLAN 2015 401k financial data
Total plan liabilities at end of year2015-12-31$624,542
Total income from all sources2015-12-31$8,318,854
Expenses. Total of all expenses incurred2015-12-31$8,371,636
Benefits paid (including direct rollovers)2015-12-31$8,335,133
Total plan assets at end of year2015-12-31$2,598,767
Total plan assets at beginning of year2015-12-31$2,027,007
Total contributions received or receivable from participants2015-12-31$4,577,185
Expenses. Other expenses not covered elsewhere2015-12-31$36,503
Other income received2015-12-31$19,124
Net income (gross income less expenses)2015-12-31$-52,782
Net plan assets at end of year (total assets less liabilities)2015-12-31$1,974,225
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$2,027,007
Total contributions received or receivable from employer(s)2015-12-31$3,722,545
2014 : FDSA/FSSA GROUP BENEFITS PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-12-31$176,266
Total unrealized appreciation/depreciation of assets2014-12-31$176,266
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$12,489
Total income from all sources (including contributions)2014-12-31$8,140,805
Total loss/gain on sale of assets2014-12-31$-207,702
Total of all expenses incurred2014-12-31$8,370,962
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$8,302,610
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$8,060,362
Value of total assets at end of year2014-12-31$2,027,007
Value of total assets at beginning of year2014-12-31$2,269,653
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$68,352
Total interest from all sources2014-12-31$881
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$62,356
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31No
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$4,394,401
Participant contributions at end of year2014-12-31$130,175
Participant contributions at beginning of year2014-12-31$2,858
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$250,000
Other income not declared elsewhere2014-12-31$48,642
Administrative expenses (other) incurred2014-12-31$53,950
Liabilities. Value of operating payables at beginning of year2014-12-31$12,489
Total non interest bearing cash at end of year2014-12-31$582,271
Total non interest bearing cash at beginning of year2014-12-31$611,476
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-230,157
Value of net assets at end of year (total assets less liabilities)2014-12-31$2,027,007
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$2,257,164
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Assets. partnership/joint venture interests at end of year2014-12-31$200,000
Assets. partnership/joint venture interests at beginning of year2014-12-31$100,945
Investment advisory and management fees2014-12-31$14,402
Value of interest in common/collective trusts at end of year2014-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$78,240
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$88,895
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$88,895
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$881
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$8,302,610
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$3,665,961
Employer contributions (assets) at end of year2014-12-31$155,068
Employer contributions (assets) at beginning of year2014-12-31$263,225
Income. Dividends from common stock2014-12-31$62,356
Assets. Corporate common stocks other than exployer securities at end of year2014-12-31$881,253
Assets. Corporate common stocks other than exployer securities at beginning of year2014-12-31$952,254
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Aggregate proceeds on sale of assets2014-12-31$1,049,444
Aggregate carrying amount (costs) on sale of assets2014-12-31$1,257,146
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31HILLS, RENAUT, HOMEN & HUGHES
Accountancy firm EIN2014-12-31942463125
2013 : FDSA/FSSA GROUP BENEFITS PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$-72,496
Total unrealized appreciation/depreciation of assets2013-12-31$-72,496
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$12,489
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$22,976
Total income from all sources (including contributions)2013-12-31$7,196,860
Total loss/gain on sale of assets2013-12-31$-107,204
Total of all expenses incurred2013-12-31$7,499,659
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$7,430,553
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$7,276,739
Value of total assets at end of year2013-12-31$2,269,653
Value of total assets at beginning of year2013-12-31$2,582,939
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$69,106
Total interest from all sources2013-12-31$2,973
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$48,760
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31No
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$3,616
Participant contributions at end of year2013-12-31$2,858
Participant contributions at beginning of year2013-12-31$22,166
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$250,000
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$211,242
Other income not declared elsewhere2013-12-31$48,088
Administrative expenses (other) incurred2013-12-31$52,707
Liabilities. Value of operating payables at end of year2013-12-31$12,489
Liabilities. Value of operating payables at beginning of year2013-12-31$22,976
Total non interest bearing cash at end of year2013-12-31$611,476
Total non interest bearing cash at beginning of year2013-12-31$584,282
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-302,799
Value of net assets at end of year (total assets less liabilities)2013-12-31$2,257,164
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$2,559,963
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Assets. partnership/joint venture interests at end of year2013-12-31$100,945
Assets. partnership/joint venture interests at beginning of year2013-12-31$117,794
Investment advisory and management fees2013-12-31$16,399
