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CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 401k Plan overview

Plan NameCALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST
Plan identification number 501

CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • 10 or more employer plan under Code section 419A(f)(6).

401k Sponsoring company profile

SAN DIEGO SOFTWARE INDUSTRY COUNCIL has sponsored the creation of one or more 401k plans.

Company Name:SAN DIEGO SOFTWARE INDUSTRY COUNCIL
Employer identification number (EIN):477116850
NAIC Classification:541519
NAIC Description:Other Computer Related Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01MILLER KAPLAN ARASE LLP
5012016-01-01MILLER KAPLAN ARASE LLP
5012015-06-01MILLER KAPLAN ARASE LLP

Plan Statistics for CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST

401k plan membership statisitcs for CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST

Measure Date Value
2021: CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 2021 401k membership
Total participants, beginning-of-year2021-01-011,586
Total number of active participants reported on line 7a of the Form 55002021-01-011,586
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-011,586
Total participants2021-01-011,586
Number of employers contributing to the scheme2021-01-0137
2020: CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 2020 401k membership
Total participants, beginning-of-year2020-01-011,855
Total number of active participants reported on line 7a of the Form 55002020-01-011,586
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-011,586
Total participants2020-01-011,586
Number of employers contributing to the scheme2020-01-0137
2019: CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 2019 401k membership
Total participants, beginning-of-year2019-01-011,624
Total number of active participants reported on line 7a of the Form 55002019-01-011,855
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-011,855
Total participants2019-01-011,855
Number of employers contributing to the scheme2019-01-0141
2018: CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 2018 401k membership
Total participants, beginning-of-year2018-01-011,599
Total number of active participants reported on line 7a of the Form 55002018-01-011,836
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-011,836
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-011,836
Number of participants with account balances2018-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
Number of employers contributing to the scheme2018-01-0133
2017: CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 2017 401k membership
Total participants, beginning-of-year2017-01-011,079
Total number of active participants reported on line 7a of the Form 55002017-01-011,445
Number of retired or separated participants receiving benefits2017-01-016
Number of other retired or separated participants entitled to future benefits2017-01-016
Total of all active and inactive participants2017-01-011,457
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-011,457
Number of participants with account balances2017-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
Number of employers contributing to the scheme2017-01-0128
2016: CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 2016 401k membership
Total participants, beginning-of-year2016-01-01317
Total number of active participants reported on line 7a of the Form 55002016-01-01830
Number of retired or separated participants receiving benefits2016-01-0113
Number of other retired or separated participants entitled to future benefits2016-01-0113
Total of all active and inactive participants2016-01-01856
Total participants2016-01-01856
Number of employers contributing to the scheme2016-01-0119
2015: CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 2015 401k membership
Total participants, beginning-of-year2015-06-01197
Total number of active participants reported on line 7a of the Form 55002015-06-01317
Number of retired or separated participants receiving benefits2015-06-010
Number of other retired or separated participants entitled to future benefits2015-06-010
Total of all active and inactive participants2015-06-01317
Total participants2015-06-01317

