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QUESTAR CORPORATION UMBRELLA HEALTH PLAN 401k Plan overview

Plan NameQUESTAR CORPORATION UMBRELLA HEALTH PLAN
Plan identification number 501

QUESTAR CORPORATION UMBRELLA HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision

401k Sponsoring company profile

QUESTAR CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:QUESTAR CORPORATION
Employer identification number (EIN):870407509
NAIC Classification:551112
NAIC Description:Offices of Other Holding Companies

Form 5500 Filing Information

Submission information for form 5500 for 401k plan QUESTAR CORPORATION UMBRELLA HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012017-01-01JASON HATCHER JOSHUA BLAKENEY2018-10-15
5012016-01-01JOSHUA BLAKENEY DAVE CURTIS2017-10-16
5012015-01-01CRAIG C. WAGSTAFF DAVID M. CURTIS2016-10-12
5012014-01-01RONALD W. JIBSON, PRESIDENT CEO KEVIN W. HADLOCK, EXEC. VP CFO2015-10-05
5012013-01-01RONALD JIBSON KEVIN HADLOCK2014-10-02
5012012-01-01RONALD JIBSON KEVIN HADLOCK2013-10-14
5012011-01-01RONALD JIBSON KEVIN HADLOCK2012-10-12
5012010-01-01RONALD JIBSON KEVIN HADLOCK2011-10-12
5012009-01-01RONALD JIBSON MARTIN CRAVEN2010-10-13

Plan Statistics for QUESTAR CORPORATION UMBRELLA HEALTH PLAN

401k plan membership statisitcs for QUESTAR CORPORATION UMBRELLA HEALTH PLAN

Measure Date Value
2017: QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-012,661
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-010
2016: QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-012,690
Total number of active participants reported on line 7a of the Form 55002016-01-011,673
Number of retired or separated participants receiving benefits2016-01-018
Number of other retired or separated participants entitled to future benefits2016-01-01980
Total of all active and inactive participants2016-01-012,661
2015: QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-012,567
Total number of active participants reported on line 7a of the Form 55002015-01-011,737
Number of retired or separated participants receiving benefits2015-01-01797
Number of other retired or separated participants entitled to future benefits2015-01-0133
Total of all active and inactive participants2015-01-012,567
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-01151
2014: QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-012,588
Total number of active participants reported on line 7a of the Form 55002014-01-011,733
Number of retired or separated participants receiving benefits2014-01-01764
Number of other retired or separated participants entitled to future benefits2014-01-0170
Total of all active and inactive participants2014-01-012,567
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-01155
2013: QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-012,601
Total number of active participants reported on line 7a of the Form 55002013-01-011,709
Number of retired or separated participants receiving benefits2013-01-01789
Number of other retired or separated participants entitled to future benefits2013-01-0190
Total of all active and inactive participants2013-01-012,588
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-01160
2012: QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-012,698
Total number of active participants reported on line 7a of the Form 55002012-01-011,720
Number of retired or separated participants receiving benefits2012-01-01764
Number of other retired or separated participants entitled to future benefits2012-01-01117
Total of all active and inactive participants2012-01-012,601
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-01162
Total participants2012-01-012,763
2011: QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-012,909
Total number of active participants reported on line 7a of the Form 55002011-01-011,712
Number of retired or separated participants receiving benefits2011-01-01785
Number of other retired or separated participants entitled to future benefits2011-01-01201
Total of all active and inactive participants2011-01-012,698
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-01174
Total participants2011-01-012,872
2010: QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-013,698
Total number of active participants reported on line 7a of the Form 55002010-01-011,689
Number of retired or separated participants receiving benefits2010-01-01826
Number of other retired or separated participants entitled to future benefits2010-01-01207
Total of all active and inactive participants2010-01-012,722
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-01187
Total participants2010-01-012,909
2009: QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-013,742
Total number of active participants reported on line 7a of the Form 55002009-01-012,451
Number of retired or separated participants receiving benefits2009-01-01856
Number of other retired or separated participants entitled to future benefits2009-01-01213
Total of all active and inactive participants2009-01-013,520
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-01178

