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ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 401k Plan overview

Plan NameROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF
Plan identification number 501

ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision

401k Sponsoring company profile

ROOFERS & WATERPROOFERS LOCAL 30 (WASH) WELFARE FUND has sponsored the creation of one or more 401k plans.

Company Name:ROOFERS & WATERPROOFERS LOCAL 30 (WASH) WELFARE FUND
Employer identification number (EIN):550810153
NAIC Classification:238100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-03-01SHAWN MCCULLOUGH2023-12-15
5012021-03-01CLARK SHILEY2022-12-15
5012020-03-01CLARK SHILEY2021-12-15 DAVID HESSE2021-12-15
5012019-03-01CLARK SHILEY2020-12-14 DAVID HESSE2020-12-11
5012018-03-01
5012017-03-01CLARK SHILEY CLARK SHILEY2018-09-28
5012016-03-01CLARK SHILEY TIMOTHY BROWN2018-03-23
5012016-03-01 CLARK SHILEY2018-03-23
5012015-03-01CLARK SHILEY CLARK SHILEY2016-12-13
5012014-03-01CLARK SHILEY CLARK SHILEY2015-12-15
5012013-03-01CLARK SHILEY TIM BROWN2014-10-10
5012012-03-01CLARK SHILEY TIM BROWN2013-09-30
5012011-03-01CLARK SHILEY CLARK SHILEY2012-09-17
5012010-03-01MIKE O'MALLEY
5012009-03-01MIKE O'MALLEY

Plan Statistics for ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF

401k plan membership statisitcs for ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF

Measure Date Value
2022: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2022 401k membership
Total participants, beginning-of-year2022-03-0156
Total number of active participants reported on line 7a of the Form 55002022-03-0157
Total of all active and inactive participants2022-03-0157
Number of employers contributing to the scheme2022-03-016
2021: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2021 401k membership
Total participants, beginning-of-year2021-03-0198
Total number of active participants reported on line 7a of the Form 55002021-03-0155
Number of retired or separated participants receiving benefits2021-03-011
Total of all active and inactive participants2021-03-0156
Number of employers contributing to the scheme2021-03-016
2020: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2020 401k membership
Total participants, beginning-of-year2020-03-0174
Total number of active participants reported on line 7a of the Form 55002020-03-0168
Total of all active and inactive participants2020-03-0168
Number of employers contributing to the scheme2020-03-014
2019: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2019 401k membership
Total participants, beginning-of-year2019-03-0177
Total number of active participants reported on line 7a of the Form 55002019-03-0174
Total of all active and inactive participants2019-03-0174
Number of employers contributing to the scheme2019-03-015
2018: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2018 401k membership
Total participants, beginning-of-year2018-03-0177
Total number of active participants reported on line 7a of the Form 55002018-03-0177
Total of all active and inactive participants2018-03-0177
Number of employers contributing to the scheme2018-03-017
2017: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2017 401k membership
Total participants, beginning-of-year2017-03-0175
Total number of active participants reported on line 7a of the Form 55002017-03-0177
Number of retired or separated participants receiving benefits2017-03-011
Total of all active and inactive participants2017-03-0178
2016: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2016 401k membership
Total participants, beginning-of-year2016-03-0168
Total number of active participants reported on line 7a of the Form 55002016-03-0175
Total of all active and inactive participants2016-03-0175
Number of employers contributing to the scheme2016-03-017
2015: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2015 401k membership
Total participants, beginning-of-year2015-03-0153
Total number of active participants reported on line 7a of the Form 55002015-03-0153
Total of all active and inactive participants2015-03-0153
Number of employers contributing to the scheme2015-03-017
2014: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2014 401k membership
Total participants, beginning-of-year2014-03-0153
Total number of active participants reported on line 7a of the Form 55002014-03-0153
Total of all active and inactive participants2014-03-0153
Number of employers contributing to the scheme2014-03-017
2013: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2013 401k membership
Total participants, beginning-of-year2013-03-0169
Total number of active participants reported on line 7a of the Form 55002013-03-0153
Total of all active and inactive participants2013-03-0153
Number of employers contributing to the scheme2013-03-017
2012: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2012 401k membership
Total participants, beginning-of-year2012-03-0163
Total number of active participants reported on line 7a of the Form 55002012-03-0169
Total of all active and inactive participants2012-03-0169
2011: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2011 401k membership
Total participants, beginning-of-year2011-03-0153
Total number of active participants reported on line 7a of the Form 55002011-03-0163
Total of all active and inactive participants2011-03-0163
Number of employers contributing to the scheme2011-03-015
2010: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2010 401k membership
Total participants, beginning-of-year2010-03-0151
Total number of active participants reported on line 7a of the Form 55002010-03-0153
Total of all active and inactive participants2010-03-0153
Number of employers contributing to the scheme2010-03-017
2009: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2009 401k membership
Total participants, beginning-of-year2009-03-0153
Total number of active participants reported on line 7a of the Form 55002009-03-0155
Total of all active and inactive participants2009-03-0155
Number of employers contributing to the scheme2009-03-017