Financial Data on CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST

Measure Date Value
2021 : CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$148,227
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$2,286,932
Total income from all sources (including contributions)2021-12-31$22,456,686
Total of all expenses incurred2021-12-31$22,466,495
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$21,057,472
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$22,456,686
Value of total assets at end of year2021-12-31$200,965
Value of total assets at beginning of year2021-12-31$2,349,479
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$1,409,023
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2021-12-31$0
Administrative expenses professional fees incurred2021-12-31$58,269
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$276,387
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$1,990
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$435,544
Administrative expenses (other) incurred2021-12-31$1,125,200
Liabilities. Value of operating payables at end of year2021-12-31$1,141
Liabilities. Value of operating payables at beginning of year2021-12-31$15,122
Total non interest bearing cash at end of year2021-12-31$181,443
Total non interest bearing cash at beginning of year2021-12-31$2,314,251
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$-9,809
Value of net assets at end of year (total assets less liabilities)2021-12-31$52,738
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$62,547
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$21,057,472
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$22,180,299
Employer contributions (assets) at end of year2021-12-31$19,522
Employer contributions (assets) at beginning of year2021-12-31$33,238
Contract administrator fees2021-12-31$225,554
Liabilities. Value of benefit claims payable at end of year2021-12-31$147,086
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$1,836,266
Did the plan have assets held for investment2021-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31MILLER KAPLAN ARASE LLP
Accountancy firm EIN2021-12-31952036255
2020 : CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$2,286,932
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$2,458,032
Total income from all sources (including contributions)2020-12-31$24,362,580
Total of all expenses incurred2020-12-31$24,346,803
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$22,846,008
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$24,362,580
Value of total assets at end of year2020-12-31$2,349,479
Value of total assets at beginning of year2020-12-31$2,504,802
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$1,500,795
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Administrative expenses professional fees incurred2020-12-31$58,437
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$395,385
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$1,990
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$1,990
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$435,544
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$204,413
Administrative expenses (other) incurred2020-12-31$1,197,941
Liabilities. Value of operating payables at end of year2020-12-31$15,122
Liabilities. Value of operating payables at beginning of year2020-12-31$146,627
Total non interest bearing cash at end of year2020-12-31$2,314,251
Total non interest bearing cash at beginning of year2020-12-31$2,352,214
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$15,777
Value of net assets at end of year (total assets less liabilities)2020-12-31$62,547
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$46,770
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$22,846,008
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$23,967,195
Employer contributions (assets) at end of year2020-12-31$33,238
Employer contributions (assets) at beginning of year2020-12-31$150,598
Contract administrator fees2020-12-31$244,417
Liabilities. Value of benefit claims payable at end of year2020-12-31$1,836,266
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$2,106,992
Did the plan have assets held for investment2020-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31MILLER KAPLAN ARASE LLP
Accountancy firm EIN2020-12-31952036255
2019 : CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,458,032
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,458,032
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,389,474
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,389,474
Total income from all sources (including contributions)2019-12-31$24,443,952
Total income from all sources (including contributions)2019-12-31$24,443,952
Total of all expenses incurred2019-12-31$24,257,123
Total of all expenses incurred2019-12-31$24,257,123
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$22,754,553
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$22,754,553
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$24,443,952
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$24,443,952
Value of total assets at end of year2019-12-31$2,504,802
Value of total assets at end of year2019-12-31$2,504,802
Value of total assets at beginning of year2019-12-31$2,249,415
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,502,570
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,502,570
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Administrative expenses professional fees incurred2019-12-31$55,195
Administrative expenses professional fees incurred2019-12-31$55,195
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
Value of fidelity bond cover2019-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$399,857
Contributions received from participants2019-12-31$399,857
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$1,990
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$1,990
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$1,990
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$1,990
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$204,413
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$204,413
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$140,978
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$140,978
Administrative expenses (other) incurred2019-12-31$1,200,743
Administrative expenses (other) incurred2019-12-31$1,200,743
Liabilities. Value of operating payables at end of year2019-12-31$146,627
Liabilities. Value of operating payables at end of year2019-12-31$146,627
Liabilities. Value of operating payables at beginning of year2019-12-31$175,975
Liabilities. Value of operating payables at beginning of year2019-12-31$175,975
Total non interest bearing cash at end of year2019-12-31$2,352,214
Total non interest bearing cash at end of year2019-12-31$2,352,214
Total non interest bearing cash at beginning of year2019-12-31$1,921,921
Total non interest bearing cash at beginning of year2019-12-31$1,921,921
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$186,829
Value of net income/loss2019-12-31$186,829
Value of net assets at end of year (total assets less liabilities)2019-12-31$46,770
Value of net assets at end of year (total assets less liabilities)2019-12-31$46,770
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$-140,059
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$-140,059
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$22,754,553
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$22,754,553
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$24,044,095
Contributions received in cash from employer2019-12-31$24,044,095
Employer contributions (assets) at end of year2019-12-31$150,598
Employer contributions (assets) at end of year2019-12-31$150,598
Employer contributions (assets) at beginning of year2019-12-31$325,504
Employer contributions (assets) at beginning of year2019-12-31$325,504
Contract administrator fees2019-12-31$246,632
Contract administrator fees2019-12-31$246,632
Liabilities. Value of benefit claims payable at end of year2019-12-31$2,106,992
