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AWB HEALTHCHOICE EMPLOYEE BENEFITS TRUST - CONSTRUCTION 401k Plan overview

Plan NameAWB HEALTHCHOICE EMPLOYEE BENEFITS TRUST - CONSTRUCTION
Plan identification number 503

AWB HEALTHCHOICE EMPLOYEE BENEFITS TRUST - CONSTRUCTION Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

THE TRUSTEES OF THE EMPLOYEE BENEFITS TRUST has sponsored the creation of one or more 401k plans.

Company Name:THE TRUSTEES OF THE EMPLOYEE BENEFITS TRUST
Employer identification number (EIN):616496436

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AWB HEALTHCHOICE EMPLOYEE BENEFITS TRUST - CONSTRUCTION

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032023-01-01STEVE SEROSHEK2024-10-14 STEVE SEROSHEK2024-10-14
5032022-01-01STEPHEN DANIELS-BROWN2023-10-12 STEPHEN DANIELS-BROWN2023-10-12
5032021-01-01STEPHEN DANIELS-BROWN2022-10-17 STEPHEN DANIELS-BROWN2022-10-17

Financial Data on AWB HEALTHCHOICE EMPLOYEE BENEFITS TRUST - CONSTRUCTION

Measure Date Value
2023 : AWB HEALTHCHOICE EMPLOYEE BENEFITS TRUST - CONSTRUCTION 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$732,510
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$818,030
Total income from all sources (including contributions)2023-12-31$50,279,287
Total loss/gain on sale of assets2023-12-31$-1,317
Total of all expenses incurred2023-12-31$49,983,026
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$49,296,523
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-12-31$50,199,844
Value of total assets at end of year2023-12-31$2,052,564
Value of total assets at beginning of year2023-12-31$1,841,823
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$686,503
Total interest from all sources2023-12-31$49,921
Total dividends received (eg from common stock, registered investment company shares)2023-12-31$1,345
Were there any nonexempt tranactions with any party-in-interest2023-12-31No
Contributions received from participants2023-12-31$63,455
Value of other receiveables (less allowance for doubtful accounts) at end of year2023-12-31$841,620
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2023-12-31$822,629
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2023-12-31$8,647
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2023-12-31$9,862
Administrative expenses (other) incurred2023-12-31$86,739
Liabilities. Value of operating payables at end of year2023-12-31$16,623
Liabilities. Value of operating payables at beginning of year2023-12-31$636
Total non interest bearing cash at end of year2023-12-31$0
Total non interest bearing cash at beginning of year2023-12-31$212,925
Value of net income/loss2023-12-31$296,261
Value of net assets at end of year (total assets less liabilities)2023-12-31$1,320,054
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$1,023,793
Were any loans by the plan or fixed income obligations due to the plan in default2023-12-31No
Were any leases to which the plan was party in default or uncollectible2023-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2023-12-31$90,484
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2023-12-31$80,664
Income. Interest from US Government securities2023-12-31$13,859
Income. Interest from corporate debt instruments2023-12-31$8,979
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-12-31$369,677
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2023-12-31$20,257
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2023-12-31$20,257
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2023-12-31$27,083
Expenses. Payments to insurance carriers foe the provision of benefits2023-12-31$49,296,523
Asset value of US Government securities at end of year2023-12-31$379,609
Asset value of US Government securities at beginning of year2023-12-31$526,664
Net investment gain/loss from registered investment companies (e.g. mutual funds)2023-12-31$29,494
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-12-31No
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Contributions received in cash from employer2023-12-31$50,136,389
Income. Dividends from preferred stock2023-12-31$1,345
Asset. Corporate debt instrument preferred debt at end of year2023-12-31$371,174
Asset. Corporate debt instrument preferred debt at beginning of year2023-12-31$178,684
Contract administrator fees2023-12-31$566,460
Liabilities. Value of benefit claims payable at end of year2023-12-31$707,240
Liabilities. Value of benefit claims payable at beginning of year2023-12-31$807,532
Did the plan have assets held for investment2023-12-31Yes
Aggregate proceeds on sale of assets2023-12-31$472,288
Aggregate carrying amount (costs) on sale of assets2023-12-31$473,605
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31CLIFTONLARSONALLEN
Accountancy firm EIN2023-12-31410746749
Total unrealized appreciation/depreciation of assets2023-01-01$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-01$732,510
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-01$818,030
Total income from all sources (including contributions)2023-01-01$50,279,287
Total loss/gain on sale of assets2023-01-01$-1,317
Total of all expenses incurred2023-01-01$49,983,026
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-01-01$49,296,523
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-01-01$50,199,844
Value of total assets at end of year2023-01-01$2,052,564
Value of total assets at beginning of year2023-01-01$1,841,823
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-01-01$686,503
Total interest from all sources2023-01-01$49,921