Value of interest in common/collective trusts at end of year2013-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$88,895
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$84,301
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$84,301
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$2,973
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$7,430,553
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$7,273,123
Employer contributions (assets) at end of year2013-12-31$263,225
Employer contributions (assets) at beginning of year2013-12-31$228,788
Income. Dividends from common stock2013-12-31$48,760
Assets. Corporate common stocks other than exployer securities at end of year2013-12-31$952,254
Assets. Corporate common stocks other than exployer securities at beginning of year2013-12-31$1,334,366
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Aggregate proceeds on sale of assets2013-12-31$160,821
Aggregate carrying amount (costs) on sale of assets2013-12-31$268,025
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31HILLS, RENAUT, HOMEN & HUGHES
Accountancy firm EIN2013-12-31942463125
2012 : FDSA/FSSA GROUP BENEFITS PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$14,620
Total unrealized appreciation/depreciation of assets2012-12-31$14,620
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$22,976
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$12,489
Total income from all sources (including contributions)2012-12-31$6,762,164
Total loss/gain on sale of assets2012-12-31$-13,887
Total of all expenses incurred2012-12-31$6,695,122
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$6,623,872
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$6,654,615
Value of total assets at end of year2012-12-31$2,582,939
Value of total assets at beginning of year2012-12-31$2,505,410
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$71,250
Total interest from all sources2012-12-31$14,947
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$47,627
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$19,815
Participant contributions at end of year2012-12-31$22,166
Participant contributions at beginning of year2012-12-31$49,302
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$211,242
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$79,282
Other income not declared elsewhere2012-12-31$44,242
Administrative expenses (other) incurred2012-12-31$52,650
Liabilities. Value of operating payables at end of year2012-12-31$22,976
Liabilities. Value of operating payables at beginning of year2012-12-31$12,489
Total non interest bearing cash at end of year2012-12-31$584,282
Total non interest bearing cash at beginning of year2012-12-31$592,266
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$67,042
Value of net assets at end of year (total assets less liabilities)2012-12-31$2,559,963
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$2,492,921
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Assets. partnership/joint venture interests at end of year2012-12-31$117,794
Assets. partnership/joint venture interests at beginning of year2012-12-31$176,249
Investment advisory and management fees2012-12-31$18,600
Value of interest in common/collective trusts at end of year2012-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$84,301
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$153,379
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$153,379
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$14,947
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$6,623,872
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31Yes
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$6,634,800
Employer contributions (assets) at end of year2012-12-31$228,788
Employer contributions (assets) at beginning of year2012-12-31$218,885
Income. Dividends from common stock2012-12-31$47,627
Assets. Corporate common stocks other than exployer securities at end of year2012-12-31$1,334,366
Assets. Corporate common stocks other than exployer securities at beginning of year2012-12-31$1,236,047
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Aggregate proceeds on sale of assets2012-12-31$482,187
Aggregate carrying amount (costs) on sale of assets2012-12-31$496,074
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31HILLS, RENAUT, HOMEN & HUGHES
Accountancy firm EIN2012-12-31942463125
2011 : FDSA/FSSA GROUP BENEFITS PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$-90,221
Total unrealized appreciation/depreciation of assets2011-12-31$-90,221
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$12,489
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$23,272
Total income from all sources (including contributions)2011-12-31$6,677,147
Total loss/gain on sale of assets2011-12-31$-1,860
Total of all expenses incurred2011-12-31$6,592,763
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$6,522,269
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$6,660,564
Value of total assets at end of year2011-12-31$2,505,410
Value of total assets at beginning of year2011-12-31$2,431,809
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$70,494
Total interest from all sources2011-12-31$10,077
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$54,096
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Administrative expenses professional fees incurred2011-12-31$13,888
Was this plan covered by a fidelity bond2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$33,323
Participant contributions at end of year2011-12-31$49,302
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$79,282
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$1,214
Other income not declared elsewhere2011-12-31$44,491
Administrative expenses (other) incurred2011-12-31$40,000
Liabilities. Value of operating payables at end of year2011-12-31$12,489
Liabilities. Value of operating payables at beginning of year2011-12-31$23,272
Total non interest bearing cash at end of year2011-12-31$592,266
Total non interest bearing cash at beginning of year2011-12-31$439,950