Liabilities. Value of benefit claims payable at end of year2019-12-31$2,106,992
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$2,072,521
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$2,072,521
Did the plan have assets held for investment2019-12-31No
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31MILLER KAPLAN ARASE LLP
Accountancy firm name2019-12-31MILLER KAPLAN ARASE LLP
Accountancy firm EIN2019-12-31952036255
Accountancy firm EIN2019-12-31952036255
2018 : CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$2,389,474
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$1,442,307
Total income from all sources (including contributions)2018-12-31$22,522,890
Total of all expenses incurred2018-12-31$22,665,944
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$21,275,827
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$22,522,890
Value of total assets at end of year2018-12-31$2,249,415
Value of total assets at beginning of year2018-12-31$1,445,302
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$1,390,117
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Administrative expenses professional fees incurred2018-12-31$46,808
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$217,797
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$1,990
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$1,990
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$140,978
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$22,221
Administrative expenses (other) incurred2018-12-31$1,111,225
Liabilities. Value of operating payables at end of year2018-12-31$175,975
Liabilities. Value of operating payables at beginning of year2018-12-31$2,687
Total non interest bearing cash at end of year2018-12-31$1,921,921
Total non interest bearing cash at beginning of year2018-12-31$1,306,120
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-143,054
Value of net assets at end of year (total assets less liabilities)2018-12-31$-140,059
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$2,995
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$21,275,827
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$22,305,093
Employer contributions (assets) at end of year2018-12-31$325,504
Employer contributions (assets) at beginning of year2018-12-31$137,192
Contract administrator fees2018-12-31$232,084
Liabilities. Value of benefit claims payable at end of year2018-12-31$2,072,521
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$1,417,399
Did the plan have assets held for investment2018-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31MILLER KAPLAN ARASE LLP
Accountancy firm EIN2018-12-31952036255
2017 : CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$1,442,307
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$894,412
Total income from all sources (including contributions)2017-12-31$15,853,391
Total of all expenses incurred2017-12-31$15,852,653
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$14,908,847
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$15,853,391
Value of total assets at end of year2017-12-31$1,445,302
Value of total assets at beginning of year2017-12-31$896,669
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$943,806
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Administrative expenses professional fees incurred2017-12-31$36,781
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$231,517
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$1,990
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$11,008
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$22,221
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$85,783
Administrative expenses (other) incurred2017-12-31$761,767
Liabilities. Value of operating payables at end of year2017-12-31$2,687
Liabilities. Value of operating payables at beginning of year2017-12-31$11,425
Total non interest bearing cash at end of year2017-12-31$1,306,120
Total non interest bearing cash at beginning of year2017-12-31$788,943
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$738
Value of net assets at end of year (total assets less liabilities)2017-12-31$2,995
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$2,257
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$14,908,847
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$15,621,874
Employer contributions (assets) at end of year2017-12-31$137,192
Employer contributions (assets) at beginning of year2017-12-31$96,718
Contract administrator fees2017-12-31$145,258
Liabilities. Value of benefit claims payable at end of year2017-12-31$1,417,399
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$797,204
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31MILLER KAPLAN ARASE LLP
Accountancy firm EIN2017-12-31952036255
2016 : CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$894,412
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$75,449
Total income from all sources (including contributions)2016-12-31$4,211,377
Total of all expenses incurred2016-12-31$4,202,355
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$3,954,291
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$4,211,377
Value of total assets at end of year2016-12-31$896,669
Value of total assets at beginning of year2016-12-31$68,684
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$248,064
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$241,008
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$86,577
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$11,008
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$85,783
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$0
Administrative expenses (other) incurred2016-12-31$7,056
Liabilities. Value of operating payables at end of year2016-12-31$11,425
Liabilities. Value of operating payables at beginning of year2016-12-31$10,670
Total non interest bearing cash at end of year2016-12-31$788,943
Total non interest bearing cash at beginning of year2016-12-31$25,262
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$9,022
Value of net assets at end of year (total assets less liabilities)2016-12-31$2,257
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$-6,765
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$3,954,291
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$4,124,800
Employer contributions (assets) at end of year2016-12-31$96,718
Employer contributions (assets) at beginning of year2016-12-31$43,422
Liabilities. Value of benefit claims payable at end of year2016-12-31$797,204
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$64,779
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31MILLER KAPLAN ARASE LLP
Accountancy firm EIN2016-12-31952036255
2015 : CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$25,173
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$25,263
Total of all expenses incurred2015-12-31$25,173
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$23,719
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$25,263
Value of total assets at end of year2015-12-31$25,263
Value of total assets at beginning of year2015-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$1,454
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$1,454
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Liabilities. Value of operating payables at end of year2015-12-31$1,454
Liabilities. Value of operating payables at beginning of year2015-12-31$0
Total non interest bearing cash at end of year2015-12-31$25,263
Total non interest bearing cash at beginning of year2015-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$90
Value of net assets at end of year (total assets less liabilities)2015-12-31$90
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$25,263
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$23,719
Liabilities. Value of benefit claims payable at end of year2015-12-31$23,719
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$0
Did the plan have assets held for investment2015-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountancy firm name2015-12-31MILLER KAPLAN ARASE LLP
Accountancy firm EIN2015-12-31952036255

