401k Plan data: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN plan

AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN
Plan identification number	501

AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Supplemental unemployment Dental Vision Temporary disability (accident and sickness) Prepaid legal Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

AFSCME LOCAL 2076 has sponsored the creation of one or more 401k plans.

Company Name: AFSCME LOCAL 2076

Employer identification number (EIN): 336136808

NAIC Classification: 813930
NAIC Description: Labor Unions and Similar Labor Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-01-01
501 2021-01-01
501 2020-01-01
501 2019-01-01
501 2018-01-01
501 2017-01-01 LORENA YONAMINE
501 2016-01-01 LORENA YONAMINE
501 2015-01-01 CHER BROCK
501 2014-01-01 CHER BROCK
501 2013-01-01 JIM CIUCKI
501 2012-01-01 JIM CIUCKI
501 2011-01-01 JIM CIUCKI
501 2010-01-01 JIM CIUCKI
501 2009-01-01 JIM CIUCKI
501 2009-01-01 JIM CIUCKI

Plan Statistics for AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN

401k plan membership statisitcs for AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN

Measure Date Value
2022: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 1,386
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 1,834
Total of all active and inactive participants 2022-01-01 1,834
Total participants 2022-01-01 1,834
2021: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 1,441
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 1,386
Total of all active and inactive participants 2021-01-01 1,386
Total participants 2021-01-01 1,386
2020: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 1,527
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 1,441
Total of all active and inactive participants 2020-01-01 1,441
Total participants 2020-01-01 1,441
2019: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 1,460
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 1,527
Total of all active and inactive participants 2019-01-01 1,527
Total participants 2019-01-01 1,527
2018: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 1,427
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 1,460
Total of all active and inactive participants 2018-01-01 1,460
Total participants 2018-01-01 1,460
2017: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 1,489
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 1,427
Total of all active and inactive participants 2017-01-01 1,427
Total participants 2017-01-01 1,427
2016: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 1,451
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 1,489
Total of all active and inactive participants 2016-01-01 1,489
Total participants 2016-01-01 1,489
2015: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1,446
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 1,451
Total of all active and inactive participants 2015-01-01 1,451
Total participants 2015-01-01 1,451
2014: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1,343
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 1,446
Total of all active and inactive participants 2014-01-01 1,446
Total participants 2014-01-01 1,446
2013: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,115
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 1,343
Total of all active and inactive participants 2013-01-01 1,343
Total participants 2013-01-01 1,343
2012: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,118
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1,115
Total of all active and inactive participants 2012-01-01 1,115
Total participants 2012-01-01 1,115
2011: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,093
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,118
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 1,118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 1,118
2010: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 1,093
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 1,093
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 1,093
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 1,093
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,093
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1,093
Total of all active and inactive participants 2009-01-01 1,093
Total participants 2009-01-01 1,093

Measure	Date	Value
2022: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	1,386
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	1,834
Total of all active and inactive participants	2022-01-01	1,834
Total participants	2022-01-01	1,834
2021: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	1,441
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	1,386
Total of all active and inactive participants	2021-01-01	1,386
Total participants	2021-01-01	1,386
2020: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	1,527
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	1,441
Total of all active and inactive participants	2020-01-01	1,441
Total participants	2020-01-01	1,441
2019: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	1,460
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	1,527
Total of all active and inactive participants	2019-01-01	1,527
Total participants	2019-01-01	1,527
2018: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	1,427
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	1,460
Total of all active and inactive participants	2018-01-01	1,460
Total participants	2018-01-01	1,460
2017: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	1,489
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	1,427
Total of all active and inactive participants	2017-01-01	1,427
Total participants	2017-01-01	1,427
2016: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,451
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	1,489
Total of all active and inactive participants	2016-01-01	1,489
Total participants	2016-01-01	1,489
2015: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,446
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1,451
Total of all active and inactive participants	2015-01-01	1,451
Total participants	2015-01-01	1,451
2014: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,343
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	1,446
Total of all active and inactive participants	2014-01-01	1,446
Total participants	2014-01-01	1,446
2013: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,115
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1,343
Total of all active and inactive participants	2013-01-01	1,343
Total participants	2013-01-01	1,343
2012: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,118
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,115
Total of all active and inactive participants	2012-01-01	1,115
Total participants	2012-01-01	1,115
2011: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,093
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,118
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	1,118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	1,118
2010: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1,093
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	1,093
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	1,093
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	1,093
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,093
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,093
Total of all active and inactive participants	2009-01-01	1,093
Total participants	2009-01-01	1,093

