SUPERVALU INC. has sponsored the creation of one or more 401k plans.
Additional information about SUPERVALU INC.
Measure | Date | Value |
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2019 : SUPERVALU GROUP HEALTH PLAN 2019 401k financial data |
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Total transfer of assets from this plan | 2019-12-31 | $-5,212,744 |
Total transfer of assets from this plan | 2019-12-31 | $-5,212,744 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $0 |
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 | $9,470,637 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $9,470,637 |
Total income from all sources (including contributions) | 2019-12-31 | $67,542,068 |
Total income from all sources (including contributions) | 2019-12-31 | $67,542,068 |
Total of all expenses incurred | 2019-12-31 | $66,228,444 |
Total of all expenses incurred | 2019-12-31 | $66,228,444 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $60,647,024 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $60,647,024 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $67,511,451 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $67,511,451 |
Value of total assets at end of year | 2019-12-31 | $0 |
Value of total assets at end of year | 2019-12-31 | $0 |
Value of total assets at beginning of year | 2019-12-31 | $2,944,269 |
Value of total assets at beginning of year | 2019-12-31 | $2,944,269 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $5,581,420 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $5,581,420 |
Total interest from all sources | 2019-12-31 | $30,617 |
Total interest from all sources | 2019-12-31 | $30,617 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
Value of fidelity bond cover | 2019-12-31 | $25,000,000 |
Value of fidelity bond cover | 2019-12-31 | $25,000,000 |
If this is an individual account plan, was there a blackout period | 2019-12-31 | No |
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 |
Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
Contributions received from participants | 2019-12-31 | $20,471,398 |
Contributions received from participants | 2019-12-31 | $20,471,398 |
Participant contributions at end of year | 2019-12-31 | $0 |
Participant contributions at end of year | 2019-12-31 | $0 |
Participant contributions at beginning of year | 2019-12-31 | $406,264 |
Participant contributions at beginning of year | 2019-12-31 | $406,264 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $2,167,878 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $2,167,878 |
Liabilities. Value of operating payables at end of year | 2019-12-31 | $0 |
Liabilities. Value of operating payables at end of year | 2019-12-31 | $0 |
Liabilities. Value of operating payables at beginning of year | 2019-12-31 | $342,012 |
Liabilities. Value of operating payables at beginning of year | 2019-12-31 | $342,012 |
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 |
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 | $1,313,624 |
Value of net income/loss | 2019-12-31 | $1,313,624 |
Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $0 |
Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $0 |
Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $-6,526,368 |
Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $-6,526,368 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
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 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 |
Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
Interest earned on other investments | 2019-12-31 | $30,617 |
Interest earned on other investments | 2019-12-31 | $30,617 |
Value of interest in master investment trust accounts at end of year | 2019-12-31 | $0 |
Value of interest in master investment trust accounts at end of year | 2019-12-31 | $0 |
Value of interest in master investment trust accounts at beginning of year | 2019-12-31 | $370,127 |
Value of interest in master investment trust accounts at beginning of year | 2019-12-31 | $370,127 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $11,091,432 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $11,091,432 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | No |
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 |
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 |
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 | $47,040,053 |
Contributions received in cash from employer | 2019-12-31 | $47,040,053 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $49,555,592 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $49,555,592 |
Contract administrator fees | 2019-12-31 | $5,581,420 |
Contract administrator fees | 2019-12-31 | $5,581,420 |
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 |
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 |
Liabilities. Value of benefit claims payable at end of year | 2019-12-31 | $0 |
Liabilities. Value of benefit claims payable at end of year | 2019-12-31 | $0 |
Liabilities. Value of benefit claims payable at beginning of year | 2019-12-31 | $9,128,625 |
Liabilities. Value of benefit claims payable at beginning of year | 2019-12-31 | $9,128,625 |
Did the plan have assets held for investment | 2019-12-31 | No |
Did the plan have assets held for investment | 2019-12-31 | 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 | 2019-12-31 | 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 | 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 | Yes |
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 | Yes |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 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 |
Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Unqualified |
Accountancy firm name | 2019-12-31 | EIDE BAILLY LLP |
Accountancy firm name | 2019-12-31 | EIDE BAILLY LLP |
Accountancy firm EIN | 2019-12-31 | 450250958 |
Accountancy firm EIN | 2019-12-31 | 450250958 |
2018 : SUPERVALU GROUP HEALTH PLAN 2018 401k financial data |
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Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $9,470,637 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $8,270,743 |
Total income from all sources (including contributions) | 2018-12-31 | $85,366,071 |
Total of all expenses incurred | 2018-12-31 | $86,385,304 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $80,366,029 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $85,355,288 |
Value of total assets at end of year | 2018-12-31 | $2,944,269 |
Value of total assets at beginning of year | 2018-12-31 | $2,763,608 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $6,019,275 |
Total interest from all sources | 2018-12-31 | $10,783 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-12-31 | No |
Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
Value of fidelity bond cover | 2018-12-31 | $25,000,000 |
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 | $23,814,271 |
Participant contributions at end of year | 2018-12-31 | $406,264 |
Participant contributions at beginning of year | 2018-12-31 | $414,106 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-12-31 | $2,167,878 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-12-31 | $1,950,766 |
