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ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 401k Plan overview

Plan NameROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN
Plan identification number 700

ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision
  • Other welfare benefit cover

401k Sponsoring company profile

ROCKWELL COLLINS, INC. has sponsored the creation of one or more 401k plans.

Company Name:ROCKWELL COLLINS, INC.
Employer identification number (EIN):522314475
NAIC Classification:335900

Additional information about ROCKWELL COLLINS, INC.

Jurisdiction of Incorporation: Nevada Department of State
Incorporation Date: 1996-10-28
Company Identification Number: 19961215484
Legal Registered Office Address: 701 S CARSON ST STE 200

CARSON CITY
United States of America (USA)
89701

More information about ROCKWELL COLLINS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
7002019-01-01
7002018-01-01
7002017-01-01ROSA BARONE ROSA BARONE2018-08-17
7002016-01-01ROSA BARONE
7002015-01-01ROSA BARONE
7002014-01-01ROSA BARONE
7002013-01-01ROSA BARONE ROSA BARONE2014-07-28
7002012-01-01ROSA BARONE ROSA BARONE2013-07-24
7002011-01-01ROSA BARONE ROSA BARONE2012-07-26
7002009-10-01ROSA BARONE ROSA BARONE2011-05-02
7002008-10-01
7002007-10-01SAMUEL WOOD

Plan Statistics for ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN

401k plan membership statisitcs for ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN

Measure Date Value
2019: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0116,207
Total number of active participants reported on line 7a of the Form 55002019-01-010
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 participants2019-01-010
2018: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0115,188
Total number of active participants reported on line 7a of the Form 55002018-01-0116,132
Number of retired or separated participants receiving benefits2018-01-0175
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-0116,207
2017: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0115,313
Total number of active participants reported on line 7a of the Form 55002017-01-0115,120
Number of retired or separated participants receiving benefits2017-01-0168
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-0115,188
2016: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0114,551
Total number of active participants reported on line 7a of the Form 55002016-01-0115,249
Number of retired or separated participants receiving benefits2016-01-0164
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-0115,313
2015: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0111,570
Total number of active participants reported on line 7a of the Form 55002015-01-0114,551
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-0114,551
2014: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0113,847
Total number of active participants reported on line 7a of the Form 55002014-01-0111,570
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0111,570
2013: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0121,200
Total number of active participants reported on line 7a of the Form 55002013-01-0113,847
Number of retired or separated participants receiving benefits2013-01-016,683
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-0120,530
2012: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0123,315
Total number of active participants reported on line 7a of the Form 55002012-01-0114,444
Number of retired or separated participants receiving benefits2012-01-016,756
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-0121,200
2011: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0120,033
Total number of active participants reported on line 7a of the Form 55002011-01-0115,555
Number of retired or separated participants receiving benefits2011-01-017,760
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-0123,315
2009: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-10-0119,987
Total number of active participants reported on line 7a of the Form 55002009-10-0115,680
Number of retired or separated participants receiving benefits2009-10-014,268
Number of other retired or separated participants entitled to future benefits2009-10-010
Total of all active and inactive participants2009-10-0119,948
2007: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2007 401k membership
Total participants, beginning-of-year2007-10-0122,676
Total number of active participants reported on line 7a of the Form 55002007-10-0115,913
Number of retired or separated participants receiving benefits2007-10-014,842
Number of other retired or separated participants entitled to future benefits2007-10-010
Total of all active and inactive participants2007-10-0120,755
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2007-10-010
Total participants2007-10-0120,755