Financial Data on ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF

Measure Date Value
2023 : ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2023 401k financial data
Total plan liabilities at end of year2023-02-28$41,492
Total plan liabilities at beginning of year2023-02-28$193,690
Total income from all sources2023-02-28$1,050,545
Expenses. Total of all expenses incurred2023-02-28$1,151,652
Benefits paid (including direct rollovers)2023-02-28$1,070,046
Total plan assets at end of year2023-02-28$831,974
Total plan assets at beginning of year2023-02-28$1,085,279
Value of fidelity bond covering the plan2023-02-28$70,000
Total contributions received or receivable from participants2023-02-28$114,673
Expenses. Other expenses not covered elsewhere2023-02-28$18,184
Other income received2023-02-28$10,643
Net income (gross income less expenses)2023-02-28$-101,107
Net plan assets at end of year (total assets less liabilities)2023-02-28$790,482
Net plan assets at beginning of year (total assets less liabilities)2023-02-28$891,589
Total contributions received or receivable from employer(s)2023-02-28$925,229
Expenses. Administrative service providers (salaries,fees and commissions)2023-02-28$63,422
2022 : ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2022 401k financial data
Total plan liabilities at end of year2022-02-28$193,690
Total plan liabilities at beginning of year2022-02-28$51,800
Total income from all sources2022-02-28$963,166
Expenses. Total of all expenses incurred2022-02-28$929,469
Benefits paid (including direct rollovers)2022-02-28$858,678
Total plan assets at end of year2022-02-28$1,085,279
Total plan assets at beginning of year2022-02-28$909,692
Value of fidelity bond covering the plan2022-02-28$70,000
Total contributions received or receivable from participants2022-02-28$94,397
Expenses. Other expenses not covered elsewhere2022-02-28$6,322
Other income received2022-02-28$2,982
Net income (gross income less expenses)2022-02-28$33,697
Net plan assets at end of year (total assets less liabilities)2022-02-28$891,589
Net plan assets at beginning of year (total assets less liabilities)2022-02-28$857,892
Total contributions received or receivable from employer(s)2022-02-28$865,787
Expenses. Administrative service providers (salaries,fees and commissions)2022-02-28$64,469
2021 : ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2021 401k financial data
Total plan liabilities at end of year2021-02-28$51,800
Total plan liabilities at beginning of year2021-02-28$60,040
Total income from all sources2021-02-28$1,224,567
Expenses. Total of all expenses incurred2021-02-28$1,163,333
Benefits paid (including direct rollovers)2021-02-28$1,088,936
Total plan assets at end of year2021-02-28$909,692
Total plan assets at beginning of year2021-02-28$856,698
Value of fidelity bond covering the plan2021-02-28$70,000
Total contributions received or receivable from participants2021-02-28$115,308
Expenses. Other expenses not covered elsewhere2021-02-28$12,504
Other income received2021-02-28$93
Net income (gross income less expenses)2021-02-28$61,234
Net plan assets at end of year (total assets less liabilities)2021-02-28$857,892
Net plan assets at beginning of year (total assets less liabilities)2021-02-28$796,658
Total contributions received or receivable from employer(s)2021-02-28$1,109,166
Expenses. Administrative service providers (salaries,fees and commissions)2021-02-28$61,893
2020 : ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2020 401k financial data
Total plan liabilities at end of year2020-02-29$60,040
Total plan liabilities at beginning of year2020-02-29$30,066
Total income from all sources2020-02-29$1,377,017
Expenses. Total of all expenses incurred2020-02-29$1,319,282
Benefits paid (including direct rollovers)2020-02-29$1,244,491
Total plan assets at end of year2020-02-29$856,698
Total plan assets at beginning of year2020-02-29$768,989
Value of fidelity bond covering the plan2020-02-29$70,000
Total contributions received or receivable from participants2020-02-29$135,967
Expenses. Other expenses not covered elsewhere2020-02-29$8,918
Other income received2020-02-29$27,730
Net income (gross income less expenses)2020-02-29$57,735
Net plan assets at end of year (total assets less liabilities)2020-02-29$796,658
Net plan assets at beginning of year (total assets less liabilities)2020-02-29$738,923
Total contributions received or receivable from employer(s)2020-02-29$1,213,320
