CALIFORNIA ASSN. OF NONPROFITS has sponsored the creation of one or more 401k plans.
| Measure | Date | Value |
|---|
| 2022 : CAN BENEFIT TRUST II 2022 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2022-06-30 | $-41,424 |
| Total unrealized appreciation/depreciation of assets | 2022-06-30 | $-41,424 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-06-30 | $192,056 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-06-30 | $238,878 |
| Total income from all sources (including contributions) | 2022-06-30 | $6,601,951 |
| Total of all expenses incurred | 2022-06-30 | $7,421,360 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-06-30 | $6,138,818 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-06-30 | $6,633,475 |
| Value of total assets at end of year | 2022-06-30 | $1,670,508 |
| Value of total assets at beginning of year | 2022-06-30 | $2,536,739 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-06-30 | $1,282,542 |
| Total interest from all sources | 2022-06-30 | $9,900 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-06-30 | No |
| Administrative expenses professional fees incurred | 2022-06-30 | $63,588 |
| Was this plan covered by a fidelity bond | 2022-06-30 | Yes |
| Value of fidelity bond cover | 2022-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2022-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2022-06-30 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-06-30 | $16,239 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-06-30 | $16,888 |
| Administrative expenses (other) incurred | 2022-06-30 | $184,998 |
| Liabilities. Value of operating payables at end of year | 2022-06-30 | $192,056 |
| Liabilities. Value of operating payables at beginning of year | 2022-06-30 | $238,878 |
| Total non interest bearing cash at end of year | 2022-06-30 | $131,038 |
| Total non interest bearing cash at beginning of year | 2022-06-30 | $11,299 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-06-30 | No |
| Value of net income/loss | 2022-06-30 | $-819,409 |
| Value of net assets at end of year (total assets less liabilities) | 2022-06-30 | $1,478,452 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-06-30 | $2,297,861 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-06-30 | No |
| Investment advisory and management fees | 2022-06-30 | $607,410 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-06-30 | $1,492,806 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-06-30 | $2,282,346 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-06-30 | $2,282,346 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-06-30 | $9,900 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-06-30 | $6,138,818 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2022-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-06-30 | No |
| Contributions received in cash from employer | 2022-06-30 | $6,633,475 |
| Employer contributions (assets) at end of year | 2022-06-30 | $30,425 |
| Employer contributions (assets) at beginning of year | 2022-06-30 | $41,206 |
| Contract administrator fees | 2022-06-30 | $426,546 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2022-06-30 | No |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2022-06-30 | $0 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2022-06-30 | $185,000 |
| Did the plan have assets held for investment | 2022-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2022-06-30 | Unqualified |
| Accountancy firm name | 2022-06-30 | CAMPBELL TAYLOR WASHBURN |
| Accountancy firm EIN | 2022-06-30 | 680251243 |
| 2021 : CAN BENEFIT TRUST II 2021 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2021-06-30 | $-40,891 |
| Total unrealized appreciation/depreciation of assets | 2021-06-30 | $-40,891 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-06-30 | $238,878 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-06-30 | $126,628 |
| Total income from all sources (including contributions) | 2021-06-30 | $6,321,196 |
| Total of all expenses incurred | 2021-06-30 | $6,849,954 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-06-30 | $5,883,521 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-06-30 | $6,317,255 |
| Value of total assets at end of year | 2021-06-30 | $2,536,739 |
| Value of total assets at beginning of year | 2021-06-30 | $2,953,247 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-06-30 | $966,433 |
| Total interest from all sources | 2021-06-30 | $44,832 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-06-30 | No |
| Administrative expenses professional fees incurred | 2021-06-30 | $56,851 |
| Was this plan covered by a fidelity bond | 2021-06-30 | Yes |
| Value of fidelity bond cover | 2021-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2021-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2021-06-30 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-06-30 | $16,888 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-06-30 | $25,743 |
| Liabilities. Value of operating payables at end of year | 2021-06-30 | $238,878 |
| Liabilities. Value of operating payables at beginning of year | 2021-06-30 | $126,628 |
| Total non interest bearing cash at end of year | 2021-06-30 | $11,299 |
| Total non interest bearing cash at beginning of year | 2021-06-30 | $53,535 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-06-30 | No |
| Value of net income/loss | 2021-06-30 | $-528,758 |
| Value of net assets at end of year (total assets less liabilities) | 2021-06-30 | $2,297,861 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-06-30 | $2,826,619 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-06-30 | No |
| Investment advisory and management fees | 2021-06-30 | $563,654 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-06-30 | $2,282,346 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-06-30 | $2,817,592 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-06-30 | $2,817,592 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-06-30 | $44,832 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-06-30 | $5,883,521 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2021-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-06-30 | No |
| Contributions received in cash from employer | 2021-06-30 | $6,317,255 |
| Employer contributions (assets) at end of year | 2021-06-30 | $41,206 |
| Employer contributions (assets) at beginning of year | 2021-06-30 | $56,377 |
| Contract administrator fees | 2021-06-30 | $345,928 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2021-06-30 | No |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2021-06-30 | $185,000 |
| Did the plan have assets held for investment | 2021-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2021-06-30 | Unqualified |
| Accountancy firm name | 2021-06-30 | CAMPBELL TAYLOR WASHBURN |
| Accountancy firm EIN | 2021-06-30 | 680251243 |
| 2020 : CAN BENEFIT TRUST II 2020 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2020-06-30 | $36,802 |
| Total unrealized appreciation/depreciation of assets | 2020-06-30 | $36,802 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-06-30 | $126,628 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-06-30 | $127,837 |
| Total income from all sources (including contributions) | 2020-06-30 | $6,299,428 |
| Total of all expenses incurred | 2020-06-30 | $6,578,693 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-06-30 | $5,844,553 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-06-30 | $6,197,122 |
| Value of total assets at end of year | 2020-06-30 | $2,953,247 |
| Value of total assets at beginning of year | 2020-06-30 | $3,233,721 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-06-30 | $734,140 |
| Total interest from all sources | 2020-06-30 | $65,504 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-06-30 | No |
| Administrative expenses professional fees incurred | 2020-06-30 | $37,276 |
| Was this plan covered by a fidelity bond | 2020-06-30 | Yes |
| Value of fidelity bond cover | 2020-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2020-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-06-30 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-06-30 | $25,743 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-06-30 | $29,126 |