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$84,384
Value of net assets at end of year (total assets less liabilities)2011-12-31$2,492,921
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$2,408,537
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Assets. partnership/joint venture interests at end of year2011-12-31$176,249
Assets. partnership/joint venture interests at beginning of year2011-12-31$532,756
Investment advisory and management fees2011-12-31$16,606
Income. Interest from US Government securities2011-12-31$4,020
Income. Interest from corporate debt instruments2011-12-31$4,138
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$153,379
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$156,018
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$156,018
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$1,919
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$6,522,269
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$6,627,241
Employer contributions (assets) at end of year2011-12-31$218,885
Employer contributions (assets) at beginning of year2011-12-31$372,789
Income. Dividends from common stock2011-12-31$54,096
Assets. Corporate common stocks other than exployer securities at end of year2011-12-31$1,236,047
Assets. Corporate common stocks other than exployer securities at beginning of year2011-12-31$929,082
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Aggregate proceeds on sale of assets2011-12-31$426,301
Aggregate carrying amount (costs) on sale of assets2011-12-31$428,161
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31HILLS, RENAUT, HOMEN & HUGHES
Accountancy firm EIN2011-12-31942463125
2010 : FDSA/FSSA GROUP BENEFITS PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$-40,445
Total unrealized appreciation/depreciation of assets2010-12-31$-40,445
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$23,272
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$43,299
Total income from all sources (including contributions)2010-12-31$6,850,745
Total loss/gain on sale of assets2010-12-31$30,771
Total of all expenses incurred2010-12-31$6,739,050
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$6,706,499
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$6,784,676
Value of total assets at end of year2010-12-31$2,431,809
Value of total assets at beginning of year2010-12-31$2,340,141
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$32,551
Total interest from all sources2010-12-31$2,550
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$28,308
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Administrative expenses professional fees incurred2010-12-31$16,104
Was this plan covered by a fidelity bond2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$16,040
Participant contributions at beginning of year2010-12-31$416
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$1,214
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$971
Other income not declared elsewhere2010-12-31$44,885
Administrative expenses (other) incurred2010-12-31$100
Liabilities. Value of operating payables at end of year2010-12-31$23,272
Liabilities. Value of operating payables at beginning of year2010-12-31$43,299
Total non interest bearing cash at end of year2010-12-31$439,950
Total non interest bearing cash at beginning of year2010-12-31$433,054
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$111,695
Value of net assets at end of year (total assets less liabilities)2010-12-31$2,408,537
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$2,296,842
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Assets. partnership/joint venture interests at end of year2010-12-31$532,756
Assets. partnership/joint venture interests at beginning of year2010-12-31$411,456
Investment advisory and management fees2010-12-31$16,347
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$156,018
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$211,492
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$211,492
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$2,550
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$6,706,499
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$6,768,636
Employer contributions (assets) at end of year2010-12-31$372,789
Employer contributions (assets) at beginning of year2010-12-31$292,680
Income. Dividends from common stock2010-12-31$28,308
Assets. Corporate common stocks other than exployer securities at end of year2010-12-31$929,082
Assets. Corporate common stocks other than exployer securities at beginning of year2010-12-31$990,072
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$424,795
Aggregate carrying amount (costs) on sale of assets2010-12-31$394,024
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31HILLS, RENAUT, HOMEN & HUGHES
Accountancy firm EIN2010-12-31942463125

Form 5500 Responses for FDSA/FSSA GROUP BENEFITS PLAN

2022: FDSA/FSSA GROUP BENEFITS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: FDSA/FSSA GROUP BENEFITS PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: FDSA/FSSA GROUP BENEFITS PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: FDSA/FSSA GROUP BENEFITS PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: FDSA/FSSA GROUP BENEFITS PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: FDSA/FSSA GROUP BENEFITS PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: FDSA/FSSA GROUP BENEFITS PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: FDSA/FSSA GROUP BENEFITS PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: FDSA/FSSA GROUP BENEFITS PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: FDSA/FSSA GROUP BENEFITS PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: FDSA/FSSA GROUP BENEFITS PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: FDSA/FSSA GROUP BENEFITS PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: FDSA/FSSA GROUP BENEFITS PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number753973
Policy instance 3
Insurance contract or identification number753973
