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UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 401k Plan overview

Plan NameUFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND
Plan identification number 501

UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

BOARD OF TRUSTEES UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH has sponsored the creation of one or more 401k plans.

Company Name:BOARD OF TRUSTEES UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH
Employer identification number (EIN):680139450
NAIC Classification:445110
NAIC Description:Supermarkets and Other Grocery (except Convenience) Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01JOHN W. HEISE2023-10-03 ALLISON FULLER2023-10-06
5012021-01-01ALLISON FULLER2022-10-17 JOHN W. HEISE2022-10-17
5012020-01-01JOHN HEISE2021-09-22 ALLISON FULLER2021-10-04
5012019-01-01JOHN HEISE2020-10-08 GORDON HINKLE2020-10-09
5012019-01-01JOHN HEISE2020-10-08 GORDON HINKLE2020-10-09
5012018-01-01JACK LANDES2019-08-28 ROGER CEBALLOS2019-08-28
5012017-01-01
5012016-01-01
5012015-01-01
5012014-01-01
5012013-01-01RICK SILVA
5012012-01-01RICK SILVA
5012011-01-01RICK SILVA
5012009-01-01JODY OSTERWEIL

Plan Statistics for UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND

401k plan membership statisitcs for UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND

Measure Date Value
2022: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2022 401k membership
Total participants, beginning-of-year2022-01-010
Total number of active participants reported on line 7a of the Form 55002022-01-010
Total of all active and inactive participants2022-01-010
2021: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2021 401k membership
Total participants, beginning-of-year2021-01-010
Total number of active participants reported on line 7a of the Form 55002021-01-010
Total of all active and inactive participants2021-01-010
2020: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2020 401k membership
Total participants, beginning-of-year2020-01-012,240
Total number of active participants reported on line 7a of the Form 55002020-01-010
Total of all active and inactive participants2020-01-010
2019: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2019 401k membership
Total participants, beginning-of-year2019-01-012,359
Total number of active participants reported on line 7a of the Form 55002019-01-011,979
Number of retired or separated participants receiving benefits2019-01-01261
Total of all active and inactive participants2019-01-012,240
Number of employers contributing to the scheme2019-01-013
2018: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2018 401k membership
Total participants, beginning-of-year2018-01-012,519
Total number of active participants reported on line 7a of the Form 55002018-01-012,091
Number of retired or separated participants receiving benefits2018-01-01268
Total of all active and inactive participants2018-01-012,359
Number of employers contributing to the scheme2018-01-014
2017: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2017 401k membership
Total participants, beginning-of-year2017-01-012,670
Total number of active participants reported on line 7a of the Form 55002017-01-012,242
Number of retired or separated participants receiving benefits2017-01-01277
Total of all active and inactive participants2017-01-012,519
Number of employers contributing to the scheme2017-01-014
2016: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2016 401k membership
Total participants, beginning-of-year2016-01-012,754
Total number of active participants reported on line 7a of the Form 55002016-01-012,384
Number of retired or separated participants receiving benefits2016-01-01286
Total of all active and inactive participants2016-01-012,670
Number of employers contributing to the scheme2016-01-014
2015: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2015 401k membership
Total participants, beginning-of-year2015-01-012,792
Total number of active participants reported on line 7a of the Form 55002015-01-012,457
Number of retired or separated participants receiving benefits2015-01-01297
Total of all active and inactive participants2015-01-012,754
Number of employers contributing to the scheme2015-01-014
2014: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2014 401k membership
Total participants, beginning-of-year2014-01-012,807
Total number of active participants reported on line 7a of the Form 55002014-01-012,485
Number of retired or separated participants receiving benefits2014-01-01307
Total of all active and inactive participants2014-01-012,792
Number of employers contributing to the scheme2014-01-015
2013: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2013 401k membership
Total participants, beginning-of-year2013-01-012,755
Total number of active participants reported on line 7a of the Form 55002013-01-012,502
Number of retired or separated participants receiving benefits2013-01-01305
Total of all active and inactive participants2013-01-012,807
Total participants2013-01-012,807
Number of employers contributing to the scheme2013-01-015
2012: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2012 401k membership
Total participants, beginning-of-year2012-01-012,707
Total number of active participants reported on line 7a of the Form 55002012-01-012,435
Number of retired or separated participants receiving benefits2012-01-01320
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-012,755
Total participants2012-01-012,755
Number of employers contributing to the scheme2012-01-015
2011: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2011 401k membership
Total participants, beginning-of-year2011-01-012,900
Total number of active participants reported on line 7a of the Form 55002011-01-012,426
Number of retired or separated participants receiving benefits2011-01-01281
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-012,707
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-012,707