Form 5500 Responses for CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST

2021: CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 2021 form 5500 responses
2021-01-01Type of plan entityMulitple employer plan
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 2020 form 5500 responses
2020-01-01Type of plan entityMulitple employer plan
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 2019 form 5500 responses
2019-01-01Type of plan entityMulitple employer plan
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 2018 form 5500 responses
2018-01-01Type of plan entityMulitple employer plan
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 2017 form 5500 responses
2017-01-01Type of plan entityMulitple employer plan
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 2016 form 5500 responses
2016-01-01Type of plan entityMulitple employer plan
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: CALIFORNIA HIGH TECHNOLOGY EMPLOYERS BENEFIT TRUST 2015 form 5500 responses
2015-06-01Type of plan entityMulitple employer plan
2015-06-01First time form 5500 has been submittedYes
2015-06-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-06-01Plan funding arrangement – TrustYes
2015-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )
Policy contract number5374599
Policy instance 2
Insurance contract or identification number5374599
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of fees paid to insurance companyUSD $439
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,421
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees125
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5374599
Policy instance 1
Insurance contract or identification number5374599
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of fees paid to insurance companyUSD $22,505
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $615,658
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees15471
Additional information about fees paid to insurance brokerSERVICE FEES/NON-MONETARY COMPENSAT
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number847221
Policy instance 1
Insurance contract or identification number847221
Number of Individuals Covered237
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of fees paid to insurance companyUSD $82,375
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,740,188
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees82375
Additional information about fees paid to insurance broker2020 PINNACLE MEDICAL RETENTION INCENTIVE RISK
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0115264
Policy instance 2
Insurance contract or identification number0115264
Number of Individuals Covered1457
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,565,635
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5374599
Policy instance 3
Insurance contract or identification number5374599
Number of Individuals Covered2977
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of fees paid to insurance companyUSD $89,346
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $2,154,719
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees59817
Additional information about fees paid to insurance brokerSERVICE FEES/NON-MONETARY COMPENSAT
Insurance broker organization code?3
SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )
Policy contract number5374599
Policy instance 4
Insurance contract or identification number5374599
Number of Individuals Covered300
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of fees paid to insurance companyUSD $2,271
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $49,030
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees683
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number0847221HNO
Policy instance 5
Insurance contract or identification number0847221HNO
Number of Individuals Covered10
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Welfare Benefit Premiums Paid to CarrierUSD $71,392
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number0115264HNO
Policy instance 6
Insurance contract or identification number0115264HNO
Number of Individuals Covered1318
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Welfare Benefit Premiums Paid to CarrierUSD $7,552,026
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: 00000 )
Policy contract number30048749
Policy instance 7
Insurance contract or identification number30048749
Number of Individuals Covered45
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,927
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 number0847221
Policy instance 2
Insurance contract or identification number0847221
Number of Individuals Covered334
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of fees paid to insurance companyUSD $132,000
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,689,654
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees132000
Additional information about fees paid to insurance broker2019 PREMIER PRODUCER PROGRAM - MEDICAL RETENTION RISK
Insurance broker organization code?3
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number0115264HNO
Policy instance 1
Insurance contract or identification number0115264HNO
Number of Individuals Covered1502
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Welfare Benefit Premiums Paid to CarrierUSD $8,241,667
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5374599
Policy instance 3
Insurance contract or identification number5374599
Number of Individuals Covered3127
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of fees paid to insurance companyUSD $90,564
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $2,569,862
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees60739
Additional information about fees paid to insurance brokerSERVICE FEES/NON-MONETARY COMPENSATION
Insurance broker organization code?3
SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )
Policy contract numberTS05374599
Policy instance 4
Insurance contract or identification numberTS05374599
Number of Individuals Covered486
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of fees paid to insurance companyUSD $2,739
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $70,497
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees816
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number0847221HNO
Policy instance 5
Insurance contract or identification number0847221HNO
Number of Individuals Covered26
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Welfare Benefit Premiums Paid to CarrierUSD $176,964
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 number0115264
Policy instance 6
Insurance contract or identification number0115264
Number of Individuals Covered1370
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,191,559
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: 00000 )
Policy contract number30048749
Policy instance 9
Insurance contract or identification number30048749
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number803563G
Policy instance 8
Insurance contract or identification number803563G
Number of Individuals Covered103
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of fees paid to insurance companyUSD $606
