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ALL POWER, INC. INSURANCE PROGRAM 401k Plan overview

Plan NameALL POWER, INC. INSURANCE PROGRAM
Plan identification number 501

ALL POWER, INC. INSURANCE PROGRAM Benefits

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

401k Sponsoring company profile

ALL POWER, INC. has sponsored the creation of one or more 401k plans.

Company Name:ALL POWER, INC.
Employer identification number (EIN):680399476
NAIC Classification:238210
NAIC Description:Electrical Contractors and Other Wiring Installation Contractors

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ALL POWER, INC. INSURANCE PROGRAM

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012024-01-01RON NICK
5012023-01-01RON NICK2024-10-06 RON NICK2024-10-06
5012022-01-01RON NICK2023-07-09 RON NICK2023-07-09
5012021-01-01RON NICK2022-10-11 RON NICK2022-10-11
5012020-01-01RON NICK2021-10-14 RON NICK2021-10-14
5012019-01-01RON NICK2020-07-23 RON NICK2020-07-23
5012018-01-01
5012017-01-01
5012016-01-01RON NICK
5012015-01-01JENNIFER HESSION
5012014-01-01MARTIN YANG
5012013-01-01MARTIN YANG
5012012-01-01MARTIN YANG
5012011-01-01MARTIN YANG
5012009-01-01MARTIN YANG MARTIN YANG2010-10-12