Number of participants with account balances2011-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
Number of employers contributing to the scheme2011-01-015
2009: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2009 401k membership
Total participants, beginning-of-year2009-01-013,067
Total number of active participants reported on line 7a of the Form 55002009-01-012,660
Number of retired or separated participants receiving benefits2009-01-01382
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-013,042
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-013,042
Number of participants with account balances2009-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010
Number of employers contributing to the scheme2009-01-010

Financial Data on UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND

Measure Date Value
2022 : UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2022 401k financial data
Total plan liabilities at end of year2022-12-31$2,096
Total income from all sources2022-12-31$596,902
Expenses. Total of all expenses incurred2022-12-31$39,824
Benefits paid (including direct rollovers)2022-12-31$-1,818
Total plan assets at end of year2022-12-31$671,661
Total plan assets at beginning of year2022-12-31$112,487
Value of fidelity bond covering the plan2022-12-31$1,000,000
Expenses. Other expenses not covered elsewhere2022-12-31$15,807
Other income received2022-12-31$596,902
Net income (gross income less expenses)2022-12-31$557,078
Net plan assets at end of year (total assets less liabilities)2022-12-31$669,565
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$112,487
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$25,835
2021 : UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2021 401k financial data
Total plan liabilities at beginning of year2021-12-31$205,496
Total income from all sources2021-12-31$1,695
Expenses. Total of all expenses incurred2021-12-31$99,804
Benefits paid (including direct rollovers)2021-12-31$-69,043
Total plan assets at end of year2021-12-31$112,487
Total plan assets at beginning of year2021-12-31$416,092
Value of fidelity bond covering the plan2021-12-31$1,000,000
Expenses. Other expenses not covered elsewhere2021-12-31$29,690
Other income received2021-12-31$1,695
Net income (gross income less expenses)2021-12-31$-98,109
Net plan assets at end of year (total assets less liabilities)2021-12-31$112,487
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$210,596
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$139,157
2020 : UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$205,496
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$2,592,812
Total income from all sources (including contributions)2020-12-31$1,114,598
Total of all expenses incurred2020-12-31$1,523,373
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$867,742
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$1,082,529
Value of total assets at end of year2020-12-31$416,092
Value of total assets at beginning of year2020-12-31$3,212,183
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$655,631
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$1,651
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$1,651
Administrative expenses professional fees incurred2020-12-31$374,722
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$125,822
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$412,308
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$196,896
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$2,553,480
Other income not declared elsewhere2020-12-31$30,021
Administrative expenses (other) incurred2020-12-31$58,229
Liabilities. Value of operating payables at end of year2020-12-31$8,600
Liabilities. Value of operating payables at beginning of year2020-12-31$39,332
Total non interest bearing cash at end of year2020-12-31$406,642
Total non interest bearing cash at beginning of year2020-12-31$1,250,648
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$-408,775
Value of net assets at end of year (total assets less liabilities)2020-12-31$210,596
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$619,371
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$131,452
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$438,104
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$397
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31Yes
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$956,707
Employer contributions (assets) at end of year2020-12-31$9,450
Employer contributions (assets) at beginning of year2020-12-31$1,417,775
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$429,638
Contract administrator fees2020-12-31$222,680
Did the plan have assets held for investment2020-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31EIDE BAILLY LLP
Accountancy firm EIN2020-12-31450250958
2019 : UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,650,475
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,650,475
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$6,101,899
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$6,101,899
Total income from all sources (including contributions)2019-12-31$19,972,102
Total income from all sources (including contributions)2019-12-31$19,972,102
Total of all expenses incurred2019-12-31$18,189,061
Total of all expenses incurred2019-12-31$18,189,061
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$16,424,098
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$16,424,098
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$19,897,139
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$19,897,139
Value of total assets at end of year2019-12-31$3,212,183
Value of total assets at end of year2019-12-31$3,212,183
Value of total assets at beginning of year2019-12-31$4,880,566
Value of total assets at beginning of year2019-12-31$4,880,566
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,764,963
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,764,963
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$20,576