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $27,707
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees606
Additional information about fees paid to insurance brokerCOMMISSIONS PAID
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0115264
Policy instance 7
Insurance contract or identification number0115264
Number of Individuals Covered1596
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,905,819
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 number0847221-231697
Policy instance 6
Insurance contract or identification number0847221-231697
Number of Individuals Covered58
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $352,912
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number0847221-231697
Policy instance 5
Insurance contract or identification number0847221-231697
Number of Individuals Covered31
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Welfare Benefit Premiums Paid to CarrierUSD $228,049
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )
Policy contract number5374599
Policy instance 4
Insurance contract or identification number5374599
Number of Individuals Covered472
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of fees paid to insurance companyUSD $2,658
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,197
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees787
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTS05374599
Policy instance 3
Insurance contract or identification numberTS05374599
Number of Individuals Covered3333
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of fees paid to insurance companyUSD $84,672
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,783,547
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees62616
Additional information about fees paid to insurance brokerSERVICE FEES/NON-MONETARY COMPENSATION
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0847221-0287529
Policy instance 2
Insurance contract or identification number0847221-0287529
Number of Individuals Covered88
Insurance policy start date2019-01-01
Insurance policy end date2019-05-31
Total amount of fees paid to insurance companyUSD $-704
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $23,599
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees-704
Additional information about fees paid to insurance brokerSHORT
Insurance broker organization code?3
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number0115264HNO
Policy instance 1
Insurance contract or identification number0115264HNO
Number of Individuals Covered1691
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Welfare Benefit Premiums Paid to CarrierUSD $8,524,947
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5948035
Policy instance 11
Insurance contract or identification number5948035
Number of Individuals Covered234
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $16
Total amount of fees paid to insurance companyUSD $3,579
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $91,335
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16
Amount paid for insurance broker fees1797
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5948079
Policy instance 12
Insurance contract or identification number5948079
Number of Individuals Covered100
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,063
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $39,257
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees1095
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
SAFEGUARD HEALTH PLANS, INC. A TEXAS CORPORATION (National Association of Insurance Commissioners NAIC id number: 95051 )
Policy contract number5948079
Policy instance 13
Insurance contract or identification number5948079
Number of Individuals Covered7
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $395
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )
Policy contract number5948079
Policy instance 14
Insurance contract or identification number5948079
Number of Individuals Covered41
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of fees paid to insurance companyUSD $133
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,341
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees76
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5948215
Policy instance 15
Insurance contract or identification number5948215
Number of Individuals Covered0
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of fees paid to insurance companyUSD $1,533
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $48,625
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1459
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00541276
Policy instance 10
Insurance contract or identification number00541276
Number of Individuals Covered79
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $5,489
Total amount of fees paid to insurance companyUSD $1,196
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $73,124
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,489
Amount paid for insurance broker fees1196
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00525815
Policy instance 9
Insurance contract or identification number00525815
Number of Individuals Covered55
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $6,646
Total amount of fees paid to insurance companyUSD $4,439
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $94,937
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,646
Amount paid for insurance broker fees4439
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00532712
Policy instance 8
Insurance contract or identification number00532712
Number of Individuals Covered119
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $16,053
Total amount of fees paid to insurance companyUSD $3,540
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $144,587
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,053
Amount paid for insurance broker fees3540
Insurance broker organization code?3
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number847221HNO
Policy instance 1
Insurance contract or identification number847221HNO
Number of Individuals Covered148
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $598,095
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 number0847221
Policy instance 2
Insurance contract or identification number0847221
Number of Individuals Covered857
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $704
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,942,292
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $704
Insurance broker organization code?3
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number279963
Policy instance 3
Insurance contract or identification number279963
Number of Individuals Covered5971
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of fees paid to insurance companyUSD $22,753
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,322,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees7936
Additional information about fees paid to insurance brokerINCENTIVES
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number30048749
Policy instance 4
Insurance contract or identification number30048749
Number of Individuals Covered188