Financial Data on ALL POWER, INC. INSURANCE PROGRAM

Measure Date Value
2023 : ALL POWER, INC. INSURANCE PROGRAM 2023 401k financial data
Total income from all sources2023-12-31$130,039
Expenses. Total of all expenses incurred2023-12-31$155,162
Benefits paid (including direct rollovers)2023-12-31$112,322
Total plan assets at end of year2023-12-31$163,674
Total plan assets at beginning of year2023-12-31$188,797
Net income (gross income less expenses)2023-12-31$-25,123
Net plan assets at end of year (total assets less liabilities)2023-12-31$163,674
Net plan assets at beginning of year (total assets less liabilities)2023-12-31$188,797
Total contributions received or receivable from employer(s)2023-12-31$130,039
Expenses. Administrative service providers (salaries,fees and commissions)2023-12-31$42,840
2022 : ALL POWER, INC. INSURANCE PROGRAM 2022 401k financial data
Total income from all sources2022-12-31$156,448
Expenses. Total of all expenses incurred2022-12-31$139,870
Benefits paid (including direct rollovers)2022-12-31$134,151
Total plan assets at end of year2022-12-31$188,797
Total plan assets at beginning of year2022-12-31$172,219
Net income (gross income less expenses)2022-12-31$16,578
Net plan assets at end of year (total assets less liabilities)2022-12-31$188,797
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$172,219
Total contributions received or receivable from employer(s)2022-12-31$156,448
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$5,719
2021 : ALL POWER, INC. INSURANCE PROGRAM 2021 401k financial data
Total income from all sources2021-12-31$176,318
Expenses. Total of all expenses incurred2021-12-31$205,220
Benefits paid (including direct rollovers)2021-12-31$173,221
Total plan assets at end of year2021-12-31$172,219
Total plan assets at beginning of year2021-12-31$201,121
Net income (gross income less expenses)2021-12-31$-28,902
Net plan assets at end of year (total assets less liabilities)2021-12-31$172,219
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$201,121
Total contributions received or receivable from employer(s)2021-12-31$176,318
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$31,999
2020 : ALL POWER, INC. INSURANCE PROGRAM 2020 401k financial data
Total income from all sources2020-12-31$318,296
Expenses. Total of all expenses incurred2020-12-31$326,888
Benefits paid (including direct rollovers)2020-12-31$317,151
Total plan assets at end of year2020-12-31$201,121
Total plan assets at beginning of year2020-12-31$209,713
Net income (gross income less expenses)2020-12-31$-8,592
Net plan assets at end of year (total assets less liabilities)2020-12-31$201,121
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$209,713
Total contributions received or receivable from employer(s)2020-12-31$318,296
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$9,737
2019 : ALL POWER, INC. INSURANCE PROGRAM 2019 401k financial data
Total income from all sources2019-12-31$318,283
Expenses. Total of all expenses incurred2019-12-31$286,597
Benefits paid (including direct rollovers)2019-12-31$280,460
Total plan assets at end of year2019-12-31$209,713
Total plan assets at beginning of year2019-12-31$178,027
Net income (gross income less expenses)2019-12-31$31,686
Net plan assets at end of year (total assets less liabilities)2019-12-31$209,713
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$178,027
Total contributions received or receivable from employer(s)2019-12-31$318,283
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$6,137
2018 : ALL POWER, INC. INSURANCE PROGRAM 2018 401k financial data
Total income from all sources2018-12-31$348,812
Expenses. Total of all expenses incurred2018-12-31$313,551
Benefits paid (including direct rollovers)2018-12-31$257,286
Total plan assets at end of year2018-12-31$178,027
Total plan assets at beginning of year2018-12-31$142,766
Net income (gross income less expenses)2018-12-31$35,261
Net plan assets at end of year (total assets less liabilities)2018-12-31$178,027
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$142,766
Total contributions received or receivable from employer(s)2018-12-31$348,812
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$56,265
2017 : ALL POWER, INC. INSURANCE PROGRAM 2017 401k financial data
Total income from all sources2017-12-31$196,678
Expenses. Total of all expenses incurred2017-12-31$175,674
Benefits paid (including direct rollovers)2017-12-31$162,533
Total plan assets at end of year2017-12-31$142,766
Total plan assets at beginning of year2017-12-31$121,762
Net income (gross income less expenses)2017-12-31$21,004
Net plan assets at end of year (total assets less liabilities)2017-12-31$142,766
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$121,762
Total contributions received or receivable from employer(s)2017-12-31$196,678
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$13,141
2016 : ALL POWER, INC. INSURANCE PROGRAM 2016 401k financial data
Total income from all sources2016-12-31$134,713
Expenses. Total of all expenses incurred2016-12-31$134,743
Benefits paid (including direct rollovers)2016-12-31$126,931
Total plan assets at end of year2016-12-31$121,762
Total plan assets at beginning of year2016-12-31$121,792
Net income (gross income less expenses)2016-12-31$-30
Net plan assets at end of year (total assets less liabilities)2016-12-31$121,762
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$121,792
Total contributions received or receivable from employer(s)2016-12-31$134,713
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$7,812
2015 : ALL POWER, INC. INSURANCE PROGRAM 2015 401k financial data
Total income from all sources2015-12-31$163,092
Expenses. Total of all expenses incurred2015-12-31$137,022
Benefits paid (including direct rollovers)2015-12-31$116,539
Total plan assets at end of year2015-12-31$121,792
Total plan assets at beginning of year2015-12-31$95,722
Net income (gross income less expenses)2015-12-31$26,070
Net plan assets at end of year (total assets less liabilities)2015-12-31$121,792
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$95,722
Total contributions received or receivable from employer(s)2015-12-31$163,092
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$20,483
2014 : ALL POWER, INC. INSURANCE PROGRAM 2014 401k financial data
Total income from all sources2014-12-31$184,833
Expenses. Total of all expenses incurred2014-12-31$191,069
Benefits paid (including direct rollovers)2014-12-31$170,670
Total plan assets at end of year2014-12-31$95,722
Total plan assets at beginning of year2014-12-31$101,958
Value of fidelity bond covering the plan2014-12-31$11,000
Net income (gross income less expenses)2014-12-31$-6,236
Net plan assets at end of year (total assets less liabilities)2014-12-31$95,722
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$101,958
Total contributions received or receivable from employer(s)2014-12-31$184,833
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$20,399
2013 : ALL POWER, INC. INSURANCE PROGRAM 2013 401k financial data
Total income from all sources2013-12-31$183,659
Expenses. Total of all expenses incurred2013-12-31$172,910
Benefits paid (including direct rollovers)2013-12-31$167,842
Total plan assets at end of year2013-12-31$101,958
Total plan assets at beginning of year2013-12-31$91,209
Net income (gross income less expenses)2013-12-31$10,749
Net plan assets at end of year (total assets less liabilities)2013-12-31$101,958
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$91,209
Total contributions received or receivable from employer(s)2013-12-31$183,659
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$5,068
2012 : ALL POWER, INC. INSURANCE PROGRAM 2012 401k financial data
Total income from all sources2012-12-31$162,173
Expenses. Total of all expenses incurred2012-12-31$146,060
Benefits paid (including direct rollovers)2012-12-31$139,393
Total plan assets at end of year2012-12-31$91,209
Total plan assets at beginning of year2012-12-31$75,096
Net income (gross income less expenses)2012-12-31$16,113
Net plan assets at end of year (total assets less liabilities)2012-12-31$91,209
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$75,096
Total contributions received or receivable from employer(s)2012-12-31$162,173
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$6,667
2011 : ALL POWER, INC. INSURANCE PROGRAM 2011 401k financial data
Total income from all sources2011-12-31$169,973
Expenses. Total of all expenses incurred2011-12-31$144,475
Benefits paid (including direct rollovers)2011-12-31$140,116
Total plan assets at end of year2011-12-31$75,096
Total plan assets at beginning of year2011-12-31$49,598
Net income (gross income less expenses)2011-12-31$25,498
Net plan assets at end of year (total assets less liabilities)2011-12-31$75,096
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$49,598
Total contributions received or receivable from employer(s)2011-12-31$169,973
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$4,359
2010 : ALL POWER, INC. INSURANCE PROGRAM 2010 401k financial data
Total income from all sources2010-12-31$164,550
Expenses. Total of all expenses incurred2010-12-31$123,279
Benefits paid (including direct rollovers)2010-12-31$121,345
Total plan assets at end of year2010-12-31$49,598
Total plan assets at beginning of year2010-12-31$8,327
Net income (gross income less expenses)2010-12-31$41,271
Net plan assets at end of year (total assets less liabilities)2010-12-31$49,598
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$8,327
Total contributions received or receivable from employer(s)2010-12-31$164,550
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$1,934