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$20,576
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$20,576
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$20,576
Administrative expenses professional fees incurred2019-12-31$811,745
Administrative expenses professional fees incurred2019-12-31$811,745
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
Value of fidelity bond cover2019-12-31$1,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$1,161,813
Contributions received from participants2019-12-31$1,161,813
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$412,308
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$412,308
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$1,293,369
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$1,293,369
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$2,611,143
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$2,611,143
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$6,057,951
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$6,057,951
Other income not declared elsewhere2019-12-31$34,895
Other income not declared elsewhere2019-12-31$34,895
Administrative expenses (other) incurred2019-12-31$103,780
Administrative expenses (other) incurred2019-12-31$103,780
Liabilities. Value of operating payables at end of year2019-12-31$39,332
Liabilities. Value of operating payables at end of year2019-12-31$39,332
Liabilities. Value of operating payables at beginning of year2019-12-31$43,948
Liabilities. Value of operating payables at beginning of year2019-12-31$43,948
Total non interest bearing cash at end of year2019-12-31$1,250,648
Total non interest bearing cash at end of year2019-12-31$1,250,648
Total non interest bearing cash at beginning of year2019-12-31$1,647,889
Total non interest bearing cash at beginning of year2019-12-31$1,647,889
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$1,783,041
Value of net income/loss2019-12-31$1,783,041
Value of net assets at end of year (total assets less liabilities)2019-12-31$561,708
Value of net assets at end of year (total assets less liabilities)2019-12-31$561,708
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$-1,221,333
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$-1,221,333
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$131,452
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$131,452
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$481,932
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$481,932
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$16,790
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$16,790
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$16,790
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$16,790
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$4,820,891
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$4,820,891
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$19,492
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$19,492
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$18,735,326
Contributions received in cash from employer2019-12-31$18,735,326
Employer contributions (assets) at end of year2019-12-31$1,417,775
Employer contributions (assets) at end of year2019-12-31$1,417,775
Employer contributions (assets) at beginning of year2019-12-31$1,440,586
Employer contributions (assets) at beginning of year2019-12-31$1,440,586
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$11,603,207
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$11,603,207
Contract administrator fees2019-12-31$849,438
Contract administrator fees2019-12-31$849,438
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31No
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31EIDE BAILLY LLP
Accountancy firm name2019-12-31EIDE BAILLY LLP
Accountancy firm EIN2019-12-31450250958
Accountancy firm EIN2019-12-31450250958
2018 : UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$6,101,899
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$6,200,761
Total income from all sources (including contributions)2018-12-31$20,958,121
Total of all expenses incurred2018-12-31$21,706,571
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$19,739,169
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$18,901,482
Value of total assets at end of year2018-12-31$4,880,566
Value of total assets at beginning of year2018-12-31$5,727,878
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$1,967,402
Total interest from all sources2018-12-31$8,961
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$41,674
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$41,674
Administrative expenses professional fees incurred2018-12-31$924,517
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$1,145,081
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$1,293,369
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$288,866
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$6,057,951
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$6,171,353
Other income not declared elsewhere2018-12-31$2,035,442
Administrative expenses (other) incurred2018-12-31$97,567
Liabilities. Value of operating payables at end of year2018-12-31$43,948
Liabilities. Value of operating payables at beginning of year2018-12-31$29,408
Total non interest bearing cash at end of year2018-12-31$1,647,889
Total non interest bearing cash at beginning of year2018-12-31$936,290
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-748,450
Value of net assets at end of year (total assets less liabilities)2018-12-31$-1,221,333
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$-472,883
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$481,932
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$2,935,795
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$16,790
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$157,289
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$157,289
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$8,961