Financial Data on ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN

Measure Date Value
2018 : ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$849,372
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$612,117
Total income from all sources (including contributions)2018-12-31$137,415,539
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$139,489,205
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$131,849,570
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$132,664,357
Value of total assets at end of year2018-12-31$19,947,359
Value of total assets at beginning of year2018-12-31$21,783,770
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$7,639,635
Total interest from all sources2018-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$149,371
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$149,371
Administrative expenses professional fees incurred2018-12-31$49,812
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$25,000,000
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$7,252,224
Participant contributions at end of year2018-12-31$0
Participant contributions at beginning of year2018-12-31$868,639
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$22,526
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$6,188,262
Other income not declared elsewhere2018-12-31$4,601,811
Administrative expenses (other) incurred2018-12-31$609,837
Liabilities. Value of operating payables at end of year2018-12-31$849,372
Liabilities. Value of operating payables at beginning of year2018-12-31$612,117
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-2,073,666
Value of net assets at end of year (total assets less liabilities)2018-12-31$19,097,987
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$21,171,653
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
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$19,924,833
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$4,295,865
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$3,020,663
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31Yes
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$125,412,133
Employer contributions (assets) at end of year2018-12-31$0
Employer contributions (assets) at beginning of year2018-12-31$10,431,004
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$128,828,907
Contract administrator fees2018-12-31$6,979,986
Did the plan have assets held for investment2018-12-31Yes
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
2017 : ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$612,117
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$1,949,861
Total income from all sources (including contributions)2017-12-31$129,477,085
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$125,999,652
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$118,732,854
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$122,832,243
Value of total assets at end of year2017-12-31$21,783,770
Value of total assets at beginning of year2017-12-31$19,644,081
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$7,266,798
Total interest from all sources2017-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$41,927
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$41,927
Administrative expenses professional fees incurred2017-12-31$22,804
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$25,000,000
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$5,948,937
Participant contributions at end of year2017-12-31$868,639
Participant contributions at beginning of year2017-12-31$1,432,809
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$6,188,262
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$5,682,121
Other income not declared elsewhere2017-12-31$6,602,915
Administrative expenses (other) incurred2017-12-31$765,624
Liabilities. Value of operating payables at end of year2017-12-31$612,117
Liabilities. Value of operating payables at beginning of year2017-12-31$1,949,861
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$3,477,433
Value of net assets at end of year (total assets less liabilities)2017-12-31$21,171,653
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$17,694,220
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
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$4,295,865
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$2,313,008
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$2,768,784
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31Yes
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$116,883,306
Employer contributions (assets) at end of year2017-12-31$10,431,004
Employer contributions (assets) at beginning of year2017-12-31$10,216,143
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$115,964,070
Contract administrator fees2017-12-31$6,478,370
Did the plan have assets held for investment2017-12-31Yes
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)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31GRANT THORNTON LLP
Accountancy firm EIN2017-12-31366055558
2016 : ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$1,949,861
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$1,170,801
Total income from all sources (including contributions)2016-12-31$123,192,075
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$120,787,695
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$112,334,377
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$114,615,497
Value of total assets at end of year2016-12-31$19,644,081
Value of total assets at beginning of year2016-12-31$16,460,641
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$8,453,318
Total interest from all sources2016-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$9,123
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$9,123
Administrative expenses professional fees incurred2016-12-31$141,400
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$25,000,000
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$11,401,033
Participant contributions at end of year2016-12-31$1,432,809
Participant contributions at beginning of year2016-12-31$1,491,562
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$5,682,121
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$1,027,174
Other income not declared elsewhere2016-12-31$8,567,455
Administrative expenses (other) incurred2016-12-31$1,844,225
Liabilities. Value of operating payables at end of year2016-12-31$1,949,861
Liabilities. Value of operating payables at beginning of year2016-12-31$1,170,801
Total non interest bearing cash at end of year2016-12-31$-784
Total non interest bearing cash at beginning of year2016-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$2,404,380
Value of net assets at end of year (total assets less liabilities)2016-12-31$17,694,220
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$15,289,840
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
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$2,313,792
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$2,369,099
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$3,073,931
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31Yes
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$103,214,464
Employer contributions (assets) at end of year2016-12-31$10,216,143