| Liabilities. Value of operating payables at end of year | 2020-06-30 | $126,628 |
| Liabilities. Value of operating payables at beginning of year | 2020-06-30 | $127,837 |
| Total non interest bearing cash at end of year | 2020-06-30 | $53,535 |
| Total non interest bearing cash at beginning of year | 2020-06-30 | $117,123 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-06-30 | No |
| Value of net income/loss | 2020-06-30 | $-279,265 |
| Value of net assets at end of year (total assets less liabilities) | 2020-06-30 | $2,826,619 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-06-30 | $3,105,884 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-06-30 | No |
| Investment advisory and management fees | 2020-06-30 | $456,244 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-06-30 | $2,817,592 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-06-30 | $3,040,133 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-06-30 | $3,040,133 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-06-30 | $65,504 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-06-30 | $5,844,553 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2020-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-06-30 | No |
| Contributions received in cash from employer | 2020-06-30 | $6,197,122 |
| Employer contributions (assets) at end of year | 2020-06-30 | $56,377 |
| Employer contributions (assets) at beginning of year | 2020-06-30 | $47,339 |
| Contract administrator fees | 2020-06-30 | $240,620 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2020-06-30 | No |
| Did the plan have assets held for investment | 2020-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2020-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2020-06-30 | Unqualified |
| Accountancy firm name | 2020-06-30 | CAMPBELL TAYLOR WASHBURN |
| Accountancy firm EIN | 2020-06-30 | 680251243 |
| 2019 : CAN BENEFIT TRUST II 2019 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-06-30 | $28,724 |
| Total unrealized appreciation/depreciation of assets | 2019-06-30 | $28,724 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-06-30 | $127,837 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-06-30 | $420,589 |
| Total income from all sources (including contributions) | 2019-06-30 | $6,406,050 |
| Total of all expenses incurred | 2019-06-30 | $6,784,274 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-06-30 | $6,037,570 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-06-30 | $6,314,166 |
| Value of total assets at end of year | 2019-06-30 | $3,233,721 |
| Value of total assets at beginning of year | 2019-06-30 | $3,904,697 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-06-30 | $746,704 |
| Total interest from all sources | 2019-06-30 | $63,160 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-06-30 | No |
| Administrative expenses professional fees incurred | 2019-06-30 | $33,681 |
| Was this plan covered by a fidelity bond | 2019-06-30 | Yes |
| Value of fidelity bond cover | 2019-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2019-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-06-30 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-06-30 | $29,126 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-06-30 | $30,617 |
| Liabilities. Value of operating payables at end of year | 2019-06-30 | $127,837 |
| Liabilities. Value of operating payables at beginning of year | 2019-06-30 | $341,682 |
| Total non interest bearing cash at end of year | 2019-06-30 | $117,123 |
| Total non interest bearing cash at beginning of year | 2019-06-30 | $109,007 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-06-30 | No |
| Value of net income/loss | 2019-06-30 | $-378,224 |
| Value of net assets at end of year (total assets less liabilities) | 2019-06-30 | $3,105,884 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-06-30 | $3,484,108 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-06-30 | No |
| Investment advisory and management fees | 2019-06-30 | $459,583 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-06-30 | $3,040,133 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-06-30 | $3,725,007 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-06-30 | $3,725,007 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-06-30 | $63,160 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-06-30 | $6,037,570 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2019-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-06-30 | No |
| Contributions received in cash from employer | 2019-06-30 | $6,314,166 |
| Employer contributions (assets) at end of year | 2019-06-30 | $47,339 |
| Employer contributions (assets) at beginning of year | 2019-06-30 | $35,446 |
| Contract administrator fees | 2019-06-30 | $253,440 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2019-06-30 | No |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-06-30 | $78,907 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2019-06-30 | $4,620 |
| Did the plan have assets held for investment | 2019-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-06-30 | Unqualified |
| Accountancy firm name | 2019-06-30 | CAMPBELL TAYLOR WASHBURN |
| Accountancy firm EIN | 2019-06-30 | 680251243 |
| 2018 : CAN BENEFIT TRUST II 2018 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2018-06-30 | $-17,156 |
| Total unrealized appreciation/depreciation of assets | 2018-06-30 | $-17,156 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-06-30 | $420,589 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-06-30 | $532,595 |
| Total income from all sources (including contributions) | 2018-06-30 | $6,283,109 |
| Total of all expenses incurred | 2018-06-30 | $7,192,475 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-06-30 | $6,230,354 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-06-30 | $6,242,306 |
| Value of total assets at end of year | 2018-06-30 | $3,904,697 |
| Value of total assets at beginning of year | 2018-06-30 | $4,926,069 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-06-30 | $962,121 |
| Total interest from all sources | 2018-06-30 | $57,959 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-06-30 | No |
| Administrative expenses professional fees incurred | 2018-06-30 | $19,516 |
| Was this plan covered by a fidelity bond | 2018-06-30 | Yes |
| Value of fidelity bond cover | 2018-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2018-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-06-30 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-06-30 | $35,237 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-06-30 | $236,624 |
| Liabilities. Value of operating payables at end of year | 2018-06-30 | $341,682 |
| Liabilities. Value of operating payables at beginning of year | 2018-06-30 | $272,373 |
| Total non interest bearing cash at end of year | 2018-06-30 | $109,007 |
| Total non interest bearing cash at beginning of year | 2018-06-30 | $327,653 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-06-30 | No |
| Value of net income/loss | 2018-06-30 | $-909,366 |
| Value of net assets at end of year (total assets less liabilities) | 2018-06-30 | $3,484,108 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-06-30 | $4,393,474 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-06-30 | No |
| Investment advisory and management fees | 2018-06-30 | $450,319 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-06-30 | $3,725,007 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-06-30 | $4,190,807 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-06-30 | $4,190,807 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-06-30 | $57,959 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-06-30 | $6,230,354 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2018-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-06-30 | No |
| Contributions received in cash from employer | 2018-06-30 | $6,242,306 |
| Employer contributions (assets) at end of year | 2018-06-30 | $35,446 |
| Employer contributions (assets) at beginning of year | 2018-06-30 | $170,985 |
| Contract administrator fees | 2018-06-30 | $492,286 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2018-06-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2018-06-30 | $78,907 |