Number of Individuals Covered783
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,994
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,994
Insurance broker organization code?3
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract numberL01236
Policy instance 8
Insurance contract or identification numberL01236
Number of Individuals Covered1327
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,559
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract number46120
Policy instance 7
Insurance contract or identification number46120
Number of Individuals Covered616
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $5,364
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $134,093
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,364
Insurance broker organization code?3
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberL01236
Policy instance 6
Insurance contract or identification numberL01236
Number of Individuals Covered538
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,792,668
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract numberL01236
Policy instance 5
Insurance contract or identification numberL01236
Number of Individuals Covered542
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,457
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract numberL01236
Policy instance 4
Insurance contract or identification numberL01236
Number of Individuals Covered789
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $338,604
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,621,820
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $338,604
Additional information about fees paid to insurance brokerBONUS OVERRIDE ALLOCATION & MISCELLANEOUS GIFTS, MEALS, ENTERTAINMENT
Insurance broker organization code?3
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number17529
Policy instance 1
Insurance contract or identification number17529
Number of Individuals Covered1379
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $30,570
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,570
Insurance broker organization code?3
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number78652
Policy instance 2
Insurance contract or identification number78652
Number of Individuals Covered93
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $724
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,488
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $724
Insurance broker organization code?3
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number78652
Policy instance 2
Insurance contract or identification number78652
Number of Individuals Covered97
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $732
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,108
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $732
Insurance broker organization code?3
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract numberL01236
Policy instance 5
Insurance contract or identification numberL01236
Number of Individuals Covered557
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,490
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract numberL01236
Policy instance 4
Insurance contract or identification numberL01236
Number of Individuals Covered829
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $314,122
Total amount of fees paid to insurance companyUSD $133,742
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,783,418
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $314,122
Amount paid for insurance broker fees133742
Additional information about fees paid to insurance brokerBONUS OVERRIDE ALLOCATION & MISCELLANEOUS GIFTS, MEALS, ENTERTAINMENT
Insurance broker organization code?3
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberL01236
Policy instance 6
Insurance contract or identification numberL01236
Number of Individuals Covered565
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,784,970
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 number753973
Policy instance 3
Insurance contract or identification number753973
Number of Individuals Covered796
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,178
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,178
Insurance broker organization code?3
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number17529
Policy instance 1
Insurance contract or identification number17529
Number of Individuals Covered1396
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $30,788
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $589,788
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,788
Insurance broker organization code?3
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract number46120
Policy instance 7
Insurance contract or identification number46120
Number of Individuals Covered639
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $135,684
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number78652
Policy instance 4
Insurance contract or identification number78652
Number of Individuals Covered77
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $614
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,271
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $614
Insurance broker organization code?3
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberW0051432
Policy instance 1
Insurance contract or identification numberW0051432
Number of Individuals Covered1433
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $5,716
Total amount of fees paid to insurance companyUSD $323,162
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,856,495
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $324
Insurance broker organization code?3
Amount paid for insurance broker fees323162
Additional information about fees paid to insurance brokerBONUS OVERRIDE ALLOCATION & MISCELLANEOUS GIFTS, MEALS, ENTERTAINMENT
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberW0051432
Policy instance 2
Insurance contract or identification numberW0051432
Number of Individuals Covered540