Employer contributions (assets) at beginning of year2016-12-31$11,572,806
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$109,260,446
Contract administrator fees2016-12-31$6,467,693
Did the plan have assets held for investment2016-12-31Yes
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)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31GRANT THORNTON LLP
Accountancy firm EIN2016-12-31366055558
2015 : ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$1,170,801
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$2,228,296
Total income from all sources (including contributions)2015-12-31$113,930,111
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$109,714,491
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$102,237,846
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$111,607,776
Value of total assets at end of year2015-12-31$16,460,641
Value of total assets at beginning of year2015-12-31$13,302,516
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$7,476,645
Total interest from all sources2015-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$65
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$65
Administrative expenses professional fees incurred2015-12-31$176,898
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$25,000,000
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$7,875,336
Participant contributions at end of year2015-12-31$1,491,562
Participant contributions at beginning of year2015-12-31$1,192,089
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$1,027,174
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$50
Other income not declared elsewhere2015-12-31$2,322,297
Administrative expenses (other) incurred2015-12-31$1,745,930
Liabilities. Value of operating payables at end of year2015-12-31$1,170,801
Liabilities. Value of operating payables at beginning of year2015-12-31$2,228,296
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$4,215,620
Value of net assets at end of year (total assets less liabilities)2015-12-31$15,289,840
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$11,074,220
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
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$2,369,099
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$3,377,741
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$2,637,832
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-27
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31Yes
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$103,732,440
Employer contributions (assets) at end of year2015-12-31$11,572,806
Employer contributions (assets) at beginning of year2015-12-31$8,732,636
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$99,600,014
Contract administrator fees2015-12-31$5,553,817
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31GRANT THORNTON LLP
Accountancy firm EIN2015-12-31366055558
2014 : ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-12-31$-261
Total unrealized appreciation/depreciation of assets2014-12-31$-261
Total transfer of assets from this plan2014-12-31$14,807,234
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$2,228,296
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$630,523
Total income from all sources (including contributions)2014-12-31$108,038,278
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$110,273,769
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$101,541,653
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$106,473,228
Value of total assets at end of year2014-12-31$13,302,516
Value of total assets at beginning of year2014-12-31$28,747,468
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$8,732,116
Total interest from all sources2014-12-31$90
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Administrative expenses professional fees incurred2014-12-31$134,477
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$25,000,000
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$8,179,748
Participant contributions at end of year2014-12-31$1,192,089
Participant contributions at beginning of year2014-12-31$1,994,340
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$50
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$2,682,114
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$167,619
Other income not declared elsewhere2014-12-31$1,565,221
Administrative expenses (other) incurred2014-12-31$1,984,682
Liabilities. Value of operating payables at end of year2014-12-31$2,228,296
Liabilities. Value of operating payables at beginning of year2014-12-31$462,904
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-2,235,491
Value of net assets at end of year (total assets less liabilities)2014-12-31$11,074,220
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$28,116,945
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$3,377,741
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$2,498,209
Interest earned on other investments2014-12-31$87
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$3
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$3,322,550
Asset value of US Government securities at end of year2014-12-31$0
Asset value of US Government securities at beginning of year2014-12-31$2,653,723
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$98,293,480
Employer contributions (assets) at end of year2014-12-31$8,732,636
Employer contributions (assets) at beginning of year2014-12-31$9,505,659
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$98,219,103
Asset. Corporate debt instrument preferred debt at end of year2014-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2014-12-31$1,362,837
Asset. Corporate debt instrument debt (other) at end of year2014-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2014-12-31$660,498
Contract administrator fees2014-12-31$6,612,957
Assets. Corporate common stocks other than exployer securities at end of year2014-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2014-12-31$7,390,088
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31DELOITTE & TOUCHE LLP
Accountancy firm EIN2014-12-31133891517
2013 : ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$732,039
Total unrealized appreciation/depreciation of assets2013-12-31$732,039
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$630,523
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$755,717
Total income from all sources (including contributions)2013-12-31$156,798,421
Total loss/gain on sale of assets2013-12-31$865,386
Total of all expenses incurred2013-12-31$154,452,382
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$146,202,153
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$153,027,631
Value of total assets at end of year2013-12-31$28,747,468
Value of total assets at beginning of year2013-12-31$26,526,623
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$8,250,229
Total interest from all sources2013-12-31$115,751
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$143,995
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Administrative expenses professional fees incurred2013-12-31$153,487
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$25,000,000
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$30,633,500
Participant contributions at end of year2013-12-31$1,994,340
Participant contributions at beginning of year2013-12-31$2,043,316