Financial Data on AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN

Measure	Date	Value
2022 : AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2022-12-31	$-9,079
Total unrealized appreciation/depreciation of assets	2022-12-31	$-9,079
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$16,325
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$13,150
Total income from all sources (including contributions)	2022-12-31	$2,449,143
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$2,323,378
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$2,282,440
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$2,455,271
Value of total assets at end of year	2022-12-31	$1,504,220
Value of total assets at beginning of year	2022-12-31	$1,375,280
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$40,938
Total interest from all sources	2022-12-31	$345
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$2,606
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Administrative expenses professional fees incurred	2022-12-31	$20,675
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$280,000
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$1,523,003
Administrative expenses (other) incurred	2022-12-31	$20,263
Liabilities. Value of operating payables at end of year	2022-12-31	$16,325
Liabilities. Value of operating payables at beginning of year	2022-12-31	$13,150
Total non interest bearing cash at end of year	2022-12-31	$1,345,122
Total non interest bearing cash at beginning of year	2022-12-31	$1,207,229
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$125,765
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$1,487,895
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$1,362,130
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$50,628
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$50,502
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$50,502
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$345
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$2,282,440
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$932,268
Income. Dividends from preferred stock	2022-12-31	$2,606
Assets. Corporate common stocks other than exployer securities at end of year	2022-12-31	$108,470
Assets. Corporate common stocks other than exployer securities at beginning of year	2022-12-31	$117,549
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	YBARRA & ASSOCIATES
Accountancy firm EIN	2022-12-31	872683828
2021 : AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2021-12-31	$33,438
Total unrealized appreciation/depreciation of assets	2021-12-31	$33,438
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$13,150
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$2,453,699
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$2,248,291
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$2,207,698
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$2,413,833
Value of total assets at end of year	2021-12-31	$1,375,280
Value of total assets at beginning of year	2021-12-31	$1,156,722
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$40,593
Total interest from all sources	2021-12-31	$292
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$6,136
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Administrative expenses professional fees incurred	2021-12-31	$26,650
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$280,000
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$1,496,240
Administrative expenses (other) incurred	2021-12-31	$13,943
Liabilities. Value of operating payables at end of year	2021-12-31	$13,150
Total non interest bearing cash at end of year	2021-12-31	$1,207,229
Total non interest bearing cash at beginning of year	2021-12-31	$1,022,318
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$205,408
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$1,362,130
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$1,156,722
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$50,502
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$50,293
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$50,293
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$292
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$2,207,698
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$917,593
Income. Dividends from common stock	2021-12-31	$6,136
Assets. Corporate common stocks other than exployer securities at end of year	2021-12-31	$117,549
Assets. Corporate common stocks other than exployer securities at beginning of year	2021-12-31	$84,111
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	YBARRA & ASSOCIATES
Accountancy firm EIN	2021-12-31	872683828
2020 : AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2020-12-31	$-13,694
Total unrealized appreciation/depreciation of assets	2020-12-31	$-13,694
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$2,374,079
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$2,179,355
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$2,159,280
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$2,384,005
Value of total assets at end of year	2020-12-31	$1,156,722
Value of total assets at beginning of year	2020-12-31	$961,998
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$20,075
Total interest from all sources	2020-12-31	$293
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$3,475
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Administrative expenses professional fees incurred	2020-12-31	$11,550
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$280,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$1,467,763
Administrative expenses (other) incurred	2020-12-31	$8,525
Total non interest bearing cash at end of year	2020-12-31	$1,022,318
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$194,724
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$1,156,722
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$961,998
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$50,293
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$864,193
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$864,193
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$293
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$2,159,280
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$916,242
Income. Dividends from common stock	2020-12-31	$3,475
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2020-12-31	No
Assets. Corporate common stocks other than exployer securities at end of year	2020-12-31	$84,111
Assets. Corporate common stocks other than exployer securities at beginning of year	2020-12-31	$97,805
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	YBARRA & GILLESPIE CPAS LLP
Accountancy firm EIN	2020-12-31	205683924
2019 : AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2019-12-31	$9,242