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $88,432
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number536494
Policy instance 5
Insurance contract or identification number536494
Number of Individuals Covered35
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $3,576
Total amount of fees paid to insurance companyUSD $740
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,954
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,576
Amount paid for insurance broker fees740
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00519695
Policy instance 6
Insurance contract or identification number00519695
Number of Individuals Covered14
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,250
Total amount of fees paid to insurance companyUSD $860
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $14,526
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,250
Amount paid for insurance broker fees860
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05939708
Policy instance 7
Insurance contract or identification numberKM05939708
Number of Individuals Covered1002
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $-12,077
Total amount of fees paid to insurance companyUSD $5,115
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $485,654
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $-12,077
Amount paid for insurance broker fees74
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0847221
Policy instance 2
Insurance contract or identification number0847221
Number of Individuals Covered567
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of fees paid to insurance companyUSD $6,328
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $2,697,030
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees6328
Additional information about fees paid to insurance broker2016-2017 PPP INCENTIVE
Insurance broker organization code?3
Insurance broker nameBARNEY & BARNEY A MARSH MCLENNAN
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number279963
Policy instance 3
Insurance contract or identification number279963
Number of Individuals Covered5720
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $326
Total amount of fees paid to insurance companyUSD $11,398
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,193,707
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $326
Additional information about fees paid to insurance brokerINCENTIVES
Insurance broker organization code?3
Amount paid for insurance broker fees11398
Insurance broker nameMARSH & MCLENNAN AGENCY LLC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number30048749
Policy instance 4
Insurance contract or identification number30048749
Number of Individuals Covered241
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,653
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number526799
Policy instance 5
Insurance contract or identification number526799
Number of Individuals Covered51
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of fees paid to insurance companyUSD $497
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,425
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees497
Additional information about fees paid to insurance brokerINCENTIVES
Insurance broker organization code?3
Insurance broker nameMARSH & MCLENNAN AGENCY LLC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00519695
Policy instance 6
Insurance contract or identification number00519695
Number of Individuals Covered12
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $24,566
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number279963
Policy instance 7
Insurance contract or identification number279963
Number of Individuals Covered503
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,452
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05939708
Policy instance 8
Insurance contract or identification numberKM05939708
Number of Individuals Covered381
Insurance policy start date2017-10-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $4,431
Total amount of fees paid to insurance companyUSD $1,664
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $62,461
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,431
Amount paid for insurance broker fees58
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameMARSH & MCLENNAN AGENCY LLC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00532712
Policy instance 9
Insurance contract or identification number00532712
Number of Individuals Covered92
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $61,378
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00525815
Policy instance 10
Insurance contract or identification number00525815
Number of Individuals Covered50
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $4,835
Total amount of fees paid to insurance companyUSD $2,581
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $81,050
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,835
Amount paid for insurance broker fees2581
Additional information about fees paid to insurance brokerINCENTIVES
Insurance broker organization code?3
Insurance broker nameMARSH & MCLENNAN AGENCY LLC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00530733
Policy instance 11
Insurance contract or identification number00530733
Number of Individuals Covered55
Insurance policy start date2017-01-01
Insurance policy end date2017-08-31
Total amount of commissions paid to insurance brokerUSD $-113
Total amount of fees paid to insurance companyUSD $170
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,546
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $-113
Insurance broker organization code?3
Amount paid for insurance broker fees170
Additional information about fees paid to insurance brokerINCENTIVES
Insurance broker nameHUB INTERNATIONAL MIDWEST
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05736659
Policy instance 12
Insurance contract or identification numberKM05736659
Number of Individuals Covered151
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $7,458
Total amount of fees paid to insurance companyUSD $1,373
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $88,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,458
Amount paid for insurance broker fees58
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameMARSH & MCLENNAN AGENCY LLC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05933725
Policy instance 13
Insurance contract or identification numberKM05933725
Number of Individuals Covered63
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $898
Total amount of fees paid to insurance companyUSD $150
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,199
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $898
Amount paid for insurance broker fees58
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameMARSH & MCLENNAN AGENCY LLC
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number847221HNO
Policy instance 1
Insurance contract or identification number847221HNO
Number of Individuals Covered105
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $414,991
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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