Expenses. Administrative service providers (salaries,fees and commissions)2020-02-29$65,873
2019 : ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2019 401k financial data
Total plan liabilities at end of year2019-02-28$30,066
Total plan liabilities at beginning of year2019-02-28$35,284
Total income from all sources2019-02-28$1,281,548
Expenses. Total of all expenses incurred2019-02-28$1,215,184
Benefits paid (including direct rollovers)2019-02-28$1,134,290
Total plan assets at end of year2019-02-28$768,989
Total plan assets at beginning of year2019-02-28$707,843
Value of fidelity bond covering the plan2019-02-28$70,000
Expenses. Other expenses not covered elsewhere2019-02-28$0
Other income received2019-02-28$1,132
Net income (gross income less expenses)2019-02-28$66,364
Net plan assets at end of year (total assets less liabilities)2019-02-28$738,923
Net plan assets at beginning of year (total assets less liabilities)2019-02-28$672,559
Total contributions received or receivable from employer(s)2019-02-28$1,280,416
Expenses. Administrative service providers (salaries,fees and commissions)2019-02-28$80,894
2018 : ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2018 401k financial data
Total plan liabilities at end of year2018-02-28$35,284
Total plan liabilities at beginning of year2018-02-28$29,713
Total income from all sources2018-02-28$1,176,843
Expenses. Total of all expenses incurred2018-02-28$1,146,508
Benefits paid (including direct rollovers)2018-02-28$1,084,317
Total plan assets at end of year2018-02-28$747,843
Total plan assets at beginning of year2018-02-28$711,937
Value of fidelity bond covering the plan2018-02-28$70,000
Expenses. Other expenses not covered elsewhere2018-02-28$4,684
Other income received2018-02-28$433
Net income (gross income less expenses)2018-02-28$30,335
Net plan assets at end of year (total assets less liabilities)2018-02-28$712,559
Net plan assets at beginning of year (total assets less liabilities)2018-02-28$682,224
Total contributions received or receivable from employer(s)2018-02-28$1,176,410
Expenses. Administrative service providers (salaries,fees and commissions)2018-02-28$57,507
2017 : ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2017 401k financial data
Total plan liabilities at end of year2017-02-28$29,713
Total plan liabilities at beginning of year2017-02-28$32,915
Total income from all sources2017-02-28$1,039,811
Expenses. Total of all expenses incurred2017-02-28$1,058,652
Benefits paid (including direct rollovers)2017-02-28$995,033
Total plan assets at end of year2017-02-28$671,937
Total plan assets at beginning of year2017-02-28$693,980
Value of fidelity bond covering the plan2017-02-28$70,000
Expenses. Other expenses not covered elsewhere2017-02-28$4,435
Other income received2017-02-28$1,198
Net income (gross income less expenses)2017-02-28$-18,841
Net plan assets at end of year (total assets less liabilities)2017-02-28$642,224
Net plan assets at beginning of year (total assets less liabilities)2017-02-28$661,065
Total contributions received or receivable from employer(s)2017-02-28$1,038,613
Expenses. Administrative service providers (salaries,fees and commissions)2017-02-28$59,184
2016 : ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2016 401k financial data
Total plan liabilities at end of year2016-02-28$32,915
Total plan liabilities at beginning of year2016-02-28$23,398
Total income from all sources2016-02-28$802,009
Expenses. Total of all expenses incurred2016-02-28$1,045,267
Benefits paid (including direct rollovers)2016-02-28$978,310
Total plan assets at end of year2016-02-28$693,980
Total plan assets at beginning of year2016-02-28$927,721
Expenses. Other expenses not covered elsewhere2016-02-28$8,081
Other income received2016-02-28$2,155
Net income (gross income less expenses)2016-02-28$-243,258
Net plan assets at end of year (total assets less liabilities)2016-02-28$661,065
Net plan assets at beginning of year (total assets less liabilities)2016-02-28$904,323
Total contributions received or receivable from employer(s)2016-02-28$799,854
Expenses. Administrative service providers (salaries,fees and commissions)2016-02-28$58,876
2015 : ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2015 401k financial data
Total plan liabilities at end of year2015-02-28$28,218
Total plan liabilities at beginning of year2015-02-28$28,101
Total income from all sources2015-02-28$745,298
Expenses. Total of all expenses incurred2015-02-28$820,378
Benefits paid (including direct rollovers)2015-02-28$747,811