Liabilities. Value of operating payables at end of year | 2018-12-31 | $342,012 |
Liabilities. Value of operating payables at beginning of year | 2018-12-31 | $642,844 |
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 | $-1,019,233 |
Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $-6,526,368 |
Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $-5,507,135 |
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 |
Interest earned on other investments | 2018-12-31 | $10,783 |
Value of interest in master investment trust accounts at end of year | 2018-12-31 | $370,127 |
Value of interest in master investment trust accounts at beginning of year | 2018-12-31 | $398,736 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $9,079,967 |
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 | $61,541,017 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-12-31 | $71,286,062 |
Contract administrator fees | 2018-12-31 | $6,019,275 |
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 |
Liabilities. Value of benefit claims payable at end of year | 2018-12-31 | $9,128,625 |
Liabilities. Value of benefit claims payable at beginning of year | 2018-12-31 | $7,627,899 |
Did the plan have assets held for investment | 2018-12-31 | 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 | 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 | EIDE BAILLY LLP |
Accountancy firm EIN | 2018-12-31 | 450250958 |
2017 : SUPERVALU GROUP HEALTH PLAN 2017 401k financial data |
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Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $8,270,743 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $8,639,859 |
Total income from all sources (including contributions) | 2017-12-31 | $80,779,296 |
Total of all expenses incurred | 2017-12-31 | $81,336,424 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $74,351,677 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $80,774,064 |
Value of total assets at end of year | 2017-12-31 | $2,763,608 |
Value of total assets at beginning of year | 2017-12-31 | $3,689,852 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $6,984,747 |
Total interest from all sources | 2017-12-31 | $5,232 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-12-31 | No |
Was this plan covered by a fidelity bond | 2017-12-31 | Yes |
Value of fidelity bond cover | 2017-12-31 | $25,000,000 |
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 | $22,073,158 |
Participant contributions at end of year | 2017-12-31 | $414,106 |
Participant contributions at beginning of year | 2017-12-31 | $437,208 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-12-31 | $1,950,766 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-12-31 | $2,674,545 |
Liabilities. Value of operating payables at end of year | 2017-12-31 | $642,844 |
Liabilities. Value of operating payables at beginning of year | 2017-12-31 | $755,076 |
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 | $-557,128 |
Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $-5,507,135 |
Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $-4,950,007 |
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 |
Interest earned on other investments | 2017-12-31 | $5,232 |
Value of interest in master investment trust accounts at end of year | 2017-12-31 | $398,736 |
Value of interest in master investment trust accounts at beginning of year | 2017-12-31 | $578,099 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $5,297,324 |
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 | $58,700,906 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-12-31 | $69,054,353 |
Contract administrator fees | 2017-12-31 | $6,984,747 |
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 |
Liabilities. Value of benefit claims payable at end of year | 2017-12-31 | $7,627,899 |
Liabilities. Value of benefit claims payable at beginning of year | 2017-12-31 | $7,884,783 |
Did the plan have assets held for investment | 2017-12-31 | 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 | 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 | EIDE BAILLY LLP |
Accountancy firm EIN | 2017-12-31 | 450250958 |
2016 : SUPERVALU GROUP HEALTH PLAN 2016 401k financial data |
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Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $8,639,859 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $11,767,775 |
Total income from all sources (including contributions) | 2016-12-31 | $111,496,457 |
Total of all expenses incurred | 2016-12-31 | $108,115,829 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $100,631,683 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $111,495,227 |
Value of total assets at end of year | 2016-12-31 | $3,689,852 |
Value of total assets at beginning of year | 2016-12-31 | $3,437,140 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $7,484,146 |
Total interest from all sources | 2016-12-31 | $1,230 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
Was this plan covered by a fidelity bond | 2016-12-31 | No |
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 | $33,284,530 |
Participant contributions at end of year | 2016-12-31 | $437,208 |
Participant contributions at beginning of year | 2016-12-31 | $480,239 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-12-31 | $2,674,545 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-12-31 | $2,342,635 |
Liabilities. Value of operating payables at end of year | 2016-12-31 | $755,076 |
Liabilities. Value of operating payables at beginning of year | 2016-12-31 | $416,301 |
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 | $3,380,628 |
Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $-4,950,007 |
Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $-8,330,635 |
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 |
Interest earned on other investments | 2016-12-31 | $1,230 |
Value of interest in master investment trust accounts at end of year | 2016-12-31 | $578,099 |
Value of interest in master investment trust accounts at beginning of year | 2016-12-31 | $614,266 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $5,429,608 |
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 | $78,210,697 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-12-31 | $95,202,075 |
Contract administrator fees | 2016-12-31 | $7,484,146 |
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 |
Liabilities. Value of benefit claims payable at end of year | 2016-12-31 | $7,884,783 |
Liabilities. Value of benefit claims payable at beginning of year | 2016-12-31 | $11,351,474 |
Did the plan have assets held for investment | 2016-12-31 | 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 | 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 | EIDE BAILLY LLP |
Accountancy firm EIN | 2016-12-31 | 450250958 |
2015 : SUPERVALU GROUP HEALTH PLAN 2015 401k financial data |
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Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $11,767,775 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $21,998,151 |
Total income from all sources (including contributions) | 2015-12-31 | $116,561,249 |