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$2,682,114
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$1,073,122
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$167,619
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$365,908
Other income not declared elsewhere2013-12-31$1,921,964
Administrative expenses (other) incurred2013-12-31$388,321
Liabilities. Value of operating payables at end of year2013-12-31$462,904
Liabilities. Value of operating payables at beginning of year2013-12-31$389,809
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$2,346,039
Value of net assets at end of year (total assets less liabilities)2013-12-31$28,116,945
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$25,770,906
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Investment advisory and management fees2013-12-31$34,255
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$2,498,209
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$1,771,223
Income. Interest from US Government securities2013-12-31$49,351
Income. Interest from corporate debt instruments2013-12-31$65,078
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$1,322
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$14,600,083
Asset value of US Government securities at end of year2013-12-31$2,653,723
Asset value of US Government securities at beginning of year2013-12-31$2,641,404
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$-8,345
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31Yes
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$122,394,131
Employer contributions (assets) at end of year2013-12-31$9,505,659
Employer contributions (assets) at beginning of year2013-12-31$11,456,684
Income. Dividends from common stock2013-12-31$143,995
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$131,602,070
Asset. Corporate debt instrument preferred debt at end of year2013-12-31$1,362,837
Asset. Corporate debt instrument preferred debt at beginning of year2013-12-31$956,200
Asset. Corporate debt instrument debt (other) at end of year2013-12-31$660,498
Asset. Corporate debt instrument debt (other) at beginning of year2013-12-31$559,727
Contract administrator fees2013-12-31$7,674,166
Assets. Corporate common stocks other than exployer securities at end of year2013-12-31$7,390,088
Assets. Corporate common stocks other than exployer securities at beginning of year2013-12-31$6,024,947
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Aggregate proceeds on sale of assets2013-12-31$11,422,061
Aggregate carrying amount (costs) on sale of assets2013-12-31$10,556,675
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31DELOITTE & TOUCHE LLP
Accountancy firm EIN2013-12-31133891517
2012 : ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$500,439
Total unrealized appreciation/depreciation of assets2012-12-31$500,439
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$755,717
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$1,307,340
Total income from all sources (including contributions)2012-12-31$167,456,725
Total loss/gain on sale of assets2012-12-31$253,603
Total of all expenses incurred2012-12-31$164,962,145
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$156,186,720
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$165,060,587
Value of total assets at end of year2012-12-31$26,526,623
Value of total assets at beginning of year2012-12-31$24,583,666
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$8,775,425
Total interest from all sources2012-12-31$106,810
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$144,126
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Administrative expenses professional fees incurred2012-12-31$135,504
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$25,000,000
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$29,283,475
Participant contributions at end of year2012-12-31$2,043,316
Participant contributions at beginning of year2012-12-31$1,864,153
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$1,073,122
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$1,528,018
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$365,908
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$379,933
Other income not declared elsewhere2012-12-31$1,379,194
Administrative expenses (other) incurred2012-12-31$568,479
Liabilities. Value of operating payables at end of year2012-12-31$389,809
Liabilities. Value of operating payables at beginning of year2012-12-31$927,407
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$2,494,580
Value of net assets at end of year (total assets less liabilities)2012-12-31$25,770,906
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$23,276,326
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Investment advisory and management fees2012-12-31$30,339
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$1,771,223
Income. Interest from US Government securities2012-12-31$46,168
Income. Interest from corporate debt instruments2012-12-31$59,495
Value of interest in common/collective trusts at end of year2012-12-31$0
Value of interest in common/collective trusts at beginning of year2012-12-31$3,302,175
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$1,147
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$22,800,425
Asset value of US Government securities at end of year2012-12-31$2,641,404
Asset value of US Government securities at beginning of year2012-12-31$1,467,774
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$9,110
Net investment gain or loss from common/collective trusts2012-12-31$2,856
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31Yes
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$135,777,112
Employer contributions (assets) at end of year2012-12-31$11,456,684
Employer contributions (assets) at beginning of year2012-12-31$9,135,847
Income. Dividends from common stock2012-12-31$144,126
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$133,386,295
Asset. Corporate debt instrument preferred debt at end of year2012-12-31$956,200
Asset. Corporate debt instrument preferred debt at beginning of year2012-12-31$1,041,604
Asset. Corporate debt instrument debt (other) at end of year2012-12-31$559,727
Asset. Corporate debt instrument debt (other) at beginning of year2012-12-31$366,204
Contract administrator fees2012-12-31$8,041,103
Assets. Corporate common stocks other than exployer securities at end of year2012-12-31$6,024,947
Assets. Corporate common stocks other than exployer securities at beginning of year2012-12-31$5,877,891
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Aggregate proceeds on sale of assets2012-12-31$9,222,384
Aggregate carrying amount (costs) on sale of assets2012-12-31$8,968,781
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31DELOITTE & TOUCHE LLP
Accountancy firm EIN2012-12-31133891517
2011 : ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$126,058
Total unrealized appreciation/depreciation of assets2011-12-31$126,058
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$1,307,340
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$1,393,215
Total income from all sources (including contributions)2011-12-31$169,556,544
Total loss/gain on sale of assets2011-12-31$-178,570
Total of all expenses incurred2011-12-31$169,859,026