Total unrealized appreciation/depreciation of assets	2019-12-31	$9,242
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$2,392,284
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$2,188,602
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$2,155,225
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$2,374,245
Value of total assets at end of year	2019-12-31	$961,998
Value of total assets at beginning of year	2019-12-31	$758,316
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$33,377
Total interest from all sources	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$8,797
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Administrative expenses professional fees incurred	2019-12-31	$17,700
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$280,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$1,454,495
Administrative expenses (other) incurred	2019-12-31	$15,677
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$203,682
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$961,998
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$758,316
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$864,193
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$669,753
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$669,753
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$2,155,225
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$919,750
Income. Dividends from common stock	2019-12-31	$8,797
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2019-12-31	No
Assets. Corporate common stocks other than exployer securities at end of year	2019-12-31	$97,805
Assets. Corporate common stocks other than exployer securities at beginning of year	2019-12-31	$88,563
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	No
Opinion of an independent qualified public accountant for this plan	2019-12-31	Unqualified
Accountancy firm name	2019-12-31	YBARRA & GILLESPIE CPAS, LLP
Accountancy firm EIN	2019-12-31	205683924
2018 : AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2018-12-31	$-36,305
Total unrealized appreciation/depreciation of assets	2018-12-31	$-36,305
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$2,251,693
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$2,124,613
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$2,083,230
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$2,287,998
Value of total assets at end of year	2018-12-31	$758,316
Value of total assets at beginning of year	2018-12-31	$631,236
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$41,383
Total interest from all sources	2018-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Administrative expenses professional fees incurred	2018-12-31	$20,850
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$45,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$1,412,046
Administrative expenses (other) incurred	2018-12-31	$20,533
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$127,080
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$758,316
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$631,236
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$669,753
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$506,368
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$506,368
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$2,083,230
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$875,952
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2018-12-31	No
Assets. Corporate common stocks other than exployer securities at end of year	2018-12-31	$88,563
Assets. Corporate common stocks other than exployer securities at beginning of year	2018-12-31	$124,868
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	No
Opinion of an independent qualified public accountant for this plan	2018-12-31	Unqualified
Accountancy firm name	2018-12-31	YBARRA & GILLESPIE CPAS LLP
Accountancy firm EIN	2018-12-31	205683924
2017 : AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2017-12-31	$11,859
Total unrealized appreciation/depreciation of assets	2017-12-31	$11,859
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$2,275,159
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$2,040,966
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$2,028,188
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$2,261,671
Value of total assets at end of year	2017-12-31	$631,236
Value of total assets at beginning of year	2017-12-31	$397,043
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$12,778
Total interest from all sources	2017-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$1,629
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Administrative expenses professional fees incurred	2017-12-31	$10,725
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$45,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$1,368,986
Administrative expenses (other) incurred	2017-12-31	$2,053
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$234,193
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$631,236
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$397,043
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$506,368
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$248,628
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$248,628
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$2,028,188
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$892,685
Employer contributions (assets) at beginning of year	2017-12-31	$35,406
Income. Dividends from common stock	2017-12-31	$1,629
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-31	No
Assets. Corporate common stocks other than exployer securities at end of year	2017-12-31	$124,868
Assets. Corporate common stocks other than exployer securities at beginning of year	2017-12-31	$113,009
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	No
Opinion of an independent qualified public accountant for this plan	2017-12-31	Unqualified
Accountancy firm name	2017-12-31	YBARRA & GILLESPIE CPAS LLP
Accountancy firm EIN	2017-12-31	205683924
2016 : AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2016-12-31	$28,877
Total unrealized appreciation/depreciation of assets	2016-12-31	$28,877
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$42,108
Total income from all sources (including contributions)	2016-12-31	$2,226,309
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$2,038,763
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$2,026,155
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$2,193,631
Value of total assets at end of year	2016-12-31	$397,043
Value of total assets at beginning of year	2016-12-31	$251,605
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$12,608
Total interest from all sources	2016-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$3,801
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Administrative expenses professional fees incurred	2016-12-31	$11,466