| Liabilities. Value of benefit claims payable at beginning of year | 2018-06-30 | $260,222 |
| Did the plan have assets held for investment | 2018-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-06-30 | Unqualified |
| Accountancy firm name | 2018-06-30 | CAMPBELL TAYLOR & COMPANY |
| Accountancy firm EIN | 2018-06-30 | 680251243 |
| 2017 : CAN BENEFIT TRUST II 2017 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2017-06-30 | $-12,390 |
| Total unrealized appreciation/depreciation of assets | 2017-06-30 | $-12,390 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-06-30 | $532,595 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-06-30 | $510,442 |
| Total income from all sources (including contributions) | 2017-06-30 | $6,770,455 |
| Total of all expenses incurred | 2017-06-30 | $6,504,519 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-06-30 | $5,267,714 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-06-30 | $6,742,998 |
| Value of total assets at end of year | 2017-06-30 | $4,926,069 |
| Value of total assets at beginning of year | 2017-06-30 | $4,637,980 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-06-30 | $1,236,805 |
| Total interest from all sources | 2017-06-30 | $39,847 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-06-30 | No |
| Administrative expenses professional fees incurred | 2017-06-30 | $13,875 |
| Was this plan covered by a fidelity bond | 2017-06-30 | Yes |
| Value of fidelity bond cover | 2017-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2017-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-06-30 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-06-30 | $236,624 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-06-30 | $902,320 |
| Liabilities. Value of operating payables at end of year | 2017-06-30 | $272,373 |
| Liabilities. Value of operating payables at beginning of year | 2017-06-30 | $150,358 |
| Total non interest bearing cash at end of year | 2017-06-30 | $327,653 |
| Total non interest bearing cash at beginning of year | 2017-06-30 | $37,059 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-06-30 | No |
| Value of net income/loss | 2017-06-30 | $265,936 |
| Value of net assets at end of year (total assets less liabilities) | 2017-06-30 | $4,393,474 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-06-30 | $4,127,538 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-06-30 | No |
| Investment advisory and management fees | 2017-06-30 | $123,605 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-06-30 | $4,190,807 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-06-30 | $3,567,733 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-06-30 | $3,567,733 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-06-30 | $39,847 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-06-30 | $5,267,714 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2017-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-06-30 | No |
| Contributions received in cash from employer | 2017-06-30 | $6,742,998 |
| Employer contributions (assets) at end of year | 2017-06-30 | $170,985 |
| Employer contributions (assets) at beginning of year | 2017-06-30 | $130,868 |
| Contract administrator fees | 2017-06-30 | $1,099,325 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2017-06-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2017-06-30 | $260,222 |
| Liabilities. Value of benefit claims payable at beginning of year | 2017-06-30 | $360,084 |
| Did the plan have assets held for investment | 2017-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-06-30 | Unqualified |
| Accountancy firm name | 2017-06-30 | CAMPBELL TAYLOR & COMPANY |
| Accountancy firm EIN | 2017-06-30 | 680251243 |
| 2016 : CAN BENEFIT TRUST II 2016 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2016-06-30 | $6,885 |
| Total unrealized appreciation/depreciation of assets | 2016-06-30 | $6,885 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-06-30 | $510,442 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-06-30 | $1,056,396 |
| Total income from all sources (including contributions) | 2016-06-30 | $6,477,659 |
| Total of all expenses incurred | 2016-06-30 | $6,012,229 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-06-30 | $4,844,203 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-06-30 | $6,441,652 |
| Value of total assets at end of year | 2016-06-30 | $4,637,980 |
| Value of total assets at beginning of year | 2016-06-30 | $4,718,504 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-06-30 | $1,168,026 |
| Total interest from all sources | 2016-06-30 | $29,122 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-06-30 | No |
| Administrative expenses professional fees incurred | 2016-06-30 | $13,000 |
| Was this plan covered by a fidelity bond | 2016-06-30 | Yes |
| Value of fidelity bond cover | 2016-06-30 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2016-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-06-30 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-06-30 | $902,320 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-06-30 | $1,366,415 |
| Administrative expenses (other) incurred | 2016-06-30 | $48,018 |
| Liabilities. Value of operating payables at end of year | 2016-06-30 | $150,358 |
| Liabilities. Value of operating payables at beginning of year | 2016-06-30 | $606,061 |
| Total non interest bearing cash at end of year | 2016-06-30 | $37,059 |
| Total non interest bearing cash at beginning of year | 2016-06-30 | $142,806 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-06-30 | No |
| Value of net income/loss | 2016-06-30 | $465,430 |
| Value of net assets at end of year (total assets less liabilities) | 2016-06-30 | $4,127,538 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-06-30 | $3,662,108 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-06-30 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-06-30 | $3,567,733 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-06-30 | $3,134,604 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-06-30 | $3,134,604 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-06-30 | $29,122 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-06-30 | $4,844,203 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2016-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-06-30 | No |
| Contributions received in cash from employer | 2016-06-30 | $6,441,652 |
| Employer contributions (assets) at end of year | 2016-06-30 | $130,868 |
| Employer contributions (assets) at beginning of year | 2016-06-30 | $74,679 |
| Contract administrator fees | 2016-06-30 | $1,107,008 |
| Liabilities. Value of benefit claims payable at end of year | 2016-06-30 | $360,084 |
| Liabilities. Value of benefit claims payable at beginning of year | 2016-06-30 | $450,335 |
| Did the plan have assets held for investment | 2016-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-06-30 | No |
| Aggregate proceeds on sale of assets | 2016-06-30 | $1,365,000 |
| Aggregate carrying amount (costs) on sale of assets | 2016-06-30 | $1,365,000 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-06-30 | Unqualified |
| Accountancy firm name | 2016-06-30 | JOHN J. TEUTEBERG, CPA |
| Accountancy firm EIN | 2016-06-30 | 770142495 |
| 2015 : CAN BENEFIT TRUST II 2015 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2015-06-30 | $2,668 |
| Total unrealized appreciation/depreciation of assets | 2015-06-30 | $2,668 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-06-30 | $1,056,396 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-06-30 | $1,523,686 |
| Total income from all sources (including contributions) | 2015-06-30 | $6,394,978 |
| Total of all expenses incurred | 2015-06-30 | $6,067,700 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-06-30 | $4,913,506 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-06-30 | $6,373,362 |
| Value of total assets at end of year | 2015-06-30 | $4,718,504 |
| Value of total assets at beginning of year | 2015-06-30 | $4,858,516 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-06-30 | $1,154,194 |
| Total interest from all sources | 2015-06-30 | $18,948 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-06-30 | No |
| Administrative expenses professional fees incurred | 2015-06-30 | $12,500 |