Total plan assets at end of year2015-02-28$927,721
Total plan assets at beginning of year2015-02-28$1,002,684
Expenses. Other expenses not covered elsewhere2015-02-28$13,742
Other income received2015-02-28$5,344
Net income (gross income less expenses)2015-02-28$-75,080
Net plan assets at end of year (total assets less liabilities)2015-02-28$899,503
Net plan assets at beginning of year (total assets less liabilities)2015-02-28$974,583
Total contributions received or receivable from employer(s)2015-02-28$739,954
Expenses. Administrative service providers (salaries,fees and commissions)2015-02-28$58,825
2014 : ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2014 401k financial data
Total plan liabilities at end of year2014-02-28$28,101
Total plan liabilities at beginning of year2014-02-28$28,193
Total income from all sources2014-02-28$641,188
Expenses. Total of all expenses incurred2014-02-28$662,770
Benefits paid (including direct rollovers)2014-02-28$599,438
Total plan assets at end of year2014-02-28$1,002,684
Total plan assets at beginning of year2014-02-28$1,024,358
Value of fidelity bond covering the plan2014-02-28$1,000,000
Expenses. Other expenses not covered elsewhere2014-02-28$4,822
Other income received2014-02-28$7,427
Net income (gross income less expenses)2014-02-28$-21,582
Net plan assets at end of year (total assets less liabilities)2014-02-28$974,583
Net plan assets at beginning of year (total assets less liabilities)2014-02-28$996,165
Total contributions received or receivable from employer(s)2014-02-28$633,761
Expenses. Administrative service providers (salaries,fees and commissions)2014-02-28$58,510
2013 : ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2013 401k financial data
Total plan liabilities at end of year2013-02-28$28,193
Total plan liabilities at beginning of year2013-02-28$12
Total income from all sources2013-02-28$743,998
Expenses. Total of all expenses incurred2013-02-28$793,445
Benefits paid (including direct rollovers)2013-02-28$717,098
Total plan assets at end of year2013-02-28$1,024,358
Total plan assets at beginning of year2013-02-28$1,045,624
Value of fidelity bond covering the plan2013-02-28$75,000
Expenses. Other expenses not covered elsewhere2013-02-28$76,347
Other income received2013-02-28$22,020
Net income (gross income less expenses)2013-02-28$-49,447
Net plan assets at end of year (total assets less liabilities)2013-02-28$996,165
Net plan assets at beginning of year (total assets less liabilities)2013-02-28$1,045,612
Total contributions received or receivable from employer(s)2013-02-28$721,978
2012 : ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2012 401k financial data
Total plan liabilities at end of year2012-02-29$12
Total plan liabilities at beginning of year2012-02-29$23
Total income from all sources2012-02-29$588,982
Expenses. Total of all expenses incurred2012-02-29$564,319
Benefits paid (including direct rollovers)2012-02-29$502,129
Total plan assets at end of year2012-02-29$1,045,624
Total plan assets at beginning of year2012-02-29$1,020,972
Value of fidelity bond covering the plan2012-02-29$75,000
Other income received2012-02-29$22,830
Net income (gross income less expenses)2012-02-29$24,663
Net plan assets at end of year (total assets less liabilities)2012-02-29$1,045,612
Net plan assets at beginning of year (total assets less liabilities)2012-02-29$1,020,949
Total contributions received or receivable from employer(s)2012-02-29$566,152
Expenses. Administrative service providers (salaries,fees and commissions)2012-02-29$62,190
2011 : ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2011 401k financial data
Total plan liabilities at end of year2011-02-28$23
Total plan liabilities at beginning of year2011-02-28$40
Total income from all sources2011-02-28$557,884
Expenses. Total of all expenses incurred2011-02-28$585,952
Benefits paid (including direct rollovers)2011-02-28$525,447
Total plan assets at end of year2011-02-28$1,020,972
Total plan assets at beginning of year2011-02-28$1,049,057
Value of fidelity bond covering the plan2011-02-28$75,000
Other income received2011-02-28$27,052
Net income (gross income less expenses)2011-02-28$-28,068
Net plan assets at end of year (total assets less liabilities)2011-02-28$1,020,949
Net plan assets at beginning of year (total assets less liabilities)2011-02-28$1,049,017
Total contributions received or receivable from employer(s)2011-02-28$530,832
Expenses. Administrative service providers (salaries,fees and commissions)2011-02-28$60,505