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$160,065,932
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$167,417,833
Value of total assets at end of year2011-12-31$24,583,666
Value of total assets at beginning of year2011-12-31$24,972,023
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$9,793,094
Total interest from all sources2011-12-31$109,284
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$124,759
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Administrative expenses professional fees incurred2011-12-31$166,721
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$25,000,000
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$42,628,739
Participant contributions at end of year2011-12-31$1,864,153
Participant contributions at beginning of year2011-12-31$1,433,902
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$1,528,018
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$1,196,833
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$379,933
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$688,256
Other income not declared elsewhere2011-12-31$1,951,306
Administrative expenses (other) incurred2011-12-31$393,027
Liabilities. Value of operating payables at end of year2011-12-31$927,407
Liabilities. Value of operating payables at beginning of year2011-12-31$704,959
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-302,482
Value of net assets at end of year (total assets less liabilities)2011-12-31$23,276,326
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$23,578,808
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Investment advisory and management fees2011-12-31$27,069
Income. Interest from US Government securities2011-12-31$38,221
Income. Interest from corporate debt instruments2011-12-31$70,115
Value of interest in common/collective trusts at end of year2011-12-31$3,302,175
Value of interest in common/collective trusts at beginning of year2011-12-31$1,643,340
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$948
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$34,007,138
Asset value of US Government securities at end of year2011-12-31$1,467,774
Asset value of US Government securities at beginning of year2011-12-31$1,283,379
Net investment gain or loss from common/collective trusts2011-12-31$5,874
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$124,789,094
Employer contributions (assets) at end of year2011-12-31$9,135,847
Employer contributions (assets) at beginning of year2011-12-31$11,566,098
Income. Dividends from preferred stock2011-12-31$124,759
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$126,058,794
Asset. Corporate debt instrument preferred debt at end of year2011-12-31$1,041,604
Asset. Corporate debt instrument preferred debt at beginning of year2011-12-31$1,256,727
Asset. Corporate debt instrument debt (other) at end of year2011-12-31$366,204
Asset. Corporate debt instrument debt (other) at beginning of year2011-12-31$320,850
Contract administrator fees2011-12-31$9,206,277
Assets. Corporate common stocks other than exployer securities at end of year2011-12-31$5,877,891
Assets. Corporate common stocks other than exployer securities at beginning of year2011-12-31$6,270,894
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Aggregate proceeds on sale of assets2011-12-31$13,257,428
Aggregate carrying amount (costs) on sale of assets2011-12-31$13,435,998
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31DELOITTE & TOUCHE LLP
Accountancy firm EIN2011-12-31133891517
2010 : ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$402,852
Total unrealized appreciation/depreciation of assets2010-12-31$402,852
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$1,393,215
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$527,513
Total income from all sources (including contributions)2010-12-31$41,105,065
Total loss/gain on sale of assets2010-12-31$129,118
Total of all expenses incurred2010-12-31$41,399,848
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$38,761,621
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$40,017,611
Value of total assets at end of year2010-12-31$24,972,023
Value of total assets at beginning of year2010-12-31$24,401,104
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$2,638,227
Total interest from all sources2010-12-31$31,649
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$32,249
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Administrative expenses professional fees incurred2010-12-31$85,642
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$25,000,000
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$5,214,946
Participant contributions at end of year2010-12-31$1,433,902
Participant contributions at beginning of year2010-12-31$3,369,287
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$1,196,833
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$1,043,050
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$688,256
Other income not declared elsewhere2010-12-31$489,262
Administrative expenses (other) incurred2010-12-31$214,958
Liabilities. Value of operating payables at end of year2010-12-31$704,959
Liabilities. Value of operating payables at beginning of year2010-12-31$527,513
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-294,783
Value of net assets at end of year (total assets less liabilities)2010-12-31$23,578,808
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$23,873,591
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Investment advisory and management fees2010-12-31$6,832
Income. Interest from US Government securities2010-12-31$10,718
Income. Interest from corporate debt instruments2010-12-31$20,799
Value of interest in common/collective trusts at end of year2010-12-31$1,643,340
Value of interest in common/collective trusts at beginning of year2010-12-31$215,426
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$132
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$7,568,299
Asset value of US Government securities at end of year2010-12-31$1,283,379
Asset value of US Government securities at beginning of year2010-12-31$1,347,870
Net investment gain or loss from common/collective trusts2010-12-31$2,324
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$34,802,665
Employer contributions (assets) at end of year2010-12-31$11,566,098
Employer contributions (assets) at beginning of year2010-12-31$10,630,713
Income. Dividends from common stock2010-12-31$32,249
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$31,193,322
Asset. Corporate debt instrument preferred debt at end of year2010-12-31$1,256,727
Asset. Corporate debt instrument preferred debt at beginning of year2010-12-31$1,410,195
Asset. Corporate debt instrument debt (other) at end of year2010-12-31$320,850
Asset. Corporate debt instrument debt (other) at beginning of year2010-12-31$434,305
Contract administrator fees2010-12-31$2,330,795
Assets. Corporate common stocks other than exployer securities at end of year2010-12-31$6,270,894
Assets. Corporate common stocks other than exployer securities at beginning of year2010-12-31$5,950,258
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$3,571,194
Aggregate carrying amount (costs) on sale of assets2010-12-31$3,442,076
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31DELOITTE & TOUCHE LLP
Accountancy firm EIN2010-12-31133891517