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$4,173,064
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-29,438
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31Yes
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$17,756,401
Employer contributions (assets) at end of year2018-12-31$1,440,586
Employer contributions (assets) at beginning of year2018-12-31$1,409,638
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$15,566,105
Contract administrator fees2018-12-31$945,318
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31EIDE BAILLY LLP
Accountancy firm EIN2018-12-31450250958
2017 : UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$6,200,761
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$6,203,285
Total income from all sources (including contributions)2017-12-31$20,534,714
Total of all expenses incurred2017-12-31$24,203,164
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$22,096,487
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$20,214,867
Value of total assets at end of year2017-12-31$5,727,878
Value of total assets at beginning of year2017-12-31$9,398,852
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$2,106,677
Total interest from all sources2017-12-31$1,742
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$74,446
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$74,446
Administrative expenses professional fees incurred2017-12-31$1,135,906
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$1,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$1,184,837
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$288,866
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$193,545
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$6,171,353
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$6,182,093
Other income not declared elsewhere2017-12-31$236,636
Administrative expenses (other) incurred2017-12-31$95,993
Liabilities. Value of operating payables at end of year2017-12-31$29,408
Liabilities. Value of operating payables at beginning of year2017-12-31$21,192
Total non interest bearing cash at end of year2017-12-31$936,290
Total non interest bearing cash at beginning of year2017-12-31$3,639,098
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-3,668,450
Value of net assets at end of year (total assets less liabilities)2017-12-31$-472,883
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$3,195,567
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$2,935,795
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$3,609,325
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$157,289
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$400,587
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$400,587
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$1,742
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$4,614,658
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$7,023
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31Yes
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$19,030,030
Employer contributions (assets) at end of year2017-12-31$1,409,638
Employer contributions (assets) at beginning of year2017-12-31$1,556,297
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$17,481,829
Contract administrator fees2017-12-31$874,778
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31VAVRINEK, TRINE, DAY & CO., LLP
Accountancy firm EIN2017-12-31952648289
2016 : UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$6,203,285
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$3,561,625
Total income from all sources (including contributions)2016-12-31$22,026,978
Total of all expenses incurred2016-12-31$25,671,612
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$23,659,487
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$21,583,129
Value of total assets at end of year2016-12-31$9,398,852
Value of total assets at beginning of year2016-12-31$10,401,826
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$2,012,125
Total interest from all sources2016-12-31$620
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$58,342
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$58,342
Administrative expenses professional fees incurred2016-12-31$865,317
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$1,000,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$1,180,366
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$193,545
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$195,147
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$6,182,093
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$3,529,215
Other income not declared elsewhere2016-12-31$433,904
Administrative expenses (other) incurred2016-12-31$103,373
Liabilities. Value of operating payables at end of year2016-12-31$21,192
Liabilities. Value of operating payables at beginning of year2016-12-31$32,410
Total non interest bearing cash at end of year2016-12-31$3,639,098
Total non interest bearing cash at beginning of year2016-12-31$4,561,910
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-3,644,634
Value of net assets at end of year (total assets less liabilities)2016-12-31$3,195,567
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$6,840,201
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$3,609,325
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$400,587
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$4,000,028
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$4,000,028
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$620
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$4,805,558
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$-49,017
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31Yes
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$20,402,763
Employer contributions (assets) at end of year2016-12-31$1,556,297
Employer contributions (assets) at beginning of year2016-12-31$1,644,741
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$18,853,929