Form 5500 Responses for ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF

2022: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2022 form 5500 responses
2022-03-01Type of plan entityMulti-employer plan
2022-03-01Plan is a collectively bargained planYes
2022-03-01Plan funding arrangement – InsuranceYes
2022-03-01Plan benefit arrangement – InsuranceYes
2021: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2021 form 5500 responses
2021-03-01Type of plan entityMulti-employer plan
2021-03-01Plan is a collectively bargained planYes
2021-03-01Plan funding arrangement – InsuranceYes
2021-03-01Plan benefit arrangement – InsuranceYes
2020: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2020 form 5500 responses
2020-03-01Type of plan entityMulti-employer plan
2020-03-01Plan is a collectively bargained planYes
2020-03-01Plan funding arrangement – InsuranceYes
2020-03-01Plan benefit arrangement – InsuranceYes
2019: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2019 form 5500 responses
2019-03-01Type of plan entityMulti-employer plan
2019-03-01Plan is a collectively bargained planYes
2019-03-01Plan funding arrangement – InsuranceYes
2019-03-01Plan benefit arrangement – InsuranceYes
2018: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2018 form 5500 responses
2018-03-01Type of plan entityMulti-employer plan
2018-03-01Plan is a collectively bargained planYes
2018-03-01Plan funding arrangement – InsuranceYes
2018-03-01Plan benefit arrangement – InsuranceYes
2017: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2017 form 5500 responses
2017-03-01Type of plan entityMulti-employer plan
2017-03-01Plan is a collectively bargained planYes
2017-03-01Plan funding arrangement – InsuranceYes
2017-03-01Plan benefit arrangement – InsuranceYes
2016: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2016 form 5500 responses
2016-03-01Type of plan entityMulti-employer plan
2016-03-01Submission has been amendedYes
2016-03-01Plan is a collectively bargained planYes
2016-03-01Plan funding arrangement – InsuranceYes
2016-03-01Plan benefit arrangement – InsuranceYes
2015: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2015 form 5500 responses
2015-03-01Type of plan entityMulti-employer plan
2015-03-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-03-01Plan is a collectively bargained planYes
2015-03-01Plan funding arrangement – InsuranceYes
2015-03-01Plan benefit arrangement – InsuranceYes
2014: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2014 form 5500 responses
2014-03-01Type of plan entityMulti-employer plan
2014-03-01Plan is a collectively bargained planYes
2014-03-01Plan funding arrangement – InsuranceYes
2014-03-01Plan benefit arrangement – InsuranceYes
2013: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2013 form 5500 responses
2013-03-01Type of plan entityMulti-employer plan
2013-03-01Plan is a collectively bargained planYes
2013-03-01Plan funding arrangement – InsuranceYes
2013-03-01Plan benefit arrangement – InsuranceYes
2012: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2012 form 5500 responses
2012-03-01Type of plan entityMulti-employer plan
2012-03-01Plan is a collectively bargained planYes
2012-03-01Plan funding arrangement – InsuranceYes
2012-03-01Plan benefit arrangement – InsuranceYes
2011: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2011 form 5500 responses
2011-03-01Type of plan entityMulti-employer plan
2011-03-01Plan is a collectively bargained planYes
2011-03-01Plan funding arrangement – InsuranceYes
2011-03-01Plan benefit arrangement – InsuranceYes
2010: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2010 form 5500 responses
2010-03-01Type of plan entityMulti-employer plan
2010-03-01Plan is a collectively bargained planYes