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $8,107
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number17529
Policy instance 3
Insurance contract or identification number17529
Number of Individuals Covered1417
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $30,943
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $618,861
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,943
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number753973
Policy instance 5
Insurance contract or identification number753973
Number of Individuals Covered822
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $4,483
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,483
Insurance broker organization code?3
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number17529
Policy instance 3
Insurance contract or identification number17529
Number of Individuals Covered1443
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $31,341
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $626,828
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,341
Insurance broker organization code?3
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberW0051432
Policy instance 1
Insurance contract or identification numberW0051432
Number of Individuals Covered1449
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $133,239
Total amount of fees paid to insurance companyUSD $300,753
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,624,694
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $132,913
Amount paid for insurance broker fees300753
Additional information about fees paid to insurance brokerBONUS OVERRIDE ALLOCATION & MISCELLANEOUS GIFTS, MEALS, ENTERTAINMENT
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number753973
Policy instance 5
Insurance contract or identification number753973
Number of Individuals Covered836
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $3,921
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,921
Insurance broker organization code?3
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberW0051432
Policy instance 2
Insurance contract or identification numberW0051432
Number of Individuals Covered676
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $8,149
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number78652
Policy instance 4
Insurance contract or identification number78652
Number of Individuals Covered68
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $564
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,271
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $564
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number753973
Policy instance 5
Insurance contract or identification number753973
Number of Individuals Covered810
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $4,227
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $110,781
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,227
Insurance broker organization code?3
Insurance broker nameDIBUDUO & DEFENDIS INS AGENCY
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number78652
Policy instance 4
Insurance contract or identification number78652
Number of Individuals Covered62
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $556
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,119
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $556
Insurance broker organization code?3
Insurance broker nameDIBUDUO & DEFENDIS INS AGENCY
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number17529
Policy instance 3
Insurance contract or identification number17529
Number of Individuals Covered1359
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $29,292
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $585,843
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,292
Insurance broker organization code?3
Insurance broker nameDIBUDUO & DEFENDIS INS AGENCY
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberW0051432
Policy instance 2
Insurance contract or identification numberW0051432
Number of Individuals Covered1080
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $8,978
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberW0051432
Policy instance 1
Insurance contract or identification numberW0051432
Number of Individuals Covered1363
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $276,638
Total amount of fees paid to insurance companyUSD $203
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,906,985
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $276,279
Amount paid for insurance broker fees203
Additional information about fees paid to insurance brokerBONUS OVERRIDE ALLOCATION & MISCELLANEOUS GIFTS, MEALS, ENTERTAINMENT
Insurance broker organization code?3
Insurance broker nameDIBUDUO & DEFENDIS INS AGENCY
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number17529
Policy instance 5
Insurance contract or identification number17529
Number of Individuals Covered1404
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $28,648
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $572,950
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,648
Insurance broker organization code?3
Insurance broker nameDIBUDIO & DEFENDIS AGENCY
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX051251
Policy instance 1
Insurance contract or identification numberFLX051251
Number of Individuals Covered699
Insurance policy start date2015-01-01
Insurance policy end date2016-01-01
Total amount of commissions paid to insurance brokerUSD $8,464
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $56,427
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,464
Insurance broker organization code?3
Insurance broker nameDIBUDIO & DEFENDIS AGENCY
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 966334
Policy instance 2
Insurance contract or identification numberOK 966334
Number of Individuals Covered699
Insurance policy start date2015-05-01
Insurance policy end date2016-02-29
Total amount of commissions paid to insurance brokerUSD $2,815
Other welfare benefits providedBASIC LIFE/ACC. DEATH & DISMEMB.
