THE TRUSTEES OF THE EMPLOYEE BENEFITS TRUST has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan AWB HEALTHCHOICE EMPLOYEE BENEFITS TRUST - RETAIL/WHOLESALE
401k plan membership statisitcs for AWB HEALTHCHOICE EMPLOYEE BENEFITS TRUST - RETAIL/WHOLESALE
Measure | Date | Value |
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2022 : AWB HEALTHCHOICE EMPLOYEE BENEFITS TRUST - RETAIL/WHOLESALE 2022 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2022-12-31 | $0 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $324,753 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $567,424 |
Total income from all sources (including contributions) | 2022-12-31 | $25,272,419 |
Total loss/gain on sale of assets | 2022-12-31 | $-174 |
Total of all expenses incurred | 2022-12-31 | $25,370,791 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $25,044,089 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-12-31 | $25,300,663 |
Value of total assets at end of year | 2022-12-31 | $2,681,831 |
Value of total assets at beginning of year | 2022-12-31 | $3,022,874 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $326,702 |
Total interest from all sources | 2022-12-31 | $28,185 |
Total dividends received (eg from common stock, registered investment company shares) | 2022-12-31 | $2,565 |
Administrative expenses professional fees incurred | 2022-12-31 | $44,991 |
Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-12-31 | $388,236 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-12-31 | $620,120 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2022-12-31 | $3,390 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2022-12-31 | $64,209 |
Other income not declared elsewhere | 2022-12-31 | $700 |
Administrative expenses (other) incurred | 2022-12-31 | $8,043 |
Liabilities. Value of operating payables at end of year | 2022-12-31 | $223 |
Liabilities. Value of operating payables at beginning of year | 2022-12-31 | $2,284 |
Total non interest bearing cash at end of year | 2022-12-31 | $603,078 |
Total non interest bearing cash at beginning of year | 2022-12-31 | $2,402,754 |
Value of net income/loss | 2022-12-31 | $-98,372 |
Value of net assets at end of year (total assets less liabilities) | 2022-12-31 | $2,357,078 |
Value of net assets at beginning of year (total assets less liabilities) | 2022-12-31 | $2,455,450 |
Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-12-31 | $169,128 |
Income. Interest from US Government securities | 2022-12-31 | $17,995 |
Income. Interest from corporate debt instruments | 2022-12-31 | $5,885 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-12-31 | $42,475 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-12-31 | $4,305 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2022-12-31 | $25,044,089 |
Asset value of US Government securities at end of year | 2022-12-31 | $1,104,265 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-12-31 | $-59,520 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
Contributions received in cash from employer | 2022-12-31 | $25,300,663 |
Income. Dividends from preferred stock | 2022-12-31 | $2,565 |
Asset. Corporate debt instrument preferred debt at end of year | 2022-12-31 | $374,649 |
Contract administrator fees | 2022-12-31 | $273,668 |
Liabilities. Value of benefit claims payable at end of year | 2022-12-31 | $321,140 |
Liabilities. Value of benefit claims payable at beginning of year | 2022-12-31 | $500,931 |
Did the plan have assets held for investment | 2022-12-31 | Yes |
Aggregate proceeds on sale of assets | 2022-12-31 | $2,333,311 |
Aggregate carrying amount (costs) on sale of assets | 2022-12-31 | $2,333,485 |
Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
Accountancy firm name | 2022-12-31 | CLIFTONLARSONALLEN LLP |
Accountancy firm EIN | 2022-12-31 | 410746749 |
2021 : AWB HEALTHCHOICE EMPLOYEE BENEFITS TRUST - RETAIL/WHOLESALE 2021 401k financial data |
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Total unrealized appreciation/depreciation of assets | 2021-12-31 | $0 |
Total transfer of assets to this plan | 2021-12-31 | $2,584,556 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $567,424 |
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 | $26,675,203 |
Total loss/gain on sale of assets | 2021-12-31 | $0 |
Total of all expenses incurred | 2021-12-31 | $26,804,309 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $25,547,782 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-12-31 | $26,672,055 |
Value of total assets at end of year | 2021-12-31 | $3,022,874 |
Value of total assets at beginning of year | 2021-12-31 | $0 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $1,256,527 |
Total interest from all sources | 2021-12-31 | $0 |
Total dividends received (eg from common stock, registered investment company shares) | 2021-12-31 | $0 |
Administrative expenses professional fees incurred | 2021-12-31 | $710,087 |
Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-12-31 | $620,120 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2021-12-31 | $64,209 |