Contract administrator fees2016-12-31$1,043,435
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31HEMMING MORSE CPAS AND CONSULTANTS
Accountancy firm EIN2016-12-31300702322
2015 : UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$3,561,625
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$4,949,188
Total income from all sources (including contributions)2015-12-31$22,180,864
Total of all expenses incurred2015-12-31$18,490,423
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$16,361,919
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$21,985,688
Value of total assets at end of year2015-12-31$10,401,826
Value of total assets at beginning of year2015-12-31$8,098,948
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$2,128,504
Total interest from all sources2015-12-31$62
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$973,769
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$1,000,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$1,381,409
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$195,147
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$215,466
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$74,938
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$124,088
Other income not declared elsewhere2015-12-31$195,114
Administrative expenses (other) incurred2015-12-31$91,906
Liabilities. Value of operating payables at end of year2015-12-31$32,410
Liabilities. Value of operating payables at beginning of year2015-12-31$190,311
Total non interest bearing cash at end of year2015-12-31$4,561,910
Total non interest bearing cash at beginning of year2015-12-31$6,354,905
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$3,690,441
Value of net assets at end of year (total assets less liabilities)2015-12-31$6,840,201
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$3,149,760
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$4,000,028
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$62
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$5,042,027
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31Yes
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$20,604,279
Employer contributions (assets) at end of year2015-12-31$1,644,741
Employer contributions (assets) at beginning of year2015-12-31$1,528,577
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$11,319,892
Contract administrator fees2015-12-31$1,062,829
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
Liabilities. Value of benefit claims payable at end of year2015-12-31$3,454,277
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$4,634,789
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31HEMMING MORSE CPAS AND CONSULTANTS
Accountancy firm EIN2015-12-31300702322
2014 : UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$4,949,188
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$5,026,633
Total income from all sources (including contributions)2014-12-31$21,690,825
Total of all expenses incurred2014-12-31$19,870,103
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$17,722,198
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$21,427,029
Value of total assets at end of year2014-12-31$8,098,948
Value of total assets at beginning of year2014-12-31$6,355,671
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$2,147,905
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Administrative expenses professional fees incurred2014-12-31$1,023,325
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$1,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$1,422,847
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$215,466
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$359,756
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$124,088
Other income not declared elsewhere2014-12-31$263,796
Administrative expenses (other) incurred2014-12-31$254,463
Liabilities. Value of operating payables at end of year2014-12-31$190,311
Liabilities. Value of operating payables at beginning of year2014-12-31$277,633
Total non interest bearing cash at end of year2014-12-31$6,354,905
Total non interest bearing cash at beginning of year2014-12-31$4,369,229
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$1,820,722
Value of net assets at end of year (total assets less liabilities)2014-12-31$3,149,760
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$1,329,038
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$5,299,540
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$20,004,182
Employer contributions (assets) at end of year2014-12-31$1,528,577
Employer contributions (assets) at beginning of year2014-12-31$1,626,686
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$12,422,658
Contract administrator fees2014-12-31$870,117
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31No
Liabilities. Value of benefit claims payable at end of year2014-12-31$4,634,789
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$4,749,000
Did the plan have assets held for investment2014-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31HEMMING MORSE CPAS AND CONSULTANTS
Accountancy firm EIN2014-12-31300702322
2013 : UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$5,027,977
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$5,932,089
Total income from all sources (including contributions)2013-12-31$21,575,500
Total of all expenses incurred2013-12-31$18,442,903
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$16,738,010
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$21,575,500
Value of total assets at end of year2013-12-31$6,357,015
Value of total assets at beginning of year2013-12-31$4,128,530
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$1,704,893
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Administrative expenses professional fees incurred2013-12-31$384,302
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$1,530,623
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$359,506
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$273,372