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$45,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$1,294,660
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$6,940
Administrative expenses (other) incurred	2016-12-31	$1,142
Liabilities. Value of operating payables at end of year	2016-12-31	$0
Liabilities. Value of operating payables at beginning of year	2016-12-31	$42,108
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$187,546
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$397,043
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$209,497
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$248,628
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$160,533
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$160,533
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$2,026,155
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$898,971
Employer contributions (assets) at end of year	2016-12-31	$35,406
Income. Dividends from common stock	2016-12-31	$3,801
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2016-12-31	No
Assets. Corporate common stocks other than exployer securities at end of year	2016-12-31	$113,009
Assets. Corporate common stocks other than exployer securities at beginning of year	2016-12-31	$84,132
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	No
Opinion of an independent qualified public accountant for this plan	2016-12-31	Unqualified
Accountancy firm name	2016-12-31	YBARRA & GILLESPIE CPAS LLP
Accountancy firm EIN	2016-12-31	205683924
2015 : AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$43,747
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$172,430
Total income from all sources (including contributions)	2015-12-31	$2,484,322
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$2,358,673
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$2,323,583
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$2,400,190
Value of total assets at end of year	2015-12-31	$244,665
Value of total assets at beginning of year	2015-12-31	$247,699
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$35,090
Total interest from all sources	2015-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Administrative expenses professional fees incurred	2015-12-31	$15,775
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$45,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$1,466,953
Other income not declared elsewhere	2015-12-31	$84,132
Administrative expenses (other) incurred	2015-12-31	$19,315
Liabilities. Value of operating payables at end of year	2015-12-31	$43,747
Liabilities. Value of operating payables at beginning of year	2015-12-31	$172,430
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$125,649
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$200,918
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$75,269
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$160,533
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$247,437
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$247,437
Expenses. Payments to insurance carriers foe the provision of benefits	2015-12-31	$2,323,583
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$933,237
Employer contributions (assets) at end of year	2015-12-31	$0
Employer contributions (assets) at beginning of year	2015-12-31	$262
Assets. Corporate common stocks other than exployer securities at end of year	2015-12-31	$84,132
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	No
Opinion of an independent qualified public accountant for this plan	2015-12-31	Unqualified
Accountancy firm name	2015-12-31	YBARRA & GILLESPIE CPAS LLP
Accountancy firm EIN	2015-12-31	205683924
2014 : AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$172,430
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$178,926
Total income from all sources (including contributions)	2014-12-31	$2,173,461
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$2,230,210
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$2,202,698
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$2,173,461
Value of total assets at end of year	2014-12-31	$247,699
Value of total assets at beginning of year	2014-12-31	$310,944
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$27,512
Total interest from all sources	2014-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Administrative expenses professional fees incurred	2014-12-31	$14,410
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$45,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$842,515
Participant contributions at end of year	2014-12-31	$262
Participant contributions at beginning of year	2014-12-31	$155,416
Administrative expenses (other) incurred	2014-12-31	$13,102
Liabilities. Value of operating payables at end of year	2014-12-31	$172,430
Liabilities. Value of operating payables at beginning of year	2014-12-31	$178,926
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$-56,749
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$75,269
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$132,018
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$247,437
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$96,466
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$96,466
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$2,202,698
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$1,330,946
Employer contributions (assets) at beginning of year	2014-12-31	$59,062
Did the plan have assets held for investment	2014-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	No
Opinion of an independent qualified public accountant for this plan	2014-12-31	Unqualified
Accountancy firm name	2014-12-31	YBARRA & GILLESPIE CPAS LLP
Accountancy firm EIN	2014-12-31	205683924
2013 : AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$178,926
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$1,975,410
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$2,148,655
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$2,116,870
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$1,975,410
Value of total assets at end of year	2013-12-31	$310,944
Value of total assets at beginning of year	2013-12-31	$305,263
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$31,785
Total interest from all sources	2013-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Administrative expenses professional fees incurred	2013-12-31	$12,250
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$45,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$1,232,097
Participant contributions at end of year	2013-12-31	$155,416
Administrative expenses (other) incurred	2013-12-31	$19,535
Liabilities. Value of operating payables at end of year	2013-12-31	$178,926
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$-173,245
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$132,018