Welfare Benefit Premiums Paid to CarrierUSD $23,148
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,815
Insurance broker organization code?3
Insurance broker nameDUBUDIO & DEFENDIS AGENCY
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberH30577, 960346
Policy instance 3
Insurance contract or identification numberH30577, 960346
Number of Individuals Covered1362
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $280,187
Total amount of fees paid to insurance companyUSD $271
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,837,426
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $280,187
Amount paid for insurance broker fees271
Additional information about fees paid to insurance brokerBONUS OVERRIDE ALLOCATION & MISCELLANEOUS GIFTS, MEALS, ENTERTAINMENT
Insurance broker organization code?3
Insurance broker nameDIBUDIO & DEFENDIS AGENCY
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberH30577,960346
Policy instance 4
Insurance contract or identification numberH30577,960346
Number of Individuals Covered540
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $295
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $7,370
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $295
Insurance broker organization code?3
Insurance broker nameDIBUDIO & DEFENDIS AGENCY
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 966334
Policy instance 1
Insurance contract or identification numberOK 966334
Number of Individuals Covered560
Insurance policy start date2014-05-01
Insurance policy end date2015-05-01
Total amount of commissions paid to insurance brokerUSD $3,317
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $27,649
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,317
Insurance broker organization code?3
Insurance broker nameDIBUDIO & DEFENDIS AGENCY
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX051251
Policy instance 2
Insurance contract or identification numberFLX051251
Number of Individuals Covered570
Insurance policy start date2014-01-01
Insurance policy end date2015-01-01
Total amount of commissions paid to insurance brokerUSD $9,831
Other welfare benefits providedBASIC LIFE/ACC. DEATH & DISMEMB.
Welfare Benefit Premiums Paid to CarrierUSD $65,537
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,831
Insurance broker organization code?3
Insurance broker nameDUBUDIO & DEFENDIS AGENCY
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberH30577, 960346
Policy instance 3
Insurance contract or identification numberH30577, 960346
Number of Individuals Covered1436
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $303,968
Total amount of fees paid to insurance companyUSD $294
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,652,371
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $303,968
Amount paid for insurance broker fees294
Additional information about fees paid to insurance brokerBONUS OVERRIDE ALLOCATION & MISCELLANEOUS GIFTS, MEALS, ENTERTAINMENT
Insurance broker organization code?3
Insurance broker nameDIBUDIO & DEFENDIS AGENCY
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberH30577,960346
Policy instance 4
Insurance contract or identification numberH30577,960346
Number of Individuals Covered528
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $313
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $7,724
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $313
Insurance broker organization code?3
Insurance broker nameDIBUDIO & DEFENDIS AGENCY
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTS05343677
Policy instance 5
Insurance contract or identification numberTS05343677
Number of Individuals Covered2267
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $14,046
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $517,626
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,046
Insurance broker organization code?3
Insurance broker nameDIBUDIO & DEFENDIS AGENCY
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX051251
Policy instance 2
Insurance contract or identification numberFLX051251
Number of Individuals Covered684
Insurance policy start date2013-01-01
Insurance policy end date2014-01-01
Total amount of commissions paid to insurance brokerUSD $10,855
Other welfare benefits providedBASIC LIFE/ACC. DEATH & DISMEMB.