Administrative expenses (other) incurred2013-12-31$305,650
Liabilities. Value of operating payables at end of year2013-12-31$278,977
Liabilities. Value of operating payables at beginning of year2013-12-31$174,089
Total non interest bearing cash at end of year2013-12-31$4,369,229
Total non interest bearing cash at beginning of year2013-12-31$2,500,368
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$3,132,597
Value of net assets at end of year (total assets less liabilities)2013-12-31$1,329,038
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$-1,803,559
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$6,170,810
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$20,044,877
Employer contributions (assets) at end of year2013-12-31$1,626,686
Employer contributions (assets) at beginning of year2013-12-31$1,353,249
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$10,567,200
Contract administrator fees2013-12-31$1,014,941
Liabilities. Value of benefit claims payable at end of year2013-12-31$4,749,000
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$5,758,000
Assets. Value of buildings and other operty used in plan operation at end of year2013-12-31$1,594
Assets. Value of buildings and other operty used in plan operation at beginning of year2013-12-31$1,541
Did the plan have assets held for investment2013-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31MILLER KAPLAN ARASE LLP
Accountancy firm EIN2013-12-31952036255
2012 : UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$5,932,089
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$5,543,427
Total income from all sources (including contributions)2012-12-31$22,785,938
Total of all expenses incurred2012-12-31$22,809,305
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$21,174,911
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$22,785,831
Value of total assets at end of year2012-12-31$4,128,530
Value of total assets at beginning of year2012-12-31$3,763,235
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$1,634,394
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Administrative expenses professional fees incurred2012-12-31$546,545
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$1,140,143
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$273,372
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$238,822
Other income not declared elsewhere2012-12-31$107
Administrative expenses (other) incurred2012-12-31$242,850
Liabilities. Value of operating payables at end of year2012-12-31$174,089
Liabilities. Value of operating payables at beginning of year2012-12-31$243,427
Total non interest bearing cash at end of year2012-12-31$2,500,368
Total non interest bearing cash at beginning of year2012-12-31$1,587,289
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-23,367
Value of net assets at end of year (total assets less liabilities)2012-12-31$-1,803,559
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$-1,780,192
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$256,354
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$256,354
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$6,351,790
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$21,645,688
Employer contributions (assets) at end of year2012-12-31$1,353,249
Employer contributions (assets) at beginning of year2012-12-31$1,667,273
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$14,823,121
Contract administrator fees2012-12-31$844,999
Liabilities. Value of benefit claims payable at end of year2012-12-31$5,758,000
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$5,300,000
Assets. Value of buildings and other operty used in plan operation at end of year2012-12-31$1,541
Assets. Value of buildings and other operty used in plan operation at beginning of year2012-12-31$13,497
Did the plan have assets held for investment2012-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31MILLER KAPLAN ARASE LLP
Accountancy firm EIN2012-12-31952036255
2011 : UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$5,543,427
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$4,937,475
Total income from all sources (including contributions)2011-12-31$20,423,884
Total of all expenses incurred2011-12-31$21,466,174
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$19,772,706
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$20,174,779
Value of total assets at end of year2011-12-31$3,763,235
Value of total assets at beginning of year2011-12-31$4,199,573
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$1,693,468
Total interest from all sources2011-12-31$1,296
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Administrative expenses professional fees incurred2011-12-31$512,738
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$120,793
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$238,822
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$219,027
Other income not declared elsewhere2011-12-31$247,809
Administrative expenses (other) incurred2011-12-31$239,493
Liabilities. Value of operating payables at end of year2011-12-31$243,427
Liabilities. Value of operating payables at beginning of year2011-12-31$208,475
Total non interest bearing cash at end of year2011-12-31$1,587,289
Total non interest bearing cash at beginning of year2011-12-31$1,337,744
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-1,042,290
Value of net assets at end of year (total assets less liabilities)2011-12-31$-1,780,192
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$-737,902
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$256,354
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$1,301,187
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$1,301,187
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$1,296
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$5,549,909
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$20,053,986
Employer contributions (assets) at end of year2011-12-31$1,667,273
Employer contributions (assets) at beginning of year2011-12-31$1,325,018