| Was this plan covered by a fidelity bond | 2015-06-30 | Yes |
| Value of fidelity bond cover | 2015-06-30 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2015-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-06-30 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-06-30 | $1,366,415 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-06-30 | $1,562,157 |
| Administrative expenses (other) incurred | 2015-06-30 | $61,372 |
| Liabilities. Value of operating payables at end of year | 2015-06-30 | $606,061 |
| Liabilities. Value of operating payables at beginning of year | 2015-06-30 | $1,106,030 |
| Total non interest bearing cash at end of year | 2015-06-30 | $142,806 |
| Total non interest bearing cash at beginning of year | 2015-06-30 | $161,615 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-06-30 | No |
| Value of net income/loss | 2015-06-30 | $327,278 |
| Value of net assets at end of year (total assets less liabilities) | 2015-06-30 | $3,662,108 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-06-30 | $3,334,830 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-06-30 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-06-30 | $3,134,604 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-06-30 | $3,013,180 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-06-30 | $3,013,180 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-06-30 | $18,948 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-06-30 | $4,913,506 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2015-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-06-30 | No |
| Contributions received in cash from employer | 2015-06-30 | $6,373,362 |
| Employer contributions (assets) at end of year | 2015-06-30 | $74,679 |
| Employer contributions (assets) at beginning of year | 2015-06-30 | $121,564 |
| Contract administrator fees | 2015-06-30 | $1,080,322 |
| Liabilities. Value of benefit claims payable at end of year | 2015-06-30 | $450,335 |
| Liabilities. Value of benefit claims payable at beginning of year | 2015-06-30 | $417,656 |
| Did the plan have assets held for investment | 2015-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-06-30 | Unqualified |
| Accountancy firm name | 2015-06-30 | JOHN J. TEUTEBERG, CPA |
| Accountancy firm EIN | 2015-06-30 | 770142495 |
| 2014 : CAN BENEFIT TRUST II 2014 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2014-06-30 | $222 |
| Total unrealized appreciation/depreciation of assets | 2014-06-30 | $222 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-06-30 | $1,523,686 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-06-30 | $1,341,589 |
| Total income from all sources (including contributions) | 2014-06-30 | $6,363,086 |
| Total of all expenses incurred | 2014-06-30 | $5,950,624 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-06-30 | $4,840,768 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-06-30 | $6,344,356 |
| Value of total assets at end of year | 2014-06-30 | $4,858,516 |
| Value of total assets at beginning of year | 2014-06-30 | $4,263,957 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-06-30 | $1,109,856 |
| Total interest from all sources | 2014-06-30 | $18,508 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-06-30 | No |
| Administrative expenses professional fees incurred | 2014-06-30 | $13,500 |
| Was this plan covered by a fidelity bond | 2014-06-30 | Yes |
| Value of fidelity bond cover | 2014-06-30 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2014-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-06-30 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-06-30 | $1,562,157 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-06-30 | $1,506,306 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2014-06-30 | $4,134 |
| Administrative expenses (other) incurred | 2014-06-30 | $25,527 |
| Liabilities. Value of operating payables at end of year | 2014-06-30 | $1,106,030 |
| Liabilities. Value of operating payables at beginning of year | 2014-06-30 | $921,766 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-06-30 | No |
| Value of net income/loss | 2014-06-30 | $412,462 |
| Value of net assets at end of year (total assets less liabilities) | 2014-06-30 | $3,334,830 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-06-30 | $2,922,368 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-06-30 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-06-30 | $3,174,795 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-06-30 | $2,681,199 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-06-30 | $2,681,199 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-06-30 | $18,508 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-06-30 | $4,840,768 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2014-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-06-30 | No |
| Contributions received in cash from employer | 2014-06-30 | $6,344,356 |
| Employer contributions (assets) at end of year | 2014-06-30 | $121,564 |
| Employer contributions (assets) at beginning of year | 2014-06-30 | $76,452 |
| Contract administrator fees | 2014-06-30 | $1,070,829 |
| Liabilities. Value of benefit claims payable at end of year | 2014-06-30 | $417,656 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-06-30 | $415,689 |
| Did the plan have assets held for investment | 2014-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-06-30 | Unqualified |
| Accountancy firm name | 2014-06-30 | JOHN J. TEUTEBERG, CPA |
| Accountancy firm EIN | 2014-06-30 | 770142495 |
| 2013 : CAN BENEFIT TRUST II 2013 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2013-06-30 | $-1,182 |
| Total unrealized appreciation/depreciation of assets | 2013-06-30 | $-1,182 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-06-30 | $1,341,589 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-06-30 | $1,150,440 |
| Total income from all sources (including contributions) | 2013-06-30 | $6,107,893 |
| Total of all expenses incurred | 2013-06-30 | $5,957,173 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-06-30 | $4,838,410 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-06-30 | $6,094,631 |
| Value of total assets at end of year | 2013-06-30 | $4,263,957 |
| Value of total assets at beginning of year | 2013-06-30 | $3,922,088 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-06-30 | $1,118,763 |
| Total interest from all sources | 2013-06-30 | $14,444 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-06-30 | No |
| Administrative expenses professional fees incurred | 2013-06-30 | $12,975 |
| Was this plan covered by a fidelity bond | 2013-06-30 | Yes |
| Value of fidelity bond cover | 2013-06-30 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2013-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-06-30 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-06-30 | $1,506,306 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-06-30 | $1,369,304 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2013-06-30 | $4,134 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2013-06-30 | $3,834 |
| Administrative expenses (other) incurred | 2013-06-30 | $65,087 |
| Liabilities. Value of operating payables at end of year | 2013-06-30 | $921,766 |
| Liabilities. Value of operating payables at beginning of year | 2013-06-30 | $749,149 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-06-30 | No |
| Value of net income/loss | 2013-06-30 | $150,720 |
| Value of net assets at end of year (total assets less liabilities) | 2013-06-30 | $2,922,368 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-06-30 | $2,771,648 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-06-30 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-06-30 | $2,681,199 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-06-30 | $2,472,209 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-06-30 | $2,472,209 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-06-30 | $14,444 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-06-30 | $4,838,410 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2013-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-06-30 | No |
| Contributions received in cash from employer | 2013-06-30 | $6,094,631 |
| Employer contributions (assets) at end of year | 2013-06-30 | $76,452 |
