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EMPLOYEE MEDICAL BENEFIT PLAN OF CA CAPITAL OPERATIONS LLC 401k Plan overview

Plan NameEMPLOYEE MEDICAL BENEFIT PLAN OF CA CAPITAL OPERATIONS LLC
Plan identification number 501

EMPLOYEE MEDICAL BENEFIT PLAN OF CA CAPITAL OPERATIONS LLC Benefits

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

401k Sponsoring company profile

CA CAPITAL OPERATIONS LLC has sponsored the creation of one or more 401k plans.

Company Name:CA CAPITAL OPERATIONS LLC
Employer identification number (EIN):271460592
NAIC Classification:531390
NAIC Description:Other Activities Related to Real Estate

Additional information about CA CAPITAL OPERATIONS LLC

Jurisdiction of Incorporation: California Department of State
Incorporation Date:
Company Identification Number: 201001510340

More information about CA CAPITAL OPERATIONS LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE MEDICAL BENEFIT PLAN OF CA CAPITAL OPERATIONS LLC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-07-01PAT GAUDIN2023-07-26
5012021-07-01PAT GAUDIN2023-03-01
5012020-07-01
5012019-07-01

Plan Statistics for EMPLOYEE MEDICAL BENEFIT PLAN OF CA CAPITAL OPERATIONS LLC

401k plan membership statisitcs for EMPLOYEE MEDICAL BENEFIT PLAN OF CA CAPITAL OPERATIONS LLC

Measure Date Value
2022: EMPLOYEE MEDICAL BENEFIT PLAN OF CA CAPITAL OPERATIONS LLC 2022 401k membership
Total participants, beginning-of-year2022-07-01368
Total number of active participants reported on line 7a of the Form 55002022-07-010
Number of retired or separated participants receiving benefits2022-07-010
Number of other retired or separated participants entitled to future benefits2022-07-010
Total of all active and inactive participants2022-07-010
Number of employers contributing to the scheme2022-07-010
2021: EMPLOYEE MEDICAL BENEFIT PLAN OF CA CAPITAL OPERATIONS LLC 2021 401k membership
Total participants, beginning-of-year2021-07-01220
Total number of active participants reported on line 7a of the Form 55002021-07-01368
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-01368
Number of employers contributing to the scheme2021-07-010
2020: EMPLOYEE MEDICAL BENEFIT PLAN OF CA CAPITAL OPERATIONS LLC 2020 401k membership
Total participants, beginning-of-year2020-07-01159
Total number of active participants reported on line 7a of the Form 55002020-07-01220
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-01220
2019: EMPLOYEE MEDICAL BENEFIT PLAN OF CA CAPITAL OPERATIONS LLC 2019 401k membership
Total participants, beginning-of-year2019-07-01100
Total number of active participants reported on line 7a of the Form 55002019-07-01158
Number of retired or separated participants receiving benefits2019-07-011
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-01159

Form 5500 Responses for EMPLOYEE MEDICAL BENEFIT PLAN OF CA CAPITAL OPERATIONS LLC

2022: EMPLOYEE MEDICAL BENEFIT PLAN OF CA CAPITAL OPERATIONS LLC 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01This submission is the final filingYes
2022-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – InsuranceYes
2021: EMPLOYEE MEDICAL BENEFIT PLAN OF CA CAPITAL OPERATIONS LLC 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – InsuranceYes
2020: EMPLOYEE MEDICAL BENEFIT PLAN OF CA CAPITAL OPERATIONS LLC 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Submission has been amendedNo
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)No
2020-07-01Plan is a collectively bargained planNo
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – InsuranceYes
2019: EMPLOYEE MEDICAL BENEFIT PLAN OF CA CAPITAL OPERATIONS LLC 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01First time form 5500 has been submittedYes
2019-07-01Submission has been amendedNo
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)No
2019-07-01Plan is a collectively bargained planNo
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number282417
Policy instance 1
Insurance contract or identification number282417
Number of Individuals Covered401
Insurance policy start date2022-07-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $81,773
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $1,521,691
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $81,773
Amount paid for insurance broker fees0
Insurance broker organization code?3
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number282417
Policy instance 1
Insurance contract or identification number282417
Number of Individuals Covered368
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $148,190
Total amount of fees paid to insurance companyUSD $6,012
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $2,831,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $148,001
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number282417
Policy instance 1
Insurance contract or identification number282417
Number of Individuals Covered295
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $130,618
Total amount of fees paid to insurance companyUSD $3,543
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,396,403
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $120,088
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number282417
Policy instance 1
Insurance contract or identification number282417
Number of Individuals Covered188
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $90,817
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,482,003
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $90,817
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3

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