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$14,222,797
Contract administrator fees2011-12-31$941,237
Liabilities. Value of benefit claims payable at end of year2011-12-31$5,300,000
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$4,729,000
Assets. Value of buildings and other operty used in plan operation at end of year2011-12-31$13,497
Assets. Value of buildings and other operty used in plan operation at beginning of year2011-12-31$16,597
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31MILLER KAPLAN ARASE LLP
Accountancy firm EIN2011-12-31952036255
2010 : UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2010 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$4,937,475
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$4,910,347
Total income from all sources (including contributions)2010-12-31$18,404,519
Total of all expenses incurred2010-12-31$20,673,824
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$19,189,802
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$18,184,996
Value of total assets at end of year2010-12-31$4,199,573
Value of total assets at beginning of year2010-12-31$6,441,750
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$1,484,022
Total interest from all sources2010-12-31$516
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Administrative expenses professional fees incurred2010-12-31$410,741
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$1,000,000
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$217,409
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$219,027
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$452,386
Other income not declared elsewhere2010-12-31$219,007
Administrative expenses (other) incurred2010-12-31$190,630
Liabilities. Value of operating payables at end of year2010-12-31$208,475
Liabilities. Value of operating payables at beginning of year2010-12-31$35,347
Total non interest bearing cash at end of year2010-12-31$1,337,744
Total non interest bearing cash at beginning of year2010-12-31$-242,984
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-2,269,305
Value of net assets at end of year (total assets less liabilities)2010-12-31$-737,902
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$1,531,403
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$1,301,187
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$5,152,578
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$5,152,578
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$516
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$5,521,155
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$17,967,587
Employer contributions (assets) at end of year2010-12-31$1,325,018
Employer contributions (assets) at beginning of year2010-12-31$1,063,026
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$13,668,647
Contract administrator fees2010-12-31$882,651
Liabilities. Value of benefit claims payable at end of year2010-12-31$4,729,000
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$4,875,000
Assets. Value of buildings and other operty used in plan operation at end of year2010-12-31$16,597
Assets. Value of buildings and other operty used in plan operation at beginning of year2010-12-31$16,744
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31MILLER, KAPLAN, ARASE & CO
Accountancy firm EIN2010-12-31952036255

Form 5500 Responses for UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND

2022: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2022 form 5500 responses
2022-01-01Type of plan entityMulti-employer plan
2022-01-01Plan is a collectively bargained planYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2021 form 5500 responses
2021-01-01Type of plan entityMulti-employer plan
2021-01-01Plan is a collectively bargained planYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2020 form 5500 responses
2020-01-01Type of plan entityMulti-employer plan
2020-01-01Plan is a collectively bargained planYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2019 form 5500 responses
2019-01-01Type of plan entityMulti-employer plan
2019-01-01Submission has been amendedYes
2019-01-01Plan is a collectively bargained planYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2018 form 5500 responses
2018-01-01Type of plan entityMulti-employer plan
2018-01-01Plan is a collectively bargained planYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2017 form 5500 responses
2017-01-01Type of plan entityMulti-employer plan
2017-01-01Plan is a collectively bargained planYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2016 form 5500 responses
2016-01-01Type of plan entityMulti-employer plan
2016-01-01Plan is a collectively bargained planYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2015 form 5500 responses
2015-01-01Type of plan entityMulti-employer plan
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2014 form 5500 responses
2014-01-01Type of plan entityMulti-employer plan
2014-01-01Plan is a collectively bargained planYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2013 form 5500 responses
2013-01-01Type of plan entityMulti-employer plan
2013-01-01Plan is a collectively bargained planYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2012 form 5500 responses
2012-01-01Type of plan entityMulti-employer plan
2012-01-01Plan is a collectively bargained planYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2011 form 5500 responses
2011-01-01Type of plan entityMulti-employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: UFCW NORTHERN CALIFORNIA AND DRUG EMPLOYERS HEALTH WELFARE TRUST FUND 2009 form 5500 responses
2009-01-01Type of plan entityMulti-employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberEXRK
Policy instance 2
Insurance contract or identification numberEXRK
Number of Individuals Covered498
Insurance policy start date2020-01-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedINDIVIDUAL EXCESS RISK
Welfare Benefit Premiums Paid to CarrierUSD $67,951