| Employer contributions (assets) at beginning of year | 2013-06-30 | $80,575 |
| Contract administrator fees | 2013-06-30 | $1,040,701 |
| Liabilities. Value of benefit claims payable at end of year | 2013-06-30 | $415,689 |
| Liabilities. Value of benefit claims payable at beginning of year | 2013-06-30 | $397,457 |
| Did the plan have assets held for investment | 2013-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-06-30 | Unqualified |
| Accountancy firm name | 2013-06-30 | JOHN J. TEUTEBERG, CPA |
| Accountancy firm EIN | 2013-06-30 | 770142495 |
| 2012 : CAN BENEFIT TRUST II 2012 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2012-06-30 | $5,188 |
| Total unrealized appreciation/depreciation of assets | 2012-06-30 | $5,188 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-06-30 | $1,150,440 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-06-30 | $979,388 |
| Total income from all sources (including contributions) | 2012-06-30 | $5,969,901 |
| Total of all expenses incurred | 2012-06-30 | $5,913,344 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-06-30 | $4,835,273 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-06-30 | $5,945,396 |
| Value of total assets at end of year | 2012-06-30 | $3,922,088 |
| Value of total assets at beginning of year | 2012-06-30 | $3,694,479 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-06-30 | $1,078,071 |
| Total interest from all sources | 2012-06-30 | $19,317 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-06-30 | No |
| Administrative expenses professional fees incurred | 2012-06-30 | $12,350 |
| Was this plan covered by a fidelity bond | 2012-06-30 | Yes |
| Value of fidelity bond cover | 2012-06-30 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2012-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-06-30 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-06-30 | $1,369,304 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-06-30 | $1,098,466 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2012-06-30 | $3,834 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2012-06-30 | $3,834 |
| Administrative expenses (other) incurred | 2012-06-30 | $40,038 |
| Liabilities. Value of operating payables at end of year | 2012-06-30 | $749,149 |
| Liabilities. Value of operating payables at beginning of year | 2012-06-30 | $584,831 |
| Total non interest bearing cash at beginning of year | 2012-06-30 | $122,711 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-06-30 | No |
| Value of net income/loss | 2012-06-30 | $56,557 |
| Value of net assets at end of year (total assets less liabilities) | 2012-06-30 | $2,771,648 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-06-30 | $2,715,091 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-06-30 | No |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-06-30 | $135,954 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-06-30 | $35,126 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-06-30 | $35,126 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-06-30 | $19,317 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-06-30 | $4,835,273 |
| Asset value of US Government securities at beginning of year | 2012-06-30 | $40,000 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2012-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-06-30 | No |
| Contributions received in cash from employer | 2012-06-30 | $5,945,396 |
| Employer contributions (assets) at end of year | 2012-06-30 | $80,575 |
| Employer contributions (assets) at beginning of year | 2012-06-30 | $76,637 |
| Asset. Corporate debt instrument debt (other) at end of year | 2012-06-30 | $2,336,255 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2012-06-30 | $2,319,622 |
| Contract administrator fees | 2012-06-30 | $1,025,683 |
| Liabilities. Value of benefit claims payable at end of year | 2012-06-30 | $397,457 |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-06-30 | $390,723 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2012-06-30 | $1,917 |
| Did the plan have assets held for investment | 2012-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-06-30 | Unqualified |
| Accountancy firm name | 2012-06-30 | JOHN J. TEUTEBERG, CPA |
| Accountancy firm EIN | 2012-06-30 | 770142495 |
| 2011 : CAN BENEFIT TRUST II 2011 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-06-30 | $979,388 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-06-30 | $811,796 |
| Total income from all sources (including contributions) | 2011-06-30 | $5,953,068 |
| Total of all expenses incurred | 2011-06-30 | $5,852,973 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-06-30 | $4,788,369 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-06-30 | $5,919,739 |
| Value of total assets at end of year | 2011-06-30 | $3,694,479 |
| Value of total assets at beginning of year | 2011-06-30 | $3,426,792 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-06-30 | $1,064,604 |
| Total interest from all sources | 2011-06-30 | $33,329 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-06-30 | No |
| Administrative expenses professional fees incurred | 2011-06-30 | $11,956 |
| Was this plan covered by a fidelity bond | 2011-06-30 | Yes |
| Value of fidelity bond cover | 2011-06-30 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2011-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-06-30 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-06-30 | $1,098,466 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-06-30 | $1,067,204 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2011-06-30 | $3,834 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2011-06-30 | $3,834 |
| Administrative expenses (other) incurred | 2011-06-30 | $32,798 |
| Liabilities. Value of operating payables at end of year | 2011-06-30 | $584,831 |
| Liabilities. Value of operating payables at beginning of year | 2011-06-30 | $450,999 |
| Total non interest bearing cash at end of year | 2011-06-30 | $122,711 |
| Total non interest bearing cash at beginning of year | 2011-06-30 | $13,564 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-06-30 | No |
| Value of net income/loss | 2011-06-30 | $100,095 |
| Value of net assets at end of year (total assets less liabilities) | 2011-06-30 | $2,715,091 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-06-30 | $2,614,996 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-06-30 | No |
| Income. Interest from US Government securities | 2011-06-30 | $50 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-06-30 | $35,126 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-06-30 | $77,550 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-06-30 | $77,550 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-06-30 | $33,279 |
| Asset value of US Government securities at end of year | 2011-06-30 | $40,000 |
| Asset value of US Government securities at beginning of year | 2011-06-30 | $40,000 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-06-30 | No |
| Was there a failure to transmit to the plan any participant contributions | 2011-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-06-30 | No |
| Contributions received in cash from employer | 2011-06-30 | $5,919,739 |
| Employer contributions (assets) at end of year | 2011-06-30 | $76,637 |
| Employer contributions (assets) at beginning of year | 2011-06-30 | $72,072 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-06-30 | $4,788,369 |
| Asset. Corporate debt instrument debt (other) at end of year | 2011-06-30 | $2,319,622 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2011-06-30 | $2,149,902 |
| Contract administrator fees | 2011-06-30 | $1,019,850 |
| Liabilities. Value of benefit claims payable at end of year | 2011-06-30 | $390,723 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-06-30 | $356,963 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2011-06-30 | $1,917 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2011-06-30 | $6,500 |
| Did the plan have assets held for investment | 2011-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-06-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-06-30 | Unqualified |
| Accountancy firm name | 2011-06-30 | JOHN J. TEUTEBERG, CPA |