Total of all expenses incurred | 2015-12-31 | $113,158,746 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $105,474,834 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-12-31 | $116,561,130 |
Value of total assets at end of year | 2015-12-31 | $3,437,140 |
Value of total assets at beginning of year | 2015-12-31 | $10,265,013 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $7,683,912 |
Total interest from all sources | 2015-12-31 | $119 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-12-31 | No |
Was this plan covered by a fidelity bond | 2015-12-31 | Yes |
Value of fidelity bond cover | 2015-12-31 | $25,000,000 |
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 | $34,252,075 |
Participant contributions at end of year | 2015-12-31 | $480,239 |
Participant contributions at beginning of year | 2015-12-31 | $1,079,772 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-12-31 | $2,342,635 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-12-31 | $3,973,390 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2015-12-31 | $10,879,980 |
Liabilities. Value of operating payables at end of year | 2015-12-31 | $416,301 |
Liabilities. Value of operating payables at beginning of year | 2015-12-31 | $627,303 |
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 | $3,402,503 |
Value of net assets at end of year (total assets less liabilities) | 2015-12-31 | $-8,330,635 |
Value of net assets at beginning of year (total assets less liabilities) | 2015-12-31 | $-11,733,138 |
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 |
Interest earned on other investments | 2015-12-31 | $119 |
Value of interest in master investment trust accounts at end of year | 2015-12-31 | $614,266 |
Value of interest in master investment trust accounts at beginning of year | 2015-12-31 | $5,211,851 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2015-12-31 | $4,834,769 |
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 | $82,309,055 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-12-31 | $100,640,065 |
Contract administrator fees | 2015-12-31 | $7,683,912 |
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 | 2015-12-31 | No |
Liabilities. Value of benefit claims payable at end of year | 2015-12-31 | $11,351,474 |
Liabilities. Value of benefit claims payable at beginning of year | 2015-12-31 | $10,490,868 |
Did the plan have assets held for investment | 2015-12-31 | 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 | 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 | EIDE BAILLY, LLP |
Accountancy firm EIN | 2015-12-31 | 450250958 |
2014 : SUPERVALU GROUP HEALTH PLAN 2014 401k financial data |
---|
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $21,998,151 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $22,808,279 |
Total income from all sources (including contributions) | 2014-12-31 | $122,017,888 |
Total of all expenses incurred | 2014-12-31 | $115,314,010 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $106,754,164 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-12-31 | $122,016,735 |
Value of total assets at end of year | 2014-12-31 | $10,265,013 |
Value of total assets at beginning of year | 2014-12-31 | $4,371,263 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $8,559,846 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-12-31 | No |
Was this plan covered by a fidelity bond | 2014-12-31 | Yes |
Value of fidelity bond cover | 2014-12-31 | $25,000,000 |
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 | $34,630,708 |
Participant contributions at end of year | 2014-12-31 | $1,079,772 |
Participant contributions at beginning of year | 2014-12-31 | $1,037,512 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-12-31 | $3,973,390 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-12-31 | $3,333,751 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2014-12-31 | $10,879,980 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2014-12-31 | $11,645,049 |
Liabilities. Value of operating payables at end of year | 2014-12-31 | $627,303 |
Liabilities. Value of operating payables at beginning of year | 2014-12-31 | $615,152 |
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 | $6,703,878 |
Value of net assets at end of year (total assets less liabilities) | 2014-12-31 | $-11,733,138 |
Value of net assets at beginning of year (total assets less liabilities) | 2014-12-31 | $-18,437,016 |
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 |
Investment advisory and management fees | 2014-12-31 | $599,737 |
Value of interest in master investment trust accounts at end of year | 2014-12-31 | $5,211,851 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2014-12-31 | $5,068,601 |
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 | $87,386,027 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-12-31 | $101,685,563 |
Contract administrator fees | 2014-12-31 | $7,960,109 |
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 | 2014-12-31 | No |
Liabilities. Value of benefit claims payable at end of year | 2014-12-31 | $10,490,868 |
Liabilities. Value of benefit claims payable at beginning of year | 2014-12-31 | $10,548,078 |
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 | EIDE BAILLY LLP |
Accountancy firm EIN | 2014-12-31 | 450250958 |
2013 : SUPERVALU GROUP HEALTH PLAN 2013 401k financial data |
---|
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $22,808,279 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $49,371,961 |
Total income from all sources (including contributions) | 2013-12-31 | $198,312,892 |
Total of all expenses incurred | 2013-12-31 | $174,813,665 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $162,056,626 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-12-31 | $198,312,892 |
Value of total assets at end of year | 2013-12-31 | $4,371,263 |
Value of total assets at beginning of year | 2013-12-31 | $7,435,718 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $12,757,039 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-12-31 | No |
Was this plan covered by a fidelity bond | 2013-12-31 | No |
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 | $49,586,142 |
Participant contributions at end of year | 2013-12-31 | $1,037,512 |
Participant contributions at beginning of year | 2013-12-31 | $1,918,048 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-12-31 | $3,333,751 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-12-31 | $5,517,670 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2013-12-31 | $11,645,049 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2013-12-31 | $8,689,587 |
Liabilities. Value of operating payables at end of year | 2013-12-31 | $615,152 |
Liabilities. Value of operating payables at beginning of year | 2013-12-31 | $1,237,100 |
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 | $23,499,227 |
Value of net assets at end of year (total assets less liabilities) | 2013-12-31 | $-18,437,016 |
Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $-41,936,243 |
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 |
Investment advisory and management fees | 2013-12-31 | $619,313 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2013-12-31 | $10,810,774 |
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 | $148,726,750 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-12-31 | $151,245,852 |