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number765
Policy instance 1
Insurance contract or identification number765
Number of Individuals Covered0
Insurance policy start date2019-10-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $1,797,441
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number765
Policy instance 1
Insurance contract or identification number765
Number of Individuals Covered665
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $4,083,829
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberEXRK
Policy instance 2
Insurance contract or identification numberEXRK
Number of Individuals Covered1724
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
Other welfare benefits providedINDIVIDUAL EXCESS RISK
Welfare Benefit Premiums Paid to CarrierUSD $538,126
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberEXRK
Policy instance 2
Insurance contract or identification numberEXRK
Number of Individuals Covered1818
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedINDIVIDUAL EXCESS RISK
Welfare Benefit Premiums Paid to CarrierUSD $423,848
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number765
Policy instance 1
Insurance contract or identification number765
Number of Individuals Covered704
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $4,227,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberEXRK
Policy instance 2
Insurance contract or identification numberEXRK
Number of Individuals Covered1941
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
Other welfare benefits providedINDIVIDUAL EXCESS RISK
Welfare Benefit Premiums Paid to CarrierUSD $415,440
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameNONE
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number765
Policy instance 1
Insurance contract or identification number765
Number of Individuals Covered778
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $3,917,466
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameNONE
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number765
Policy instance 1
Insurance contract or identification number765
Number of Individuals Covered884
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $4,241,703
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameNONE
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberEXRK
Policy instance 2
Insurance contract or identification numberEXRK
Number of Individuals Covered2123
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedINDIVIDUAL EXCESS RISK
Welfare Benefit Premiums Paid to CarrierUSD $459,460
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameNONE
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number765
Policy instance 1
Insurance contract or identification number765
Number of Individuals Covered895
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
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
Welfare Benefit Premiums Paid to CarrierUSD $4,385,772
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberEXRK
Policy instance 2
Insurance contract or identification numberEXRK
Number of Individuals Covered2114
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedINDIVIDUAL EXCESS RISK
Welfare Benefit Premiums Paid to CarrierUSD $471,547
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number765
Policy instance 3
Insurance contract or identification number765
Number of Individuals Covered1019
Insurance policy start date2013-01-01
Insurance policy end date2013-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,236,446
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberEXRK
Policy instance 2
Insurance contract or identification numberEXRK
Number of Individuals Covered2074
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Welfare Benefit Premiums Paid to CarrierUSD $441,580
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00102968
Policy instance 1
Insurance contract or identification number00102968
Number of Individuals Covered2531
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number765
Policy instance 1
Insurance contract or identification number765
Number of Individuals Covered1216
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,584,377
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00102968
Policy instance 3
Insurance contract or identification number00102968
Number of Individuals Covered2548
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberEXRK
Policy instance 2
Insurance contract or identification numberEXRK
Number of Individuals Covered1982
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Welfare Benefit Premiums Paid to CarrierUSD $345,479
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number765
Policy instance 3
Insurance contract or identification number765
Number of Individuals Covered1184
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,723,063
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberEXRK
Policy instance 2
Insurance contract or identification numberEXRK
Number of Individuals Covered2025
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Welfare Benefit Premiums Paid to CarrierUSD $303,359
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00102968
Policy instance 1
Insurance contract or identification number00102968
Number of Individuals Covered2649
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00102968
Policy instance 2
Insurance contract or identification number00102968
Number of Individuals Covered2710
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number765
Policy instance 1
Insurance contract or identification number765
Number of Individuals Covered1203
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,921,296
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberEXRK
Policy instance 3
Insurance contract or identification numberEXRK
Number of Individuals Covered2108
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Welfare Benefit Premiums Paid to CarrierUSD $248,239
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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