| Accountancy firm EIN | 2011-06-30 | 770142495 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18688 |
| Policy instance | 6 |
| Insurance contract or identification number | 18688 | | Number of Individuals Covered | 4532 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18692 |
| Policy instance | 10 |
| Insurance contract or identification number | 18692 | | Number of Individuals Covered | 632 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18691 |
| Policy instance | 9 |
| Insurance contract or identification number | 18691 | | Number of Individuals Covered | 788 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18690 |
| Policy instance | 8 |
| Insurance contract or identification number | 18690 | | Number of Individuals Covered | 106 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18689 |
| Policy instance | 7 |
| Insurance contract or identification number | 18689 | | Number of Individuals Covered | 1754 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18687 |
| Policy instance | 5 |
| Insurance contract or identification number | 18687 | | Number of Individuals Covered | 916 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18686 |
| Policy instance | 4 |
| Insurance contract or identification number | 18686 | | Number of Individuals Covered | 285 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18685 |
| Policy instance | 3 |
| Insurance contract or identification number | 18685 | | Number of Individuals Covered | 1682 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ALPHA DENTAL OF ARIZONA, INC. (National Association of Insurance Commissioners NAIC id number: 95366 ) |
| Policy contract number | 78764 |
| Policy instance | 2 |
| Insurance contract or identification number | 78764 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | 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 number | 30071595 |
| Policy instance | 1 |
| Insurance contract or identification number | 30071595 | | Number of Individuals Covered | 6067 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18693 |
| Policy instance | 11 |
| Insurance contract or identification number | 18693 | | Number of Individuals Covered | 584 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18694 |
| Policy instance | 12 |
| Insurance contract or identification number | 18694 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18697 |
| Policy instance | 21 |
| Insurance contract or identification number | 18697 | | Number of Individuals Covered | 44 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18696 |
| Policy instance | 20 |
| Insurance contract or identification number | 18696 | | Number of Individuals Covered | 34 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18703 |
| Policy instance | 19 |
| Insurance contract or identification number | 18703 | | Number of Individuals Covered | 38 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18700 |
| Policy instance | 18 |
| Insurance contract or identification number | 18700 | | Number of Individuals Covered | 148 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18699 |
| Policy instance | 17 |
| Insurance contract or identification number | 18699 | | Number of Individuals Covered | 141 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 78664 |
| Policy instance | 22 |
| Insurance contract or identification number | 78664 | | Number of Individuals Covered | 268 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18702 |
| Policy instance | 16 |
| Insurance contract or identification number | 18702 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18701 |
| Policy instance | 15 |
| Insurance contract or identification number | 18701 | | Number of Individuals Covered | 143 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18698 |
| Policy instance | 14 |
| Insurance contract or identification number | 18698 | | Number of Individuals Covered | 80 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18695 |
| Policy instance | 13 |
| Insurance contract or identification number | 18695 | | Number of Individuals Covered | 23 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18688 |
| Policy instance | 6 |
| Insurance contract or identification number | 18688 | | Number of Individuals Covered | 4501 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18689 |
| Policy instance | 7 |
| Insurance contract or identification number | 18689 | | Number of Individuals Covered | 1296 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18690 |
| Policy instance | 8 |
| Insurance contract or identification number | 18690 | | Number of Individuals Covered | 82 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18691 |
| Policy instance | 9 |
| Insurance contract or identification number | 18691 | | Number of Individuals Covered | 770 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18700 |
| Policy instance | 18 |
| Insurance contract or identification number | 18700 | | Number of Individuals Covered | 149 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18687 |
| Policy instance | 5 |
| Insurance contract or identification number | 18687 | | Number of Individuals Covered | 873 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18686 |
| Policy instance | 4 |
| Insurance contract or identification number | 18686 | | Number of Individuals Covered | 234 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18685 |
| Policy instance | 3 |
| Insurance contract or identification number | 18685 | | Number of Individuals Covered | 1528 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 78674 |
| Policy instance | 2 |
| Insurance contract or identification number | 78674 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | 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 number | 30071595 |
| Policy instance | 1 |
| Insurance contract or identification number | 30071595 | | Number of Individuals Covered | 5381 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18693 |
| Policy instance | 11 |
| Insurance contract or identification number | 18693 | | Number of Individuals Covered | 611 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18694 |
| Policy instance | 12 |
| Insurance contract or identification number | 18694 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18692 |
| Policy instance | 10 |
| Insurance contract or identification number | 18692 | | Number of Individuals Covered | 704 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 78664 |
| Policy instance | 22 |
| Insurance contract or identification number | 78664 | | Number of Individuals Covered | 178 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18697 |
| Policy instance | 21 |
| Insurance contract or identification number | 18697 | | Number of Individuals Covered | 49 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18696 |
| Policy instance | 20 |
| Insurance contract or identification number | 18696 | | Number of Individuals Covered | 35 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18703 |
| Policy instance | 19 |
| Insurance contract or identification number | 18703 | | Number of Individuals Covered | 47 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18699 |
| Policy instance | 17 |
| Insurance contract or identification number | 18699 | | Number of Individuals Covered | 142 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18702 |
| Policy instance | 16 |
| Insurance contract or identification number | 18702 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18701 |
| Policy instance | 15 |
| Insurance contract or identification number | 18701 | | Number of Individuals Covered | 140 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18698 |
| Policy instance | 14 |
| Insurance contract or identification number | 18698 | | Number of Individuals Covered | 82 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18695 |
| Policy instance | 13 |
| Insurance contract or identification number | 18695 | | Number of Individuals Covered | 15 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18693 |
| Policy instance | 11 |
| Insurance contract or identification number | 18693 | | Number of Individuals Covered | 838 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18692 |
| Policy instance | 10 |
| Insurance contract or identification number | 18692 | | Number of Individuals Covered | 1026 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18691 |