Contract administrator fees | 2013-12-31 | $12,137,726 |
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 | 2013-12-31 | No |
Liabilities. Value of benefit claims payable at end of year | 2013-12-31 | $10,548,078 |
Liabilities. Value of benefit claims payable at beginning of year | 2013-12-31 | $39,445,274 |
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 | EIDE BAILLY LLP |
Accountancy firm EIN | 2013-12-31 | 450250958 |
2012 : SUPERVALU GROUP HEALTH PLAN 2012 401k financial data |
---|
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $49,371,961 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $47,898,299 |
Total income from all sources (including contributions) | 2012-12-31 | $377,476,491 |
Total of all expenses incurred | 2012-12-31 | $380,314,056 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $354,235,034 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $377,476,491 |
Value of total assets at end of year | 2012-12-31 | $7,435,718 |
Value of total assets at beginning of year | 2012-12-31 | $8,799,621 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $26,079,022 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
Was this plan covered by a fidelity bond | 2012-12-31 | No |
If this is an individual account plan, was there a blackout period | 2012-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
Contributions received from participants | 2012-12-31 | $94,063,256 |
Participant contributions at end of year | 2012-12-31 | $1,918,048 |
Participant contributions at beginning of year | 2012-12-31 | $3,860,214 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-12-31 | $5,517,670 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-12-31 | $4,939,407 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2012-12-31 | $8,689,587 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2012-12-31 | $8,346,102 |
Liabilities. Value of operating payables at end of year | 2012-12-31 | $1,237,100 |
Liabilities. Value of operating payables at beginning of year | 2012-12-31 | $1,063,838 |
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 | $-2,837,565 |
Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $-41,936,243 |
Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $-39,098,678 |
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 |
Investment advisory and management fees | 2012-12-31 | $525,306 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2012-12-31 | $25,001,744 |
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 | $283,413,235 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $329,233,290 |
Contract administrator fees | 2012-12-31 | $25,553,716 |
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 | 2012-12-31 | No |
Liabilities. Value of benefit claims payable at end of year | 2012-12-31 | $39,445,274 |
Liabilities. Value of benefit claims payable at beginning of year | 2012-12-31 | $38,488,359 |
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 | EIDE BAILLY LLP |
Accountancy firm EIN | 2012-12-31 | 450250958 |
2011 : SUPERVALU GROUP HEALTH PLAN 2011 401k financial data |
---|
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $47,898,299 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $52,168,313 |
Total income from all sources (including contributions) | 2011-12-31 | $382,887,197 |
Total of all expenses incurred | 2011-12-31 | $380,689,722 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $353,211,749 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $382,887,197 |
Value of total assets at end of year | 2011-12-31 | $8,799,621 |
Value of total assets at beginning of year | 2011-12-31 | $10,872,160 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $27,477,973 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
Was this plan covered by a fidelity bond | 2011-12-31 | No |
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 |
Amount of non-exempt transactions with any party-in-interest | 2011-12-31 | $71,697 |
Contributions received from participants | 2011-12-31 | $92,928,485 |
Participant contributions at end of year | 2011-12-31 | $3,860,214 |
Participant contributions at beginning of year | 2011-12-31 | $3,792,502 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-12-31 | $4,939,407 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-12-31 | $7,079,658 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2011-12-31 | $8,346,102 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2011-12-31 | $6,815,583 |
Liabilities. Value of operating payables at end of year | 2011-12-31 | $1,063,838 |
Liabilities. Value of operating payables at beginning of year | 2011-12-31 | $907,581 |
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 | $2,197,475 |
Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $-39,098,678 |
Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $-41,296,153 |
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 |
Investment advisory and management fees | 2011-12-31 | $453,003 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2011-12-31 | $26,679,817 |
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 | $289,958,712 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $326,531,932 |
Contract administrator fees | 2011-12-31 | $27,024,970 |
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 | $38,488,359 |
Liabilities. Value of benefit claims payable at beginning of year | 2011-12-31 | $44,445,149 |
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 | EIDE BAILLY LLP |
Accountancy firm EIN | 2011-12-31 | 450250958 |
2010 : SUPERVALU GROUP HEALTH PLAN 2010 401k financial data |
---|
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $52,168,313 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $48,263,736 |
Total income from all sources (including contributions) | 2010-12-31 | $430,593,610 |
Total of all expenses incurred | 2010-12-31 | $443,491,897 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $417,729,806 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $430,525,852 |
Value of total assets at end of year | 2010-12-31 | $10,872,160 |
Value of total assets at beginning of year | 2010-12-31 | $19,865,870 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $25,762,091 |
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 | $2,614,681 |
Was this plan covered by a fidelity bond | 2010-12-31 | No |
If this is an individual account plan, was there a blackout period | 2010-12-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | Yes |
Amount of non-exempt transactions with any party-in-interest | 2010-12-31 | $71,697 |
Contributions received from participants | 2010-12-31 | $95,707,590 |
Participant contributions at end of year | 2010-12-31 | $3,792,502 |
Participant contributions at beginning of year | 2010-12-31 | $1,435,753 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2010-12-31 | $7,079,658 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2010-12-31 | $6,625,117 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2010-12-31 | $6,815,583 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2010-12-31 | $10,136,756 |
Other income not declared elsewhere | 2010-12-31 | $67,758 |
Administrative expenses (other) incurred | 2010-12-31 | $508,482 |