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$305,263
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$96,466
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$127,111
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$127,111
Expenses. Payments to insurance carriers foe the provision of benefits	2013-12-31	$2,116,870
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$743,313
Employer contributions (assets) at end of year	2013-12-31	$59,062
Employer contributions (assets) at beginning of year	2013-12-31	$178,152
Did the plan have assets held for investment	2013-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	No
Opinion of an independent qualified public accountant for this plan	2013-12-31	Unqualified
Accountancy firm name	2013-12-31	YBARRA & GILLESPIE CPAS LLP
Accountancy firm EIN	2013-12-31	205683924
2012 : AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$145,470
Total income from all sources (including contributions)	2012-12-31	$1,781,813
Total of all expenses incurred	2012-12-31	$1,794,775
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$1,773,541
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$1,781,728
Value of total assets at end of year	2012-12-31	$305,263
Value of total assets at beginning of year	2012-12-31	$463,695
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$21,234
Total interest from all sources	2012-12-31	$85
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Administrative expenses professional fees incurred	2012-12-31	$9,795
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$45,000
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$1,093,783
Participant contributions at end of year	2012-12-31	$178,152
Participant contributions at beginning of year	2012-12-31	$209,817
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$2,254
Administrative expenses (other) incurred	2012-12-31	$11,439
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$-12,962
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$305,263
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$318,225
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$127,111
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$253,878
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$253,878
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$85
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$1,773,541
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$687,945
Liabilities. Value of benefit claims payable at end of year	2012-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2012-12-31	$143,216
Did the plan have assets held for investment	2012-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	YBARRA & GILLESPIE CPAS
Accountancy firm EIN	2012-12-31	205683924
2011 : AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2011 401k financial data
Total transfer of assets to this plan	2011-12-31	$0
Total transfer of assets from this plan	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$145,470
Total income from all sources (including contributions)	2011-12-31	$1,704,016
Total of all expenses incurred	2011-12-31	$1,698,863
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$1,676,483
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$1,703,521
Value of total assets at end of year	2011-12-31	$463,695
Value of total assets at beginning of year	2011-12-31	$314,072
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$22,380
Total interest from all sources	2011-12-31	$495
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Administrative expenses professional fees incurred	2011-12-31	$11,112
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$45,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$1,038,235
Participant contributions at end of year	2011-12-31	$209,817
Participant contributions at beginning of year	2011-12-31	$77,660
Administrative expenses (other) incurred	2011-12-31	$11,268
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$5,153
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$318,225
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$314,072
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$253,878
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$236,412
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$236,412
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$495
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-31	$1,676,483
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$665,286
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-12-31	No
Liabilities. Value of benefit claims payable at end of year	2011-12-31	$145,470
Did the plan have assets held for investment	2011-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	YBARRA & GILLESPIE CPAS
Accountancy firm EIN	2011-12-31	205683924
2010 : AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2010 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$1,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$1,000
Total income from all sources (including contributions)	2010-12-31	$1,546,531
Total of all expenses incurred	2010-12-31	$1,546,861
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$1,526,529
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$1,545,756
Value of total assets at end of year	2010-12-31	$314,072
Value of total assets at beginning of year	2010-12-31	$314,402
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$20,332
Total interest from all sources	2010-12-31	$775
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Administrative expenses professional fees incurred	2010-12-31	$8,867
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$45,000
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$871,300
Participant contributions at end of year	2010-12-31	$77,660
Participant contributions at beginning of year	2010-12-31	$104,558
Administrative expenses (other) incurred	2010-12-31	$11,465
Liabilities. Value of operating payables at end of year	2010-12-31	$1,000
Liabilities. Value of operating payables at beginning of year	2010-12-31	$1,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$-330
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$313,072
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$313,402
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$236,412
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$209,844
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$209,844
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$775
Expenses. Payments to insurance carriers foe the provision of benefits	2010-12-31	$1,526,529
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$674,456
Did the plan have assets held for investment	2010-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Unqualified
Accountancy firm name	2010-12-31	YBARRA & GILLESPIE CPAS
Accountancy firm EIN	2010-12-31	205683924