Total dividends received (eg from common stock, registered investment company shares)2023-01-01$1,345
Were there any nonexempt tranactions with any party-in-interest2023-01-01No
Contributions received from participants2023-01-01$63,455
Value of other receiveables (less allowance for doubtful accounts) at end of year2023-01-01$841,620
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2023-01-01$822,629
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2023-01-01$8,647
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2023-01-01$9,862
Administrative expenses (other) incurred2023-01-01$86,739
Liabilities. Value of operating payables at end of year2023-01-01$16,623
Liabilities. Value of operating payables at beginning of year2023-01-01$636
Total non interest bearing cash at end of year2023-01-01$0
Total non interest bearing cash at beginning of year2023-01-01$212,925
Value of net income/loss2023-01-01$296,261
Value of net assets at end of year (total assets less liabilities)2023-01-01$1,320,054
Value of net assets at beginning of year (total assets less liabilities)2023-01-01$1,023,793
Were any loans by the plan or fixed income obligations due to the plan in default2023-01-01No
Were any leases to which the plan was party in default or uncollectible2023-01-01No
Value of interest in registered invesment companies (eg mutual funds) at end of year2023-01-01$90,484
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2023-01-01$80,664
Income. Interest from US Government securities2023-01-01$13,859
Income. Interest from corporate debt instruments2023-01-01$8,979
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-01-01$369,677
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2023-01-01$27,083
Expenses. Payments to insurance carriers foe the provision of benefits2023-01-01$49,296,523
Asset value of US Government securities at end of year2023-01-01$379,609
Asset value of US Government securities at beginning of year2023-01-01$526,664
Net investment gain/loss from registered investment companies (e.g. mutual funds)2023-01-01$29,494
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-01-01No
Has the plan failed to provide any benefit when due under the plan2023-01-01No
Contributions received in cash from employer2023-01-01$50,136,389
Income. Dividends from preferred stock2023-01-01$1,345
Asset. Corporate debt instrument preferred debt at end of year2023-01-01$371,174
Asset. Corporate debt instrument preferred debt at beginning of year2023-01-01$178,684
Contract administrator fees2023-01-01$566,460
Liabilities. Value of benefit claims payable at end of year2023-01-01$707,240
Liabilities. Value of benefit claims payable at beginning of year2023-01-01$807,532
Did the plan have assets held for investment2023-01-01Yes
Aggregate proceeds on sale of assets2023-01-01$472,288
Aggregate carrying amount (costs) on sale of assets2023-01-01$473,605
Opinion of an independent qualified public accountant for this plan2023-01-011
Accountancy firm name2023-01-01CLIFTONLARSONALLEN
Accountancy firm EIN2023-01-01410746749
2022 : AWB HEALTHCHOICE EMPLOYEE BENEFITS TRUST - CONSTRUCTION 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$818,031
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$917,359
Total income from all sources (including contributions)2022-12-31$47,448,070
Total loss/gain on sale of assets2022-12-31$-83
Total of all expenses incurred2022-12-31$47,562,016
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$46,894,641
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$47,453,597
Value of total assets at end of year2022-12-31$1,841,824
Value of total assets at beginning of year2022-12-31$2,055,098
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$667,375
Total interest from all sources2022-12-31$19,019
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$1,224
Administrative expenses professional fees incurred2022-12-31$83,074
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$822,629
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$909,530
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$9,863
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$55,708
Other income not declared elsewhere2022-12-31$2,700
Administrative expenses (other) incurred2022-12-31$14,983
Liabilities. Value of operating payables at end of year2022-12-31$636
Liabilities. Value of operating payables at beginning of year2022-12-31$3,928
Total non interest bearing cash at end of year2022-12-31$212,925
Total non interest bearing cash at beginning of year2022-12-31$1,145,568
Value of net income/loss2022-12-31$-113,946
Value of net assets at end of year (total assets less liabilities)2022-12-31$1,023,793
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$1,137,739
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$80,664
Income. Interest from US Government securities2022-12-31$8,582
Income. Interest from corporate debt instruments2022-12-31$2,807
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$20,258
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$7,630
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$46,894,641
Asset value of US Government securities at end of year2022-12-31$526,664
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-28,387
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$47,453,597
Income. Dividends from preferred stock2022-12-31$1,224
Asset. Corporate debt instrument preferred debt at end of year2022-12-31$178,684
Contract administrator fees2022-12-31$569,318
Liabilities. Value of benefit claims payable at end of year2022-12-31$807,532
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$857,723