Financial Data on QUESTAR CORPORATION UMBRELLA HEALTH PLAN

Measure Date Value
2017 : QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total transfer of assets from this plan2017-12-31$1,665,734
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$4,561,904
Total income from all sources (including contributions)2017-12-31$25,092,623
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$22,193,859
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$20,765,968
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$25,067,116
Value of total assets at end of year2017-12-31$0
Value of total assets at beginning of year2017-12-31$3,328,874
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$1,427,891
Total interest from all sources2017-12-31$25,507
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31Yes
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$50,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$7,770,883
Total non interest bearing cash at end of year2017-12-31$0
Total non interest bearing cash at beginning of year2017-12-31$841,591
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$2,898,764
Value of net assets at end of year (total assets less liabilities)2017-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$-1,233,030
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$2,487,283
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$2,487,283
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$25,507
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$488,887
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31Yes
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$17,296,233
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$20,277,081
Contract administrator fees2017-12-31$1,427,891
Liabilities. Value of benefit claims payable at end of year2017-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$4,561,904
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31GRANT THORNTON LLP
Accountancy firm EIN2017-12-31366055558
2016 : QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total transfer of assets to this plan2016-12-31$4,296,502
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$4,561,904
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$4,227,666
Total income from all sources (including contributions)2016-12-31$30,586,936
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$33,530,288
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$32,455,705
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$30,579,679
Value of total assets at end of year2016-12-31$3,328,874
Value of total assets at beginning of year2016-12-31$1,641,486
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$1,074,583
Total interest from all sources2016-12-31$7,257
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$20,000,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$8,310,078
Administrative expenses (other) incurred2016-12-31$5,368
Total non interest bearing cash at end of year2016-12-31$841,591
Total non interest bearing cash at beginning of year2016-12-31$998,356
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-2,943,352
Value of net assets at end of year (total assets less liabilities)2016-12-31$-1,233,030
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$-2,586,180
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$2,487,283
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$643,130
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$643,130
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$7,257
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$3,514,759
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31Yes
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$22,269,601
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$28,940,946
Contract administrator fees2016-12-31$1,069,215
Liabilities. Value of benefit claims payable at end of year2016-12-31$4,561,904
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$4,227,666
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31GRANT THORNTON LLP
Accountancy firm EIN2016-12-31366055558
2015 : QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total transfer of assets to this plan2015-12-31$1,374,655
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$4,227,666
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$5,544,940
Total income from all sources (including contributions)2015-12-31$29,538,939
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$28,704,081
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$27,577,953
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$29,538,047
Value of total assets at end of year2015-12-31$1,641,486
Value of total assets at beginning of year2015-12-31$749,247
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$1,126,128
Total interest from all sources2015-12-31$892
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$20,000,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$7,491,861
Administrative expenses (other) incurred2015-12-31$4,609
Total non interest bearing cash at end of year2015-12-31$998,356
Total non interest bearing cash at beginning of year2015-12-31$325,783
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$834,858
Value of net assets at end of year (total assets less liabilities)2015-12-31$-2,586,180
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$-4,795,693
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$643,130
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$423,464
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$423,464
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$892
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$3,627,999
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31Yes
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$22,046,186
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$23,949,954
Contract administrator fees2015-12-31$1,121,519
Liabilities. Value of benefit claims payable at end of year2015-12-31$4,227,666
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$5,544,940
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31GRANT THORNTON LLP
Accountancy firm EIN2015-12-31366055558
2014 : QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total transfer of assets to this plan2014-12-31$1,409,048
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$5,544,940
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$3,813,717
Total income from all sources (including contributions)2014-12-31$25,754,527
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$29,343,568
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$28,163,083
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$25,754,068
Value of total assets at end of year2014-12-31$749,247
Value of total assets at beginning of year2014-12-31$1,198,017
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$1,180,485
Total interest from all sources2014-12-31$459
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$20,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$7,480,169
Administrative expenses (other) incurred2014-12-31$3,763
Total non interest bearing cash at end of year2014-12-31$325,783
Total non interest bearing cash at beginning of year2014-12-31$90,686
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-3,589,041
Value of net assets at end of year (total assets less liabilities)2014-12-31$-4,795,693
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$-2,615,700
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$423,464
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$1,107,331
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$1,107,331
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$459
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$3,898,899
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$18,273,899
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$24,264,184
Contract administrator fees2014-12-31$1,176,722
Liabilities. Value of benefit claims payable at end of year2014-12-31$5,544,940
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$3,813,717
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31GRANT THORNTON LLP
Accountancy firm EIN2014-12-31366055558