Form 5500 Responses for AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN

2022: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	Yes
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	Yes
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: AFSCME LOCAL 2076 AND ORANGE COUNTY WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	Yes
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )

Policy contract number

0164562

Policy instance

Insurance contract or identification number	0164562
Number of Individuals Covered	1350
Insurance policy start date	2021-05-01
Insurance policy end date	2022-04-30
Total amount of commissions paid to insurance broker	USD $23,170
Total amount of fees paid to insurance company	USD $11,546
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $232,441
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $23,170
Amount paid for insurance broker fees	11546
Additional information about fees paid to insurance broker	PRODUCER SERVICE FEES & SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

525555

Policy instance

Insurance contract or identification number	525555
Number of Individuals Covered	1463
Insurance policy start date	2021-05-01
Insurance policy end date	2022-04-30
Total amount of commissions paid to insurance broker	USD $171,953
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $1,092,397
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $171,953
Insurance broker organization code?	3

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

30089972

Policy instance

Insurance contract or identification number	30089972
Number of Individuals Covered	1385
Insurance policy start date	2021-05-01
Insurance policy end date	2022-04-30
Total amount of commissions paid to insurance broker	USD $20,130
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $201,499
Commission paid to Insurance Broker	USD $20,130
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

0164562

Policy instance

Insurance contract or identification number	0164562
Number of Individuals Covered	955
Insurance policy start date	2021-05-01
Insurance policy end date	2022-04-30
Total amount of commissions paid to insurance broker	USD $74,031
Total amount of fees paid to insurance company	USD $37,243
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $738,911
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $74,031
Amount paid for insurance broker fees	37243
Additional information about fees paid to insurance broker	DENTAL PRODUCER SERVICE FEES & SUPPLEMENTAL
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

525555

Policy instance

Insurance contract or identification number	525555
Number of Individuals Covered	1418
Insurance policy start date	2020-05-01
Insurance policy end date	2021-04-30
Total amount of commissions paid to insurance broker	USD $147,897
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $940,289
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $147,897
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

0164562

Policy instance

Insurance contract or identification number	0164562
Number of Individuals Covered	962
Insurance policy start date	2020-05-01
Insurance policy end date	2021-04-30
Total amount of commissions paid to insurance broker	USD $74,883
Total amount of fees paid to insurance company	USD $50,170
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $773,529
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $74,883
Amount paid for insurance broker fees	50170
Additional information about fees paid to insurance broker	SERVICE FEES: SUPPLEMENTAL COMPENSATION: NONMONETARY COMPENSATION
Insurance broker organization code?	3

SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )

Policy contract number

0164562

Policy instance

Insurance contract or identification number	0164562
Number of Individuals Covered	1332
Insurance policy start date	2020-05-01
Insurance policy end date	2021-04-30
Total amount of commissions paid to insurance broker	USD $22,544
Total amount of fees paid to insurance company	USD $23,907
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $231,225
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,544
Amount paid for insurance broker fees	23907
Additional information about fees paid to insurance broker	SERVICE FEES: SUPPLEMENTAL COMPENSATION.
Insurance broker organization code?	3

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

30089972

Policy instance

Insurance contract or identification number	30089972
Number of Individuals Covered	1349
Insurance policy start date	2020-05-01
Insurance policy end date	2021-04-30
Total amount of commissions paid to insurance broker	USD $14,967
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $200,349
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,967
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00525555

Policy instance

Insurance contract or identification number	00525555
Number of Individuals Covered	1418
Insurance policy start date	2020-05-01
Insurance policy end date	2021-04-30
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $940,289
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $147,897
Insurance broker organization code?	3

HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

9901137

Policy instance

Insurance contract or identification number	9901137
Number of Individuals Covered	141
Insurance policy start date	2020-05-01
Insurance policy end date	2021-04-30
Total amount of commissions paid to insurance broker	USD $3,047
Total amount of fees paid to insurance company	USD $562
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	LEGAL INSURANCE
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 Carrier	USD $32,724
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,047
Amount paid for insurance broker fees	562
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )

Policy contract number

0164562

Policy instance

Insurance contract or identification number	0164562
Number of Individuals Covered	1332
Insurance policy start date	2020-05-01
Insurance policy end date	2021-04-30
Total amount of commissions paid to insurance broker	USD $22,544
Total amount of fees paid to insurance company	USD $23,097
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $231,225
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,544
Amount paid for insurance broker fees	23907
Additional information about fees paid to insurance broker	SERVICES FEES, SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