Liabilities. Value of operating payables at end of year | 2010-12-31 | $907,581 |
Liabilities. Value of operating payables at beginning of year | 2010-12-31 | $668,518 |
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 | $-12,898,287 |
Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $-41,296,153 |
Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $-28,397,866 |
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 in master investment trust accounts at beginning of year | 2010-12-31 | $11,805,000 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2010-12-31 | $26,915,829 |
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 | $334,818,262 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2010-12-31 | $390,813,977 |
Contract administrator fees | 2010-12-31 | $22,638,928 |
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 | 2010-12-31 | No |
Liabilities. Value of benefit claims payable at end of year | 2010-12-31 | $44,445,149 |
Liabilities. Value of benefit claims payable at beginning of year | 2010-12-31 | $37,458,462 |
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 | EIDE BAILLY |
Accountancy firm EIN | 2010-12-31 | 450250958 |
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 3172320 |
Policy instance | 1 |
Insurance contract or identification number | 3172320 | Number of Individuals Covered | 85 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Other welfare benefits provided | PREPAID DENTAL | Welfare Benefit Premiums Paid to Carrier | USD $3,118 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 22231-7000 |
Policy instance | 13 |
Insurance contract or identification number | 22231-7000 | Number of Individuals Covered | 4 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $350 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,873 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $350 |
|
HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
Policy contract number | 553234 |
Policy instance | 14 |
Insurance contract or identification number | 553234 | Number of Individuals Covered | 351 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $138,675 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,857,830 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $138,675 |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 101709-36 |
Policy instance | 11 |
Insurance contract or identification number | 101709-36 | Number of Individuals Covered | 20 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $2,797 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $86,203 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,797 |
|
GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 ) |
Policy contract number | 1461000 |
Policy instance | 10 |
Insurance contract or identification number | 1461000 | Number of Individuals Covered | 20 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $1,657 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $83,745 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,657 |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1944 |
Policy instance | 9 |
Insurance contract or identification number | 1944 | Number of Individuals Covered | 51 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $571 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $337,447 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 571 | Additional information about fees paid to insurance broker | BONUS AMOUNT | Insurance broker organization code? | 3 |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 101709-0 |
Policy instance | 8 |
Insurance contract or identification number | 101709-0 | Number of Individuals Covered | 263 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $55,274 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,696,522 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $55,274 | Insurance broker organization code? | 3 |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 101709 |
Policy instance | 7 |
Insurance contract or identification number | 101709 | Number of Individuals Covered | 301 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $64,128 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,985,235 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $64,128 |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 22231 |
Policy instance | 6 |
Insurance contract or identification number | 22231 | Number of Individuals Covered | 123 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $18,841 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $557,795 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,841 |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 1487101 |
Policy instance | 4 |
Insurance contract or identification number | 1487101 | Number of Individuals Covered | 334 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,601,424 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 051057 |
Policy instance | 5 |
Insurance contract or identification number | 051057 | Number of Individuals Covered | 10821 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12314418 |
Policy instance | 3 |
Insurance contract or identification number | 12314418 | Number of Individuals Covered | 4468 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $10,657 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,657 | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12236423 |
Policy instance | 2 |
Insurance contract or identification number | 12236423 | Number of Individuals Covered | 1 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 22231-0 |
Policy instance | 12 |
Insurance contract or identification number | 22231-0 | Number of Individuals Covered | 114 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $17,624 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $520,704 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,624 |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 22231 |
Policy instance | 7 |
Insurance contract or identification number | 22231 | Number of Individuals Covered | 117 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $19,459 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $720,247 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $19,459 | Insurance broker organization code? | 3 |
|
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 3172320 |
Policy instance | 1 |
Insurance contract or identification number | 3172320 | Number of Individuals Covered | 168 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Other welfare benefits provided | PREPAID DENTAL | Welfare Benefit Premiums Paid to Carrier | USD $39,140 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 ) |
Policy contract number | 1461000 |
Policy instance | 12 |
Insurance contract or identification number | 1461000 | Number of Individuals Covered | 11 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $3,066 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $134,622 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,066 | Insurance broker organization code? | 3 |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1944 |
Policy instance | 11 |