Form 5500 Responses for ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN

2019: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingYes
2019-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-01-01Plan is a collectively bargained planYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planYes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2009 form 5500 responses
2009-10-01Type of plan entitySingle employer plan
2009-10-01Submission has been amendedNo
2009-10-01This submission is the final filingNo
2009-10-01This return/report is a short plan year return/report (less than 12 months)No
2009-10-01Plan is a collectively bargained planYes
2009-10-01Plan funding arrangement – InsuranceYes
2009-10-01Plan funding arrangement – TrustYes
2009-10-01Plan funding arrangement – General assets of the sponsorYes
2009-10-01Plan benefit arrangement – InsuranceYes
2009-10-01Plan benefit arrangement - TrustYes
2009-10-01Plan benefit arrangement – General assets of the sponsorYes
2008: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2008 form 5500 responses
2008-10-01Type of plan entitySingle employer plan
2008-10-01Submission has been amendedYes
2008-10-01This submission is the final filingNo
2008-10-01This return/report is a short plan year return/report (less than 12 months)No
2008-10-01Plan is a collectively bargained planNo
2007: ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 2007 form 5500 responses
2007-10-01Type of plan entitySingle employer plan
2007-10-01Submission has been amendedYes
2007-10-01This submission is the final filingNo
2007-10-01This return/report is a short plan year return/report (less than 12 months)No
2007-10-01Plan is a collectively bargained planYes
2007-10-01Plan funding arrangement – InsuranceYes
2007-10-01Plan funding arrangement – TrustYes
2007-10-01Plan funding arrangement – General assets of the sponsorYes
2007-10-01Plan benefit arrangement – InsuranceYes
2007-10-01Plan benefit arrangement - TrustYes
2007-10-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number124746
Policy instance 4
Insurance contract or identification number124746
Number of Individuals Covered0
Insurance policy start date2019-01-01
Insurance policy end date2019-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $220,910
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 number2685
Policy instance 3
Insurance contract or identification number2685
Number of Individuals Covered0
Insurance policy start date2019-01-01
Insurance policy end date2019-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $102,672
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 number468864
Policy instance 2
Insurance contract or identification number468864
Number of Individuals Covered0
Insurance policy start date2019-01-01
Insurance policy end date2019-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $70,726
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: 0000 )
Policy contract number291
Policy instance 1
Insurance contract or identification number291
Number of Individuals Covered0
Insurance policy start date2019-01-01
Insurance policy end date2019-03-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $175,074
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: 0000 )
Policy contract number124746
Policy instance 1
Insurance contract or identification number124746
Number of Individuals Covered279
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,818,105
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 number2685
Policy instance 2
Insurance contract or identification number2685
Number of Individuals Covered72
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $357,902
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: 0000 )
Policy contract number291
Policy instance 3
Insurance contract or identification number291
Number of Individuals Covered31
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $100,660
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 number468864
Policy instance 4
Insurance contract or identification number468864
Number of Individuals Covered72
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $400,243
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: 0000 )
Policy contract number124746
Policy instance 4
Insurance contract or identification number124746
Number of Individuals Covered371
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,806,421
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 number2685
Policy instance 3
Insurance contract or identification number2685
Number of Individuals Covered86
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $450,436
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: 0000 )
Policy contract number291
Policy instance 1
Insurance contract or identification number291
Number of Individuals Covered30
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $183,822
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 number468864
Policy instance 2
Insurance contract or identification number468864
Number of Individuals Covered81
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $386,599
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 number2685
Policy instance 1
Insurance contract or identification number2685
Number of Individuals Covered121
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $581,841
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: 0000 )
Policy contract number124746
Policy instance 2
Insurance contract or identification number124746
Number of Individuals Covered419
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,656,545
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA GLOBAL BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number299486
Policy instance 3
Insurance contract or identification number299486
Number of Individuals Covered112
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $392,151
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA GLOBAL BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number299486
Policy instance 3
Insurance contract or identification number299486
Number of Individuals Covered98
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $752,818
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: 0000 )
Policy contract number124746
Policy instance 2
Insurance contract or identification number124746
Number of Individuals Covered449
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $4,258
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,753,465
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,258
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE, INC.
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number2685
Policy instance 1
Insurance contract or identification number2685
Number of Individuals Covered118
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,841
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $546,769
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,841
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE INC.
AETNA GLOBAL BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number299486
Policy instance 9
Insurance contract or identification number299486
Number of Individuals Covered500
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $36,418
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,180,376
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,418
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE INC.
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number20430
Policy instance 8
Insurance contract or identification number20430
Number of Individuals Covered48
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,907
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $194,913
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,907
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE INC
HEALTH FIRST HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95019 )
Policy contract number111099
Policy instance 7
Insurance contract or identification number111099
Number of Individuals Covered1186
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $135,352
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $6,338,168
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $135,352
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE INC
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number64301 1
Policy instance 5
Insurance contract or identification number64301 1
Number of Individuals Covered0
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $9,561
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: 0000 )
Policy contract number124746
Policy instance 4
Insurance contract or identification number124746
Number of Individuals Covered644
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $55,240
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,873,258
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $55,240
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE, INC.
COVENTRY HEALTH CARE OF KANSAS, INC. (National Association of Insurance Commissioners NAIC id number: 95489 )
Policy contract number3700790000
Policy instance 3
Insurance contract or identification number3700790000
Number of Individuals Covered16