2010-03-01Plan funding arrangement – InsuranceYes
2010-03-01Plan benefit arrangement – InsuranceYes
2009: ROOFERS & WATERPROOFERS LOCAL 30 (WASHINGTON) WELF 2009 form 5500 responses
2009-03-01Type of plan entityMulti-employer plan
2009-03-01This submission is the final filingNo
2009-03-01Plan is a collectively bargained planYes
2009-03-01Plan funding arrangement – InsuranceYes
2009-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number865911G
Policy instance 2
Insurance contract or identification number865911G
Number of Individuals Covered57
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,498
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3339528
Policy instance 1
Insurance contract or identification number3339528
Number of Individuals Covered57
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $982,109
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number865911G
Policy instance 2
Insurance contract or identification number865911G
Number of Individuals Covered56
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,155
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3339528
Policy instance 1
Insurance contract or identification number3339528
Number of Individuals Covered56
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $771,337
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number865911G
Policy instance 2
Insurance contract or identification number865911G
Number of Individuals Covered68
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,251
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3339528
Policy instance 1
Insurance contract or identification number3339528
Number of Individuals Covered68
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $978,845
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number865911G
Policy instance 2
Insurance contract or identification number865911G
Number of Individuals Covered74
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,556
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3339528
Policy instance 1
Insurance contract or identification number3339528
Number of Individuals Covered74
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,103,285
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3339528
Policy instance 1
Insurance contract or identification number3339528
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3339528
Policy instance 1
Insurance contract or identification number3339528
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )
Policy contract numberTL260000
Policy instance 1
Insurance contract or identification numberTL260000
Insurance policy start date2015-03-01
Insurance policy end date2016-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )
Policy contract numberTL260000
Policy instance 1
Insurance contract or identification numberTL260000
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )
Policy contract numberTL260000
Policy instance 1
Insurance contract or identification numberTL260000
Number of Individuals Covered53
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )
Policy contract numberTL260000
Policy instance 1
Insurance contract or identification numberTL260000
Number of Individuals Covered69
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )
Policy contract numberTL260000
Policy instance 1
Insurance contract or identification numberTL260000
Number of Individuals Covered64
Insurance policy start date2011-03-01
Insurance policy end date2012-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )
Policy contract numberTL260000
Policy instance 1
Insurance contract or identification numberTL260000
Number of Individuals Covered53
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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