Insurance contract or identification number | 1944 | Number of Individuals Covered | 57 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $7,194 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $465,632 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,194 | Insurance broker organization code? | 3 |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 3003 |
Policy instance | 10 |
Insurance contract or identification number | 3003 | Number of Individuals Covered | 5 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,765 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 101709 |
Policy instance | 9 |
Insurance contract or identification number | 101709 | Number of Individuals Covered | 5 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $1,586 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $60,531 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,586 | Insurance broker organization code? | 3 |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 101709 |
Policy instance | 8 |
Insurance contract or identification number | 101709 | Number of Individuals Covered | 377 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $67,052 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,387,516 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $67,052 | Insurance broker organization code? | 3 |
|
DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 051057B943 |
Policy instance | 6 |
Insurance contract or identification number | 051057B943 | Number of Individuals Covered | 211 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 0505290001 |
Policy instance | 5 |
Insurance contract or identification number | 0505290001 | Number of Individuals Covered | 12667 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 1487101 |
Policy instance | 4 |
Insurance contract or identification number | 1487101 | Number of Individuals Covered | 338 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,667,416 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12314418 |
Policy instance | 3 |
Insurance contract or identification number | 12314418 | Number of Individuals Covered | 5247 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $14,073 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,073 | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12236423 |
Policy instance | 2 |
Insurance contract or identification number | 12236423 | Number of Individuals Covered | 187 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12314418 |
Policy instance | 3 |
Insurance contract or identification number | 12314418 | Number of Individuals Covered | 5767 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $11,616 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,616 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12236423 |
Policy instance | 2 |
Insurance contract or identification number | 12236423 | Number of Individuals Covered | 168 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 3172320 |
Policy instance | 1 |
Insurance contract or identification number | 3172320 | Number of Individuals Covered | 157 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Other welfare benefits provided | PREPAID DENTAL | Welfare Benefit Premiums Paid to Carrier | USD $35,055 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 051057-ACTIVE |
Policy instance | 4 |
Insurance contract or identification number | 051057-ACTIVE | Number of Individuals Covered | 13810 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 1487101 |
Policy instance | 5 |
Insurance contract or identification number | 1487101 | Number of Individuals Covered | 365 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,641,858 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 1487101 |
Policy instance | 5 |
Insurance contract or identification number | 1487101 | Number of Individuals Covered | 388 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,672,507 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 051057-ACTIVE |
Policy instance | 4 |
Insurance contract or identification number | 051057-ACTIVE | Number of Individuals Covered | 10630 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12314418 |
Policy instance | 3 |
Insurance contract or identification number | 12314418 | Number of Individuals Covered | 8800 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $22,833 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $22,833 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC |
|
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 3172320 |
Policy instance | 1 |
Insurance contract or identification number | 3172320 | Number of Individuals Covered | 43 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Other welfare benefits provided | PREPAID DENTAL | Welfare Benefit Premiums Paid to Carrier | USD $20,165 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12236423 |
Policy instance | 2 |
Insurance contract or identification number | 12236423 | Number of Individuals Covered | 128 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
Policy contract number | G1006924 1003 |
Policy instance | 6 |
Insurance contract or identification number | G1006924 1003 | Number of Individuals Covered | 11 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $26,722 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 1487101 |
Policy instance | 7 |
Insurance contract or identification number | 1487101 | Number of Individuals Covered | 270 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,485,011 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
Policy contract number | G1006924 1001 |
Policy instance | 5 |
Insurance contract or identification number | G1006924 1001 | Number of Individuals Covered | 14 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $357,896 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 051057-ACTIVE |
Policy instance | 4 |
Insurance contract or identification number | 051057-ACTIVE | Number of Individuals Covered | 11124 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12314418 |
Policy instance | 3 |
Insurance contract or identification number | 12314418 | Number of Individuals Covered | 9426 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $21,847 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $21,847 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES, INC |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12236423 |
Policy instance | 2 |
Insurance contract or identification number | 12236423 | Number of Individuals Covered | 126 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 3172320 |
Policy instance | 1 |
Insurance contract or identification number | 3172320 | Number of Individuals Covered | 29 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Other welfare benefits provided | PREPAID DENTAL | Welfare Benefit Premiums Paid to Carrier | USD $9,444 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 3172320 |
Policy instance | 1 |
Insurance contract or identification number | 3172320 | Number of Individuals Covered | 20 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Other welfare benefits provided | PREPAID DENTAL | Welfare Benefit Premiums Paid to Carrier | USD $6,542 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12236423 |
Policy instance | 2 |
Insurance contract or identification number | 12236423 | Number of Individuals Covered | 121 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 228365 |
