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| Plan Name | SOUTHERN CALIFORNIA VET SPECIALTY HOSPITAL WELFARE BENEFITS PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | SO CALIFORNIA VET SPECIALTY HOSPITAL, GP |
| Employer identification number (EIN): | 463787210 |
| NAIC Classification: | 541940 |
| NAIC Description: | Veterinary Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2018-01-01 | ||||
| 501 | 2017-01-01 | GILBERT VELASQUEZ | GILBERT VELASQUEZ | 2018-10-08 | |
| 501 | 2016-01-01 | GILBERT VELASQUEZ |
| Measure | Date | Value |
|---|---|---|
| 2018: SOUTHERN CALIFORNIA VET SPECIALTY HOSPITAL WELFARE BENEFITS PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-01-01 | 137 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 143 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 143 |
| 2017: SOUTHERN CALIFORNIA VET SPECIALTY HOSPITAL WELFARE BENEFITS PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-01-01 | 140 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 137 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 137 |
| 2016: SOUTHERN CALIFORNIA VET SPECIALTY HOSPITAL WELFARE BENEFITS PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-01-01 | 129 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 140 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 140 |
| 2018: SOUTHERN CALIFORNIA VET SPECIALTY HOSPITAL WELFARE BENEFITS PLAN 2018 form 5500 responses | ||
|---|---|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: SOUTHERN CALIFORNIA VET SPECIALTY HOSPITAL WELFARE BENEFITS PLAN 2017 form 5500 responses | ||
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: SOUTHERN CALIFORNIA VET SPECIALTY HOSPITAL WELFARE BENEFITS PLAN 2016 form 5500 responses | ||
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 1015919 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 275673 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 5456681 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 275673 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 231515 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 5 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 0412800000 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 6 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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