| Policy instance | 9 |
| Insurance contract or identification number | 18691 | | Number of Individuals Covered | 851 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18690 |
| Policy instance | 8 |
| Insurance contract or identification number | 18690 | | Number of Individuals Covered | 82 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18689 |
| Policy instance | 7 |
| Insurance contract or identification number | 18689 | | Number of Individuals Covered | 697 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18688 |
| Policy instance | 6 |
| Insurance contract or identification number | 18688 | | Number of Individuals Covered | 4619 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18687 |
| Policy instance | 5 |
| Insurance contract or identification number | 18687 | | Number of Individuals Covered | 777 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18686 |
| Policy instance | 4 |
| Insurance contract or identification number | 18686 | | Number of Individuals Covered | 232 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18685 |
| Policy instance | 3 |
| Insurance contract or identification number | 18685 | | Number of Individuals Covered | 1508 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18694 |
| Policy instance | 12 |
| Insurance contract or identification number | 18694 | | Number of Individuals Covered | 15 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18695 |
| Policy instance | 13 |
| Insurance contract or identification number | 18695 | | Number of Individuals Covered | 20 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18698 |
| Policy instance | 14 |
| Insurance contract or identification number | 18698 | | Number of Individuals Covered | 99 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 78664 |
| Policy instance | 22 |
| Insurance contract or identification number | 78664 | | Number of Individuals Covered | 175 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18697 |
| Policy instance | 21 |
| Insurance contract or identification number | 18697 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18696 |
| Policy instance | 20 |
| Insurance contract or identification number | 18696 | | Number of Individuals Covered | 38 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18703 |
| Policy instance | 19 |
| Insurance contract or identification number | 18703 | | Number of Individuals Covered | 48 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18700 |
| Policy instance | 18 |
| Insurance contract or identification number | 18700 | | Number of Individuals Covered | 159 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18699 |
| Policy instance | 17 |
| Insurance contract or identification number | 18699 | | Number of Individuals Covered | 130 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | 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 number | 30071595 |
| Policy instance | 1 |
| Insurance contract or identification number | 30071595 | | Number of Individuals Covered | 5233 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18702 |
| Policy instance | 16 |
| Insurance contract or identification number | 18702 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18701 |
| Policy instance | 15 |
| Insurance contract or identification number | 18701 | | Number of Individuals Covered | 144 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 78674 |
| Policy instance | 2 |
| Insurance contract or identification number | 78674 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | 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 number | 30071595 |
| Policy instance | 1 |
| Insurance contract or identification number | 30071595 | | Number of Individuals Covered | 2324 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18703 |
| Policy instance | 19 |
| Insurance contract or identification number | 18703 | | Number of Individuals Covered | 48 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18700 |
| Policy instance | 18 |
| Insurance contract or identification number | 18700 | | Number of Individuals Covered | 188 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18699 |
| Policy instance | 17 |
| Insurance contract or identification number | 18699 | | Number of Individuals Covered | 113 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | 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 number | 30071595 |
| Policy instance | 2 |
| Insurance contract or identification number | 30071595 | | Number of Individuals Covered | 4796 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18685 |
| Policy instance | 3 |
| Insurance contract or identification number | 18685 | | Number of Individuals Covered | 1498 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18686 |
| Policy instance | 4 |
| Insurance contract or identification number | 18686 | | Number of Individuals Covered | 360 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18687 |
| Policy instance | 5 |
| Insurance contract or identification number | 18687 | | Number of Individuals Covered | 932 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18688 |
| Policy instance | 6 |
| Insurance contract or identification number | 18688 | | Number of Individuals Covered | 5090 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18689 |
| Policy instance | 7 |
| Insurance contract or identification number | 18689 | | Number of Individuals Covered | 738 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18690 |
| Policy instance | 8 |
| Insurance contract or identification number | 18690 | | Number of Individuals Covered | 75 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18691 |
| Policy instance | 9 |
| Insurance contract or identification number | 18691 | | Number of Individuals Covered | 595 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18692 |
| Policy instance | 10 |
| Insurance contract or identification number | 18692 | | Number of Individuals Covered | 1008 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18702 |
| Policy instance | 16 |
| Insurance contract or identification number | 18702 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18701 |
| Policy instance | 15 |
| Insurance contract or identification number | 18701 | | Number of Individuals Covered | 133 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18698 |
| Policy instance | 14 |
| Insurance contract or identification number | 18698 | | Number of Individuals Covered | 81 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18695 |
| Policy instance | 13 |
| Insurance contract or identification number | 18695 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18694 |
| Policy instance | 12 |
| Insurance contract or identification number | 18694 | | Number of Individuals Covered | 16 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18693 |
| Policy instance | 11 |
| Insurance contract or identification number | 18693 | | Number of Individuals Covered | 803 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18688 |
| Policy instance | 9 |
| Insurance contract or identification number | 18688 | | Number of Individuals Covered | 5224 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18687 |
| Policy instance | 8 |
| Insurance contract or identification number | 18687 | | Number of Individuals Covered | 915 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18686 |
| Policy instance | 7 |
| Insurance contract or identification number | 18686 | | Number of Individuals Covered | 398 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18685 |
| Policy instance | 6 |
| Insurance contract or identification number | 18685 | | Number of Individuals Covered | 1382 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4255 |
| Policy instance | 4 |
| Insurance contract or identification number | 4255 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | 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 number | 00103620 |
| Policy instance | 3 |
| Insurance contract or identification number | 00103620 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 327 |
| Policy instance | 2 |
| Insurance contract or identification number | 327 | | Number of Individuals Covered | 16 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4278 |
| Policy instance | 1 |