Policy instance | 16 |
Insurance contract or identification number | 228365 | Number of Individuals Covered | 0 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-03-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $456,394 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 604096 |
Policy instance | 15 |
Insurance contract or identification number | 604096 | Number of Individuals Covered | 7 | Insurance policy start date | 2013-04-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,953 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 231573 |
Policy instance | 14 |
Insurance contract or identification number | 231573 | Number of Individuals Covered | 2 | Insurance policy start date | 2013-04-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,397 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 19217 |
Policy instance | 12 |
Insurance contract or identification number | 19217 | Number of Individuals Covered | 1 | Insurance policy start date | 2013-04-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,060 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 01487101 |
Policy instance | 11 |
Insurance contract or identification number | 01487101 | Number of Individuals Covered | 296 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,177,972 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 10046 |
Policy instance | 10 |
Insurance contract or identification number | 10046 | Number of Individuals Covered | 0 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-03-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $419,470 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
Policy contract number | G1006924 1001 |
Policy instance | 8 |
Insurance contract or identification number | G1006924 1001 | Number of Individuals Covered | 41 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $801,066 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 ) |
Policy contract number | 005389, 009610 |
Policy instance | 7 |
Insurance contract or identification number | 005389, 009610 | Number of Individuals Covered | 11601 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 620397 |
Policy instance | 6 |
Insurance contract or identification number | 620397 | Number of Individuals Covered | 474 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $822,414 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | H00018 |
Policy instance | 5 |
Insurance contract or identification number | H00018 | Number of Individuals Covered | 5 | Insurance policy start date | 2013-03-22 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $232,545 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 602049 |
Policy instance | 4 |
Insurance contract or identification number | 602049 | Number of Individuals Covered | 0 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-03-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,651 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12314418 |
Policy instance | 3 |
Insurance contract or identification number | 12314418 | Number of Individuals Covered | 9837 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $38,019 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $25,744 | Insurance broker organization code? | 3 | Insurance broker name | SCOTT HOWELL |
|
SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
Policy contract number | G1006924 1003 |
Policy instance | 9 |
Insurance contract or identification number | G1006924 1003 | Number of Individuals Covered | 4 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $23,371 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | H80008, H80009 |
Policy instance | 13 |
Insurance contract or identification number | H80008, H80009 | Number of Individuals Covered | 0 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-03-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,068,614 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 ) |
Policy contract number | 005389, 009610 |
Policy instance | 8 |
Insurance contract or identification number | 005389, 009610 | Number of Individuals Covered | 38057 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 04181962 |
Policy instance | 12 |
Insurance contract or identification number | 04181962 | Number of Individuals Covered | 335 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,006,203 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 10046 |
Policy instance | 11 |
Insurance contract or identification number | 10046 | Number of Individuals Covered | 522 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,589,050 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
Policy contract number | G1006924 1003 |
Policy instance | 10 |
Insurance contract or identification number | G1006924 1003 | Number of Individuals Covered | 9 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,659 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
Policy contract number | G1006924 1001 |
Policy instance | 9 |
Insurance contract or identification number | G1006924 1001 | Number of Individuals Covered | 665 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,957,283 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 620397 |
Policy instance | 7 |
Insurance contract or identification number | 620397 | Number of Individuals Covered | 6459 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,239,781 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | H80008 |
Policy instance | 6 |
Insurance contract or identification number | H80008 | Number of Individuals Covered | 1933 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,080,507 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 602049 |
Policy instance | 5 |
Insurance contract or identification number | 602049 | Number of Individuals Covered | 11 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $57,009 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12314418 |
Policy instance | 4 |
Insurance contract or identification number | 12314418 | Number of Individuals Covered | 37287 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $80,603 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $80,603 | Insurance broker organization code? | 3 | Insurance broker name | |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12236423 |
Policy instance | 3 |
Insurance contract or identification number | 12236423 | Number of Individuals Covered | 158 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 228365 |
Policy instance | 1 |
Insurance contract or identification number | 228365 | Number of Individuals Covered | 516 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,592,521 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
Policy contract number | 3172320 |
Policy instance | 2 |
Insurance contract or identification number | 3172320 | Number of Individuals Covered | 32 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Other welfare benefits provided | PREPAID DENTAL | Welfare Benefit Premiums Paid to Carrier | USD $5,174 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 620397 |
Policy instance | 7 |
Insurance contract or identification number | 620397 | Number of Individuals Covered | 7376 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,376,802 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12236423 |