Did the plan have assets held for investment2022-12-31Yes
Aggregate proceeds on sale of assets2022-12-31$1,112,841
Aggregate carrying amount (costs) on sale of assets2022-12-31$1,112,924
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2022-12-31410746749
Total unrealized appreciation/depreciation of assets2022-01-01$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$818,031
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$917,359
Total income from all sources (including contributions)2022-01-01$47,448,070
Total loss/gain on sale of assets2022-01-01$-83
Total of all expenses incurred2022-01-01$47,562,016
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-01-01$46,894,641
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-01-01$47,453,597
Value of total assets at end of year2022-01-01$1,841,824
Value of total assets at beginning of year2022-01-01$2,055,098
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-01-01$667,375
Total interest from all sources2022-01-01$19,019
Total dividends received (eg from common stock, registered investment company shares)2022-01-01$1,224
Administrative expenses professional fees incurred2022-01-01$83,074
Were there any nonexempt tranactions with any party-in-interest2022-01-01No
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-01-01$822,629
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-01-01$909,530
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-01-01$9,863
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-01-01$55,708
Other income not declared elsewhere2022-01-01$2,700
Administrative expenses (other) incurred2022-01-01$14,983
Liabilities. Value of operating payables at end of year2022-01-01$636
Liabilities. Value of operating payables at beginning of year2022-01-01$3,928
Total non interest bearing cash at end of year2022-01-01$212,925
Total non interest bearing cash at beginning of year2022-01-01$1,145,568
Value of net income/loss2022-01-01$-113,946
Value of net assets at end of year (total assets less liabilities)2022-01-01$1,023,793
Value of net assets at beginning of year (total assets less liabilities)2022-01-01$1,137,739
Were any loans by the plan or fixed income obligations due to the plan in default2022-01-01No
Were any leases to which the plan was party in default or uncollectible2022-01-01No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-01-01$80,664
Income. Interest from US Government securities2022-01-01$8,582
Income. Interest from corporate debt instruments2022-01-01$2,807
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-01-01$20,258
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-01-01$7,630
Expenses. Payments to insurance carriers foe the provision of benefits2022-01-01$46,894,641
Asset value of US Government securities at end of year2022-01-01$526,664
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-01-01$-28,387
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-01-01No
Has the plan failed to provide any benefit when due under the plan2022-01-01No
Contributions received in cash from employer2022-01-01$47,453,597
Income. Dividends from preferred stock2022-01-01$1,224
Asset. Corporate debt instrument preferred debt at end of year2022-01-01$178,684
Contract administrator fees2022-01-01$569,318
Liabilities. Value of benefit claims payable at end of year2022-01-01$807,532
Liabilities. Value of benefit claims payable at beginning of year2022-01-01$857,723
Did the plan have assets held for investment2022-01-01Yes
Aggregate proceeds on sale of assets2022-01-01$1,112,841
Aggregate carrying amount (costs) on sale of assets2022-01-01$1,112,924
Opinion of an independent qualified public accountant for this plan2022-01-011
Accountancy firm name2022-01-01CLIFTONLARSONALLEN LLP
Accountancy firm EIN2022-01-01410746749
2021 : AWB HEALTHCHOICE EMPLOYEE BENEFITS TRUST - CONSTRUCTION 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total transfer of assets to this plan2021-12-31$1,366,519
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$917,359
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$45,425,900
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$45,654,680
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$43,474,098
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$45,419,159
Value of total assets at end of year2021-12-31$2,055,098
Value of total assets at beginning of year2021-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$2,180,582
Total interest from all sources2021-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Administrative expenses professional fees incurred2021-12-31$1,199,830
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$909,530
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$55,708
Other income not declared elsewhere2021-12-31$6,741
Administrative expenses (other) incurred2021-12-31$17,491
Liabilities. Value of operating payables at end of year2021-12-31$3,928
Total non interest bearing cash at end of year2021-12-31$1,145,568
Value of net income/loss2021-12-31$-228,780
Value of net assets at end of year (total assets less liabilities)2021-12-31$1,137,739
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$0
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$43,474,098
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$45,419,159
Contract administrator fees2021-12-31$963,261
Liabilities. Value of benefit claims payable at end of year2021-12-31$857,723
Did the plan have assets held for investment2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31FROST & COMPANY PLLC
Accountancy firm EIN2021-12-31275137616