0164562

Policy instance

Insurance contract or identification number	0164562
Number of Individuals Covered	962
Insurance policy start date	2020-05-01
Insurance policy end date	2021-04-30
Total amount of commissions paid to insurance broker	USD $74,883
Total amount of fees paid to insurance company	USD $50,170
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $773,529
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $74,883
Amount paid for insurance broker fees	50170
Additional information about fees paid to insurance broker	SERVICE FEES, SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

30089972

Policy instance

Insurance contract or identification number	30089972
Number of Individuals Covered	1350
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $20,143
Total amount of fees paid to insurance company	USD $52,386
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $201,486
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $20,143
Insurance broker organization code?	3

SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )

Policy contract number

0164562

Policy instance

Insurance contract or identification number	0164562
Number of Individuals Covered	1327
Insurance policy start date	2018-05-01
Insurance policy end date	2019-04-30
Total amount of commissions paid to insurance broker	USD $20,225
Total amount of fees paid to insurance company	USD $30,546
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $220,055
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $20,225
Amount paid for insurance broker fees	30546
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION AND NON-MONETARY COMPENSATION.
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

0164562

Policy instance

Insurance contract or identification number	0164562
Number of Individuals Covered	2244
Insurance policy start date	2018-05-01
Insurance policy end date	2019-04-30
Total amount of commissions paid to insurance broker	USD $88,042
Total amount of fees paid to insurance company	USD $71,332
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $971,343
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $88,042
Amount paid for insurance broker fees	71332
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION AND NON-MONETARY COMPENSATION.
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00525555

Policy instance

Insurance contract or identification number	00525555
Number of Individuals Covered	1446
Insurance policy start date	2018-05-01
Insurance policy end date	2019-04-30
Total amount of commissions paid to insurance broker	USD $145,922
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $909,498
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $145,922
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00525555

Policy instance

Insurance contract or identification number	00525555
Number of Individuals Covered	1432
Insurance policy start date	2017-05-01
Insurance policy end date	2018-04-30
Total amount of commissions paid to insurance broker	USD $142,184
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $895,429
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $142,184
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

0164562

Policy instance

Insurance contract or identification number	0164562
Number of Individuals Covered	2201
Insurance policy start date	2017-05-01
Insurance policy end date	2018-04-30
Total amount of commissions paid to insurance broker	USD $112,213
Total amount of fees paid to insurance company	USD $10,504
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $944,412
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $112,213
Amount paid for insurance broker fees	10504
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION AND NON-MONETARY COMPENSATION.
Insurance broker organization code?	3

SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )

Policy contract number

0164562

Policy instance

Insurance contract or identification number	0164562
Number of Individuals Covered	1325
Insurance policy start date	2017-05-01
Insurance policy end date	2018-04-30
Total amount of commissions paid to insurance broker	USD $24,270
Total amount of fees paid to insurance company	USD $2,206
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $203,572
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $24,270
Amount paid for insurance broker fees	2206
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION AND NON-MONETARY COMPENSATION.
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

0164562

Policy instance

Insurance contract or identification number	0164562
Number of Individuals Covered	2180
Insurance policy start date	2016-05-01
Insurance policy end date	2017-04-30
Total amount of commissions paid to insurance broker	USD $139,685
Total amount of fees paid to insurance company	USD $7,157
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $894,640
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $139,685
Amount paid for insurance broker fees	7157
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION AND NON-MONETARY COMPENSATION.
Insurance broker organization code?	3
Insurance broker name	JOHN M FICKEWIRTH AND ASSOCIATION

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00525555

Policy instance

Insurance contract or identification number	00525555
Number of Individuals Covered	1450
Insurance policy start date	2016-05-01
Insurance policy end date	2017-04-30
Total amount of commissions paid to insurance broker	USD $143,281
Total amount of fees paid to insurance company	USD $16,040
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $861,116
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $132
Amount paid for insurance broker fees	16040
Insurance broker organization code?	3
Insurance broker name	JOHN M FICKEWIRTH AND ASSOC INS

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Company Name:	AFSCME LOCAL 2076
Employer identification number (EIN):	336136808
NAIC Classification:	813930
NAIC Description:	Labor Unions and Similar Labor Organizations