Policy instance | 3 |
Insurance contract or identification number | 12236423 | Number of Individuals Covered | 145 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 ) |
Policy contract number | 005389, 009610 |
Policy instance | 8 |
Insurance contract or identification number | 005389, 009610 | Number of Individuals Covered | 40971 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
Policy contract number | G1006924 1003 |
Policy instance | 10 |
Insurance contract or identification number | G1006924 1003 | Number of Individuals Covered | 1 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $34,114 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 04181962 |
Policy instance | 13 |
Insurance contract or identification number | 04181962 | Number of Individuals Covered | 335 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,558,997 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12314418 |
Policy instance | 4 |
Insurance contract or identification number | 12314418 | Number of Individuals Covered | 39000 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $60,910 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 602049 |
Policy instance | 5 |
Insurance contract or identification number | 602049 | Number of Individuals Covered | 10 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $80,759 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 228365 |
Policy instance | 1 |
Insurance contract or identification number | 228365 | Number of Individuals Covered | 263 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,044,984 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | H80008 |
Policy instance | 6 |
Insurance contract or identification number | H80008 | Number of Individuals Covered | 2207 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,845,752 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 ) |
Policy contract number | 5923500000 |
Policy instance | 12 |
Insurance contract or identification number | 5923500000 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,337,112 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 10046 |
Policy instance | 11 |
Insurance contract or identification number | 10046 | Number of Individuals Covered | 207 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,576,611 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
Policy contract number | G1006924 1001 |
Policy instance | 9 |
Insurance contract or identification number | G1006924 1001 | Number of Individuals Covered | 802 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,252,272 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
Policy contract number | 3172320 |
Policy instance | 2 |
Insurance contract or identification number | 3172320 | Number of Individuals Covered | 41 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Other welfare benefits provided | PREPAID DENTAL | Welfare Benefit Premiums Paid to Carrier | USD $6,154 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 10046 |
Policy instance | 12 |
Insurance contract or identification number | 10046 | Number of Individuals Covered | 219 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,554,279 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 04181962 |
Policy instance | 15 |
Insurance contract or identification number | 04181962 | Number of Individuals Covered | 131 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,548,406 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
Policy contract number | G1006924 1003 |
Policy instance | 11 |
Insurance contract or identification number | G1006924 1003 | Number of Individuals Covered | 23 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $83,349 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 602049 |
Policy instance | 5 |
Insurance contract or identification number | 602049 | Number of Individuals Covered | 10 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $98,388 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12236423 |
Policy instance | 3 |
Insurance contract or identification number | 12236423 | Number of Individuals Covered | 143 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 ) |
Policy contract number | 5923500000 |
Policy instance | 14 |
Insurance contract or identification number | 5923500000 | Number of Individuals Covered | 909 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,661,364 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTHAMERICA OF PENNSYLVANIA, INC. HMO (National Association of Insurance Commissioners NAIC id number: 95060 ) |
Policy contract number | 5850000000 |
Policy instance | 13 |
Insurance contract or identification number | 5850000000 | Number of Individuals Covered | 157 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $409,019 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 228365 |
Policy instance | 1 |
Insurance contract or identification number | 228365 | Number of Individuals Covered | 327 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,361,546 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 12314418 |
Policy instance | 4 |
Insurance contract or identification number | 12314418 | Number of Individuals Covered | 43382 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $66,241 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 ) |
Policy contract number | G1006924 1001 |
Policy instance | 10 |
Insurance contract or identification number | G1006924 1001 | Number of Individuals Covered | 885 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,490,720 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 ) |
Policy contract number | 40789 |
Policy instance | 9 |
Insurance contract or identification number | 40789 | Number of Individuals Covered | 304 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,570,336 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 ) |
Policy contract number | 005389, 009610 |
Policy instance | 8 |
Insurance contract or identification number | 005389, 009610 | Number of Individuals Covered | 47115 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 620397 |
Policy instance | 7 |
Insurance contract or identification number | 620397 | Number of Individuals Covered | 4892 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,882,242 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | H80008 |
Policy instance | 6 |
Insurance contract or identification number | H80008 | Number of Individuals Covered | 2629 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,930,302 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
Policy contract number | 3172320 |
Policy instance | 2 |
Insurance contract or identification number | 3172320 | Number of Individuals Covered | 52 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Other welfare benefits provided | PREPAID DENTAL | Welfare Benefit Premiums Paid to Carrier | USD $8,278 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 40002 555 |
Policy instance | 16 |
Insurance contract or identification number | 40002 555 | Number of Individuals Covered | 12 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $292,772 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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