Other income not declared elsewhere | 2021-12-31 | $3,148 |
Administrative expenses (other) incurred | 2021-12-31 | $10,279 |
Liabilities. Value of operating payables at end of year | 2021-12-31 | $2,284 |
Total non interest bearing cash at end of year | 2021-12-31 | $2,402,754 |
Value of net income/loss | 2021-12-31 | $-129,106 |
Value of net assets at end of year (total assets less liabilities) | 2021-12-31 | $2,455,450 |
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 default | 2021-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
Expenses. Payments to insurance carriers foe the provision of benefits | 2021-12-31 | $25,547,782 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-12-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
Contributions received in cash from employer | 2021-12-31 | $26,672,055 |
Contract administrator fees | 2021-12-31 | $536,161 |
Liabilities. Value of benefit claims payable at end of year | 2021-12-31 | $500,931 |
Did the plan have assets held for investment | 2021-12-31 | No |
Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
Accountancy firm name | 2021-12-31 | FROST & COMPANY PLLC |
Accountancy firm EIN | 2021-12-31 | 275137616 |
WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 ) |
Policy contract number | WA385 |
Policy instance | 1 |
Insurance contract or identification number | WA385 | Number of Individuals Covered | 35 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
Policy contract number | 122482630016-19 |
Policy instance | 6 |
Insurance contract or identification number | 122482630016-19 | Number of Individuals Covered | 2814 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $115,661 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47341 ) |
Policy contract number | 09450-09457 |
Policy instance | 5 |
Insurance contract or identification number | 09450-09457 | Number of Individuals Covered | 842 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 168475-6,168505 |
Policy instance | 4 |
Insurance contract or identification number | 168475-6,168505 | Number of Individuals Covered | 524 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&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 Carrier | USD $54,689 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0234392 |
Policy instance | 3 |
Insurance contract or identification number | 0234392 | Number of Individuals Covered | 2815 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&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 Carrier | USD $81,548 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 ) |
Policy contract number | 100000147 |
Policy instance | 2 |
Insurance contract or identification number | 100000147 | Number of Individuals Covered | 2816 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $24,105,579 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 168475-6,168505 |
Policy instance | 7 |
Insurance contract or identification number | 168475-6,168505 | Number of Individuals Covered | 597 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&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 Carrier | USD $54,277 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50020272 |
Policy instance | 6 |
Insurance contract or identification number | 50020272 | Number of Individuals Covered | 0 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-11-30 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&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 Carrier | USD $118,030 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 ) |
Policy contract number | WA385 |
Policy instance | 5 |
Insurance contract or identification number | WA385 | Number of Individuals Covered | 42 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
Policy contract number | 122482630016-19 |
Policy instance | 4 |
Insurance contract or identification number | 122482630016-19 | Number of Individuals Covered | 3106 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $121,829 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PREMERA BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 47570 ) |
Policy contract number | 100000147 |
Policy instance | 3 |
Insurance contract or identification number | 100000147 | Number of Individuals Covered | 3106 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $24,486,511 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0234392 |
Policy instance | 2 |
Insurance contract or identification number | 0234392 | Number of Individuals Covered | 3096 | Insurance policy start date | 2021-12-01 | Insurance policy end date | 2021-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&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 Carrier | USD $5,443 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47341 ) |
Policy contract number | 09450-09457 |
Policy instance | 1 |
Insurance contract or identification number | 09450-09457 | Number of Individuals Covered | 922 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 |
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