2013 : QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total transfer of assets to this plan2013-12-31$1,434,009
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$3,813,717
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$3,288,604
Total income from all sources (including contributions)2013-12-31$21,099,961
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$23,176,304
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$22,026,183
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$21,099,115
Value of total assets at end of year2013-12-31$1,198,017
Value of total assets at beginning of year2013-12-31$1,315,238
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$1,150,121
Total interest from all sources2013-12-31$846
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$20,000,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$7,516,890
Administrative expenses (other) incurred2013-12-31$5,465
Total non interest bearing cash at end of year2013-12-31$90,686
Total non interest bearing cash at beginning of year2013-12-31$232,287
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-2,076,343
Value of net assets at end of year (total assets less liabilities)2013-12-31$-2,615,700
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$-1,973,366
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$1,107,331
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$1,082,951
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$1,082,951
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$846
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$3,826,984
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31Yes
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$13,582,225
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$18,199,199
Contract administrator fees2013-12-31$1,144,656
Liabilities. Value of benefit claims payable at end of year2013-12-31$3,813,717
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$3,288,604
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31GRANT THORNTON LLP
Accountancy firm EIN2013-12-31366055558
2012 : QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total transfer of assets to this plan2012-12-31$2,560,365
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$3,288,604
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$2,422,512
Total income from all sources (including contributions)2012-12-31$18,193,487
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$22,770,348
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$21,599,689
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$18,190,398
Value of total assets at end of year2012-12-31$1,315,238
Value of total assets at beginning of year2012-12-31$2,465,642
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$1,170,659
Total interest from all sources2012-12-31$3,089
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$20,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$7,355,865
Administrative expenses (other) incurred2012-12-31$5,489
Total non interest bearing cash at end of year2012-12-31$232,287
Total non interest bearing cash at beginning of year2012-12-31$69,028
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-4,576,861
Value of net assets at end of year (total assets less liabilities)2012-12-31$-1,973,366
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$43,130
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$1,082,951
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$2,396,614
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$2,396,614
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$3,089
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$4,055,155
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31Yes
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$10,834,533
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$17,544,534
Contract administrator fees2012-12-31$1,165,170
Liabilities. Value of benefit claims payable at end of year2012-12-31$3,288,604
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$2,422,512
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31ERNST & YOUNG, LLP
Accountancy firm EIN2012-12-31346565596
2011 : QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2011 401k financial data
Total transfer of assets to this plan2011-12-31$6,970,285
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$2,422,512
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$2,183,002
Total income from all sources (including contributions)2011-12-31$20,702,029
Total of all expenses incurred2011-12-31$26,458,787
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$24,930,699
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$20,699,369
Value of total assets at end of year2011-12-31$2,465,642
Value of total assets at beginning of year2011-12-31$1,012,605
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$1,528,088
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$20,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$7,622,237
Administrative expenses (other) incurred2011-12-31$7,924
Total non interest bearing cash at end of year2011-12-31$69,028
Total non interest bearing cash at beginning of year2011-12-31$10,571
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-5,756,758
Value of net assets at end of year (total assets less liabilities)2011-12-31$43,130
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$-1,170,397
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$2,396,614
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$1,002,034
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$1,002,034
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$245,242
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$2,660
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$13,077,132
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$24,685,457
Contract administrator fees2011-12-31$1,520,164
Liabilities. Value of benefit claims payable at end of year2011-12-31$2,422,512
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$2,183,002
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31ERNST & YOUNG, LLP
Accountancy firm EIN2011-12-31346565596
2010 : QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2010 401k financial data
Total transfer of assets to this plan2010-12-31$4,090,802
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$2,183,002
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$1,922,000
Total income from all sources (including contributions)2010-12-31$19,905,503
Total of all expenses incurred2010-12-31$26,399,345
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$24,659,225
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$19,902,594
Value of total assets at end of year2010-12-31$1,012,605
Value of total assets at beginning of year2010-12-31$3,154,643
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$1,740,120
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$20,000,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$7,470,077
Administrative expenses (other) incurred2010-12-31$5,129
Total non interest bearing cash at end of year2010-12-31$10,571
Total non interest bearing cash at beginning of year2010-12-31$132,970
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-6,493,842
Value of net assets at end of year (total assets less liabilities)2010-12-31$-1,170,397
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$1,232,643
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$1,002,034
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$3,021,673
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$3,021,673
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$299,605
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$2,909
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$12,432,517
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$24,359,620
Contract administrator fees2010-12-31$1,734,991
Liabilities. Value of benefit claims payable at end of year2010-12-31$2,183,002
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$1,922,000
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31ERNST & YOUNG
Accountancy firm EIN2010-12-31346565596