Welfare Benefit Premiums Paid to CarrierUSD $72,366
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,855
Insurance broker organization code?3
Insurance broker nameDUBUDIO & DEFENDIS AGENCY
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number15599
Policy instance 5
Insurance contract or identification number15599
Number of Individuals Covered1491
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $27,850
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $556,998
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,850
Insurance broker organization code?3
Insurance broker nameDIBUDIO & DEFENDIS AGENCY
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberH30577,960346
Policy instance 4
Insurance contract or identification numberH30577,960346
Number of Individuals Covered512
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $310
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $10,336
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $310
Insurance broker organization code?3
Insurance broker nameDIBUDIO & DEFENDIS AGENCY
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberH30577, 960346
Policy instance 3
Insurance contract or identification numberH30577, 960346
Number of Individuals Covered1501
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $263,853
Total amount of fees paid to insurance companyUSD $7,886
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,118,890
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $263,853
Amount paid for insurance broker fees7886
Additional information about fees paid to insurance brokerBONUS OVERRIDE ALLOCATION & MISCELLANEOUS GIFTS, MEALS, ENTERTAINMENT
Insurance broker organization code?3
Insurance broker nameDIBUDIO & DEFENDIS AGENCY
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 966334
Policy instance 1
Insurance contract or identification numberOK 966334
Number of Individuals Covered684
Insurance policy start date2013-05-01
Insurance policy end date2014-05-01
Total amount of commissions paid to insurance brokerUSD $2,574
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $20,740
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,574
Insurance broker organization code?3
Insurance broker nameDIBUDIO & DEFENDIS AGENCY
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberH30577,960346
Policy instance 2
Insurance contract or identification numberH30577,960346
Number of Individuals Covered513
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $276
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $8,504
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $276
Insurance broker organization code?3
Insurance broker nameDIBUDIO & DEFENDIS AGENCY
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 820304
Policy instance 5
Insurance contract or identification numberOK 820304
Number of Individuals Covered639
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $947
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $6,316
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $947
Insurance broker organization code?3
Insurance broker nameDIBUDIO & DEFENDIS AGENCY
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX051251
Policy instance 4
Insurance contract or identification numberFLX051251
Number of Individuals Covered639
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $10,782
Other welfare benefits providedBASIC LIFE/ACC. DEATH & DISMEMB.
Welfare Benefit Premiums Paid to CarrierUSD $71,883
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,782
Insurance broker organization code?3
Insurance broker nameDUBUDIO & DEFENDIS AGENCY
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberH30577, 960346
Policy instance 3
Insurance contract or identification numberH30577, 960346
Number of Individuals Covered607
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $242,929
Total amount of fees paid to insurance companyUSD $5,405
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,043,868
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $242,929
Amount paid for insurance broker fees5405
Additional information about fees paid to insurance brokerBONUS OVERRIDE ALLOCATION & MISCELLANEOUS GIFTS, MEALS, ENTERTAINMENT
Insurance broker organization code?3
Insurance broker nameDIBUDIO & DEFENDIS AGENCY
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number15599
Policy instance 1
Insurance contract or identification number15599
Number of Individuals Covered605
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $24,220
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $484,240
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,220
Insurance broker organization code?3
Insurance broker nameDIBUDIO & DEFENDIS AGENCY
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX051251
Policy instance 5
Insurance contract or identification numberFLX051251
Number of Individuals Covered425
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $12,221
Other welfare benefits providedBASIC LIFE/ACC. DEATH & DISMEMB.
Welfare Benefit Premiums Paid to CarrierUSD $81,477
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberH30577, 960346
Policy instance 4
Insurance contract or identification numberH30577, 960346
Number of Individuals Covered566
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $237,890
Total amount of fees paid to insurance companyUSD $216
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,928,868
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTS05339300
Policy instance 1
Insurance contract or identification numberTS05339300
Number of Individuals Covered1671
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $21,450
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $467,184
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 820304
Policy instance 6
Insurance contract or identification numberOK 820304
Number of Individuals Covered647
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $2,545
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $16,964
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number03092
Policy instance 2
Insurance contract or identification number03092
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,988
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberH30577,960346
Policy instance 3
Insurance contract or identification numberH30577,960346
Number of Individuals Covered481
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $282
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $7,020
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number3092
Policy instance 1
Insurance contract or identification number3092
Number of Individuals Covered578
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $24,213
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberH30577,960346
Policy instance 2
Insurance contract or identification numberH30577,960346
Number of Individuals Covered499
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $293
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $7,305
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberH30577, 960346
Policy instance 3
Insurance contract or identification numberH30577, 960346
Number of Individuals Covered578
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $238,180
Total amount of fees paid to insurance companyUSD $157
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,944,182
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 820304
Policy instance 5
Insurance contract or identification numberOK 820304
Number of Individuals Covered655
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $2,312
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $15,414
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX051251
Policy instance 4
Insurance contract or identification numberFLX051251
Number of Individuals Covered655
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $10,860
Other welfare benefits providedBASIC LIFE/ACC. DEATH & DISMEMB.
Welfare Benefit Premiums Paid to CarrierUSD $72,401
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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