Form 5500 Responses for ALL POWER, INC. INSURANCE PROGRAM

2023: ALL POWER, INC. INSURANCE PROGRAM 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement - TrustYes
2022: ALL POWER, INC. INSURANCE PROGRAM 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: ALL POWER, INC. INSURANCE PROGRAM 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: ALL POWER, INC. INSURANCE PROGRAM 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: ALL POWER, INC. INSURANCE PROGRAM 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: ALL POWER, INC. INSURANCE PROGRAM 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: ALL POWER, INC. INSURANCE PROGRAM 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: ALL POWER, INC. INSURANCE PROGRAM 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: ALL POWER, INC. INSURANCE PROGRAM 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: ALL POWER, INC. INSURANCE PROGRAM 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: ALL POWER, INC. INSURANCE PROGRAM 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: ALL POWER, INC. INSURANCE PROGRAM 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: ALL POWER, INC. INSURANCE PROGRAM 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: ALL POWER, INC. INSURANCE PROGRAM 2009 form 5500 responses
2009-01-01Type of plan entitySingle 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 planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number216623010
Policy instance 2
Insurance contract or identification number216623010
Number of Individuals Covered7
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $582
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number78053-0000
Policy instance 1
Insurance contract or identification number78053-0000
Number of Individuals Covered7
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $1,473
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $52,123
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number216623010
Policy instance 2
Insurance contract or identification number216623010
Number of Individuals Covered9
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $690
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number78053-0000
Policy instance 1
Insurance contract or identification number78053-0000
Number of Individuals Covered9
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,320
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $82,872
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number216623010
Policy instance 2
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number78053-0000
Policy instance 1
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number78053-0000
Policy instance 1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number216623010
Policy instance 2
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number216623010
Policy instance 2
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number78053-0000
Policy instance 1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number216623010
Policy instance 2
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number78053-0000
Policy instance 1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number216623010
Policy instance 2
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number78053-0000
Policy instance 1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number216623-010
Policy instance 1
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number78053-0000
Policy instance 2
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number78053-0000
Policy instance 1
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202728
Policy instance 2
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number78053-0000
Policy instance 1
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202728
Policy instance 2
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202728
Policy instance 2
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number78053-0000
Policy instance 1
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202728
Policy instance 2
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number78053-0000
Policy instance 1
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number78053-0000
Policy instance 1
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202728
Policy instance 2

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