Form 5500 Responses for QUESTAR CORPORATION UMBRELLA HEALTH PLAN

2017: QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingYes
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: QUESTAR CORPORATION UMBRELLA HEALTH PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number247654
Policy instance 1
Insurance contract or identification number247654
Number of Individuals Covered0
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $48,839
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $488,391
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $48,839
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE INC.
REGENCE BLUECROSS BLUESHIELD OF UTAH (National Association of Insurance Commissioners NAIC id number: 54550 )
Policy contract number40000331
Policy instance 2
Insurance contract or identification number40000331
Number of Individuals Covered1046
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $107,976
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,840,160
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $107,976
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number839552
Policy instance 1
Insurance contract or identification number839552
Number of Individuals Covered1788
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $574,167
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
REGENCE BLUECROSS BLUESHIELD OF UTAH (National Association of Insurance Commissioners NAIC id number: 54550 )
Policy contract number40000331
Policy instance 3
Insurance contract or identification number40000331
Number of Individuals Covered1026
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $82,648
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,824,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $82,648
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-007003-000
Policy instance 2
Insurance contract or identification number16-007003-000
Number of Individuals Covered1754
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $619,939
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number839552
Policy instance 1
Insurance contract or identification number839552
Number of Individuals Covered1780
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $39,780
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
REGENCE BLUECROSS BLUESHIELD OF UTAH (National Association of Insurance Commissioners NAIC id number: 54550 )
Policy contract number40000331
Policy instance 3
Insurance contract or identification number40000331
Number of Individuals Covered1039
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $99,384
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,829,876
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $99,384
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number839552
Policy instance 2
Insurance contract or identification number839552
Number of Individuals Covered1762
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $52,103
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-007003-000
Policy instance 1
Insurance contract or identification number16-007003-000
Number of Individuals Covered1765
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $686
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $753,740
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees686
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS LLC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract numberR4143
Policy instance 4
Insurance contract or identification numberR4143
Number of Individuals Covered271
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $160,050
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $160,050
Insurance broker organization code?4
Insurance broker nameMERCER HEALTH & BENEFITS LLC
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16007003000
Policy instance 3
Insurance contract or identification number16007003000
Number of Individuals Covered1750
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,460
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $651,502
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees1783
Additional information about fees paid to insurance brokerADMINISTRATIVE FEE
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number839552
Policy instance 2
Insurance contract or identification number839552
Number of Individuals Covered3379
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $53,025
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract numberR4152
Policy instance 1
Insurance contract or identification numberR4152
Number of Individuals Covered760
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 )
Policy contract number011390
Policy instance 1
Insurance contract or identification number011390
Number of Individuals Covered4391
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $11,835,055
SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 )
Policy contract number011390
Policy instance 1
Insurance contract or identification number011390
Number of Individuals Covered4273
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $10,740,619

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