Form 5500 Responses for AWB HEALTHCHOICE EMPLOYEE BENEFITS TRUST - CONSTRUCTION

2023: AWB HEALTHCHOICE EMPLOYEE BENEFITS TRUST - CONSTRUCTION 2023 form 5500 responses
2023-01-01Type of plan entityDFE (Diect Filing Entity)
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: AWB HEALTHCHOICE EMPLOYEE BENEFITS TRUST - CONSTRUCTION 2022 form 5500 responses
2022-01-01Type of plan entityDFE (Diect Filing Entity)
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: AWB HEALTHCHOICE EMPLOYEE BENEFITS TRUST - CONSTRUCTION 2021 form 5500 responses
2021-01-01Type of plan entityDFE (Diect Filing Entity)
2021-01-01First time form 5500 has been submittedYes
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47341 )
Policy contract number09450-09457
Policy instance 6
Insurance contract or identification number09450-09457
Number of Individuals Covered2282
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
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 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
PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 )
Policy contract number100000143
Policy instance 5
Insurance contract or identification number100000143
Number of Individuals Covered6400
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
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 $47,034,284
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number122482630016-19
Policy instance 4
Insurance contract or identification number122482630016-19
Number of Individuals Covered6416
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
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 $214,770
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number168475-6,168505
Policy instance 3
Insurance contract or identification number168475-6,168505
Number of Individuals Covered781
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $77,667
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 )
Policy contract numberWA385
Policy instance 2
Insurance contract or identification numberWA385
Number of Individuals Covered74
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
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 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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0234392
Policy instance 1
Insurance contract or identification number0234392
Number of Individuals Covered6394
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $147,364
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47341 )
Policy contract number09450-09457
Policy instance 6
PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 )
Policy contract number100000143
Policy instance 5
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number168475-6,168505
Policy instance 4
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0234392
Policy instance 3
WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 )
Policy contract numberWA385
Policy instance 2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number122482630016-19
Policy instance 1
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0234392
Policy instance 7
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number168475-6,168505
Policy instance 6
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47341 )
Policy contract number09450-09457
Policy instance 5
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50020272
Policy instance 4
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number122482630016-19
Policy instance 3
WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 )
Policy contract numberWA385
Policy instance 2
PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 )
Policy contract number100000143
Policy instance 1

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