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,249
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $112,435
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,249
Insurance broker organization code?3
Insurance broker nameWATSON WYATT INSURANCE CONS. INC.
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
Policy contract number5527
Policy instance 2
Insurance contract or identification number5527
Number of Individuals Covered116
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $554,007
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 number2685
Policy instance 1
Insurance contract or identification number2685
Number of Individuals Covered209
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $23,342
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,135,344
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,342
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE INC.
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number291
Policy instance 6
Insurance contract or identification number291
Number of Individuals Covered106
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,114
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $584,348
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,114
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE, INC.
SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 )
Policy contract numberG1009275 1001
Policy instance 10
Insurance contract or identification numberG1009275 1001
Number of Individuals Covered283
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $26,916
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,348,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,916
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE, INC.
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number468864
Policy instance 7
Insurance contract or identification number468864
Number of Individuals Covered170
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $14,368
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $564,794
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,368
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE INC.
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number2685
Policy instance 1
Insurance contract or identification number2685
Number of Individuals Covered371
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $38,440
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,569,937
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,138
Insurance broker organization code?3
Insurance broker nameWATSON WYATT INS CONSULTING, INC.
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number20430
Policy instance 12
Insurance contract or identification number20430
Number of Individuals Covered59
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $33,548
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $671,626
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,548
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE INC
HEALTH FIRST HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95019 )
Policy contract number111099
Policy instance 11
Insurance contract or identification number111099
Number of Individuals Covered2268
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $289,475
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $9,649,179
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $289,475
Insurance broker organization code?3
Insurance broker nameWATSON WYATT WORLDWIDE
PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 )
Policy contract number778262 S001
Policy instance 9
Insurance contract or identification number778262 S001
Number of Individuals Covered118
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $608,507
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: 0000 )
Policy contract number291
Policy instance 8
Insurance contract or identification number291
Number of Individuals Covered163
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $14,747
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,097,527
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,747
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE, INC.
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number64301 1
Policy instance 6
Insurance contract or identification number64301 1
Number of Individuals Covered12
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $45,784
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA GLOBAL BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number299486
Policy instance 13
Insurance contract or identification number299486
Number of Individuals Covered563
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $23,426
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,744,798
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,426
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
Policy contract number5527
Policy instance 2
Insurance contract or identification number5527
Number of Individuals Covered149
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,635
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $637,436
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,635
Insurance broker organization code?3
Insurance broker nameWATSON WYATT INS CONSULTING INC
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number02033
Policy instance 3
Insurance contract or identification number02033
Number of Individuals Covered496
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,010
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $201,992
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,010
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE
COVENTRY HEALTH CARE OF KANSAS, INC. (National Association of Insurance Commissioners NAIC id number: 95489 )
Policy contract number3700790000
Policy instance 4
Insurance contract or identification number3700790000
Number of Individuals Covered207
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $22,270
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,113,513
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,270
Insurance broker organization code?3
Insurance broker nameWATSON WYATT INS. CONSULTING INC.
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number124746
Policy instance 5
Insurance contract or identification number124746
Number of Individuals Covered717
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $68,978
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,352,531
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $68,978
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE, INC.
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number*Q8316
Policy instance 7
Insurance contract or identification number*Q8316
Number of Individuals Covered4066
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $7,146,189
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: 0000 )
Policy contract number124746
Policy instance 8
Insurance contract or identification number124746
Number of Individuals Covered994
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $131,694
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $4,245,649
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number20430
Policy instance 9
Insurance contract or identification number20430
Number of Individuals Covered85
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $10,317
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $372,000
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 number2685
Policy instance 10
Insurance contract or identification number2685
Number of Individuals Covered329
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $39,470
Total amount of fees paid to insurance companyUSD $1,067
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,338,342
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH FIRST HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95019 )
Policy contract number111099
Policy instance 6
Insurance contract or identification number111099
Number of Individuals Covered2310
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $297,835
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $9,926,426
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COVENTRY HEALTH CARE OF KANSAS, INC. (National Association of Insurance Commissioners NAIC id number: 95489 )
Policy contract number500466
Policy instance 13
Insurance contract or identification number500466
Number of Individuals Covered257
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $35,320
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,177,334
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 )
Policy contract number778262
Policy instance 14
Insurance contract or identification number778262
Number of Individuals Covered46
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $564,217
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 numberG1009275 1001
Policy instance 15
Insurance contract or identification numberG1009275 1001
Number of Individuals Covered394
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $44,803
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,494,029
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 )
Policy contract number018137
Policy instance 16