| Insurance contract or identification number | 4278 | | Number of Individuals Covered | 34 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | 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 number | 30071595 |
| Policy instance | 5 |
| Insurance contract or identification number | 30071595 | | Number of Individuals Covered | 5478 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18689 |
| Policy instance | 10 |
| Insurance contract or identification number | 18689 | | Number of Individuals Covered | 715 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18690 |
| Policy instance | 11 |
| Insurance contract or identification number | 18690 | | Number of Individuals Covered | 67 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18691 |
| Policy instance | 12 |
| Insurance contract or identification number | 18691 | | Number of Individuals Covered | 338 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 186700 |
| Policy instance | 21 |
| Insurance contract or identification number | 186700 | | Number of Individuals Covered | 158 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18699 |
| Policy instance | 20 |
| Insurance contract or identification number | 18699 | | Number of Individuals Covered | 61 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18702 |
| Policy instance | 19 |
| Insurance contract or identification number | 18702 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18701 |
| Policy instance | 18 |
| Insurance contract or identification number | 18701 | | Number of Individuals Covered | 133 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18698 |
| Policy instance | 17 |
| Insurance contract or identification number | 18698 | | Number of Individuals Covered | 52 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18695 |
| Policy instance | 16 |
| Insurance contract or identification number | 18695 | | Number of Individuals Covered | 61 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18694 |
| Policy instance | 15 |
| Insurance contract or identification number | 18694 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18693 |
| Policy instance | 14 |
| Insurance contract or identification number | 18693 | | Number of Individuals Covered | 1237 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 18692 |
| Policy instance | 13 |
| Insurance contract or identification number | 18692 | | Number of Individuals Covered | 1291 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4278 |
| Policy instance | 1 |
| Insurance contract or identification number | 4278 | | Number of Individuals Covered | 4802 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 16804 |
| Policy instance | 5 |
| Insurance contract or identification number | 16804 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4255 |
| Policy instance | 4 |
| Insurance contract or identification number | 4255 | | Number of Individuals Covered | 657 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Dental Insurance Welfare Benefit | Yes | | 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 number | 00103620 |
| Policy instance | 3 |
| Insurance contract or identification number | 00103620 | | Number of Individuals Covered | 4777 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 327 |
| Policy instance | 2 |
| Insurance contract or identification number | 327 | | Number of Individuals Covered | 2434 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 16805 |
| Policy instance | 6 |
| Insurance contract or identification number | 16805 | | Number of Individuals Covered | 205 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 327 |
| Policy instance | 2 |
| Insurance contract or identification number | 327 | | Number of Individuals Covered | 2135 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4255 |
| Policy instance | 4 |
| Insurance contract or identification number | 4255 | | Number of Individuals Covered | 614 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 16804 |
| Policy instance | 5 |
| Insurance contract or identification number | 16804 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 16805 |
| Policy instance | 6 |
| Insurance contract or identification number | 16805 | | Number of Individuals Covered | 100 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4278 |
| Policy instance | 1 |
| Insurance contract or identification number | 4278 | | Number of Individuals Covered | 4314 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Dental Insurance Welfare Benefit | Yes | | 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 number | 00103620 |
| Policy instance | 3 |
| Insurance contract or identification number | 00103620 | | Number of Individuals Covered | 4482 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 16805 |
| Policy instance | 6 |
| Insurance contract or identification number | 16805 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4255 |
| Policy instance | 4 |
| Insurance contract or identification number | 4255 | | Number of Individuals Covered | 631 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 16804 |
| Policy instance | 5 |
| Insurance contract or identification number | 16804 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Dental Insurance Welfare Benefit | Yes | | 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 number | 00103620 |
| Policy instance | 3 |
| Insurance contract or identification number | 00103620 | | Number of Individuals Covered | 4460 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 327 |
| Policy instance | 2 |
| Insurance contract or identification number | 327 | | Number of Individuals Covered | 1960 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4278 |
| Policy instance | 1 |
| Insurance contract or identification number | 4278 | | Number of Individuals Covered | 4513 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4278 |
| Policy instance | 1 |
| Insurance contract or identification number | 4278 | | Number of Individuals Covered | 4423 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 327 |
| Policy instance | 2 |
| Insurance contract or identification number | 327 | | Number of Individuals Covered | 2146 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Dental Insurance Welfare Benefit | Yes | | 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 number | 00103620 |
| Policy instance | 3 |
| Insurance contract or identification number | 00103620 | | Number of Individuals Covered | 4425 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4255 |
| Policy instance | 4 |
| Insurance contract or identification number | 4255 | | Number of Individuals Covered | 675 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4255 |
| Policy instance | 4 |
| Insurance contract or identification number | 4255 | | Number of Individuals Covered | 660 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Dental Insurance Welfare Benefit | Yes | | 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 number | 00103620 |
| Policy instance | 3 |
| Insurance contract or identification number | 00103620 | | Number of Individuals Covered | 4389 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 327 |
| Policy instance | 2 |
| Insurance contract or identification number | 327 | | Number of Individuals Covered | 2283 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4278 |
| Policy instance | 1 |
| Insurance contract or identification number | 4278 | | Number of Individuals Covered | 4165 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4278 |
| Policy instance | 1 |
| Insurance contract or identification number | 4278 | | Number of Individuals Covered | 4462 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Dental Insurance Welfare Benefit | Yes | | 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 number | 00103620 |
| Policy instance | 3 |
| Insurance contract or identification number | 00103620 | | Number of Individuals Covered | 3892 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4255 |
| Policy instance | 4 |
| Insurance contract or identification number | 4255 | | Number of Individuals Covered | 533 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 327 |
| Policy instance | 2 |
| Insurance contract or identification number | 327 | | Number of Individuals Covered | 2338 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