Insurance contract or identification number018137
Number of Individuals Covered74
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $279,018
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: 0000 )
Policy contract number291
Policy instance 11
Insurance contract or identification number291
Number of Individuals Covered262
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $26,941
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,558,399
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 52566 )
Policy contract number02033
Policy instance 5
Insurance contract or identification number02033
Number of Individuals Covered553
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,141
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number64301 1
Policy instance 4
Insurance contract or identification number64301 1
Number of Individuals Covered11
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $49,685
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: 95109 )
Policy contract numberUS250716
Policy instance 3
Insurance contract or identification numberUS250716
Number of Individuals Covered2
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,673
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 numberUS250571
Policy instance 2
Insurance contract or identification numberUS250571
Number of Individuals Covered290
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $309,379
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 number468864-ERG
Policy instance 1
Insurance contract or identification number468864-ERG
Number of Individuals Covered174
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $27,950
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $422,409
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
Policy contract number5527
Policy instance 12
Insurance contract or identification number5527
Number of Individuals Covered186
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $18,397
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $679,519
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 )
Policy contract number465488
Policy instance 17
Insurance contract or identification number465488
Number of Individuals Covered1492
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,901,130
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number20430
Policy instance 11
Insurance contract or identification number20430
Number of Individuals Covered98
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $10,631
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $355,076
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,631
Insurance broker organization code?3
Insurance broker nameWATSON WYATT & COMPANY
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract numberQ3401
Policy instance 8
Insurance contract or identification numberQ3401
Number of Individuals Covered98
Insurance policy start date2010-10-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $41,200
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract numberQ0846
Policy instance 7
Insurance contract or identification numberQ0846
Number of Individuals Covered2182
Insurance policy start date2010-10-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $909,646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH FIRST HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95019 )
Policy contract number111099
Policy instance 6
Insurance contract or identification number111099
Number of Individuals Covered2204
Insurance policy start date2010-10-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $71,510
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,165,180
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $71,510
Insurance broker organization code?3
Insurance broker nameWATSON WYATT WORLDWIDE
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number02033
Policy instance 5
Insurance contract or identification number02033
Number of Individuals Covered490
Insurance policy start date2010-10-01
Insurance policy end date2010-12-30
Total amount of commissions paid to insurance brokerUSD $234
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $234
Insurance broker organization code?3
Insurance broker nameWATSON WYATT WORLDWIDE
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number64301 1
Policy instance 4
Insurance contract or identification number64301 1
Number of Individuals Covered12
Insurance policy start date2010-10-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $12,485
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: 95094 )
Policy contract numberUS381580
Policy instance 3
Insurance contract or identification numberUS381580
Number of Individuals Covered24
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $191,352
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number*Q8231
Policy instance 9
Insurance contract or identification number*Q8231
Number of Individuals Covered2095
Insurance policy start date2010-10-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $783,489
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: 0000 )
Policy contract number124746
Policy instance 10
Insurance contract or identification number124746
Number of Individuals Covered1166
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $110,836
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,967,005
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $110,836
Insurance broker organization code?3
Insurance broker nameWATSON WYATT & COMPANY
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 )
Policy contract numberUS250716
Policy instance 2
Insurance contract or identification numberUS250716
Number of Individuals Covered2
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,385
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 numberG1009275 1001
Policy instance 18
Insurance contract or identification numberG1009275 1001
Number of Individuals Covered414
Insurance policy start date2010-10-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $10,413
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $346,520
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,413
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE, INC.
PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 )
Policy contract number778262
Policy instance 17
Insurance contract or identification number778262
Number of Individuals Covered45
Insurance policy start date2010-10-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $117,690
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 )
Policy contract number465488
Policy instance 19
Insurance contract or identification number465488
Number of Individuals Covered1077
Insurance policy start date2010-10-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $478,795
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PREFERRED PLUS OF KANSAS (National Association of Insurance Commissioners NAIC id number: 95390 )
Policy contract number500466
Policy instance 16
Insurance contract or identification number500466
Number of Individuals Covered250
Insurance policy start date2010-10-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $7,168
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $238,935
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,168
Insurance broker organization code?3
Insurance broker nameWATSON WYATT
UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 )
Policy contract number018137
Policy instance 15
Insurance contract or identification number018137
Number of Individuals Covered79
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $271,141
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
Policy contract number5527
Policy instance 14
Insurance contract or identification number5527
Number of Individuals Covered153
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $13,458
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $491,290
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,458
Insurance broker organization code?3
Insurance broker nameWATSON WYATT INS CONSULTING INC
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number291
Policy instance 13
Insurance contract or identification number291
Number of Individuals Covered439
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $36,237
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,574,800
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,237
Insurance broker organization code?3
Insurance broker nameWATSON WYATT & COMPANY
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number2685
Policy instance 12
Insurance contract or identification number2685
Number of Individuals Covered274
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $30,227
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $970,893
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,227
Insurance broker organization code?3
Insurance broker nameWATSON WYATT INS CONSULTING, INC.
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberUS250571
Policy instance 1
Insurance contract or identification numberUS250571
Number of Individuals Covered317
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $333,220
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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