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SAN MATEO ELECTRICAL WORKERS HEALTH PLAN 401k Plan overview

Plan NameSAN MATEO ELECTRICAL WORKERS HEALTH PLAN
Plan identification number 501

SAN MATEO ELECTRICAL WORKERS HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

BOARD OF TRUSTEES, SAN MATEO ELECTRICAL WORKERS HEALTH PLAN has sponsored the creation of one or more 401k plans.

Company Name:BOARD OF TRUSTEES, SAN MATEO ELECTRICAL WORKERS HEALTH PLAN
Employer identification number (EIN):902104422
NAIC Classification:238210
NAIC Description:Electrical Contractors and Other Wiring Installation Contractors

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SAN MATEO ELECTRICAL WORKERS HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-06-01SCOTT WEIN2023-03-09 WILLIAM KUHR2023-03-09

Plan Statistics for SAN MATEO ELECTRICAL WORKERS HEALTH PLAN

401k plan membership statisitcs for SAN MATEO ELECTRICAL WORKERS HEALTH PLAN

Measure Date Value
2021: SAN MATEO ELECTRICAL WORKERS HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-06-011,505
Total number of active participants reported on line 7a of the Form 55002021-06-011,076
Number of retired or separated participants receiving benefits2021-06-01342
Total of all active and inactive participants2021-06-011,418
Number of employers contributing to the scheme2021-06-01138

Financial Data on SAN MATEO ELECTRICAL WORKERS HEALTH PLAN

Measure Date Value
2022 : SAN MATEO ELECTRICAL WORKERS HEALTH PLAN 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-05-31$-4,318,418
Total unrealized appreciation/depreciation of assets2022-05-31$-4,318,418
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-05-31$21,031,211
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-05-31$24,118,098
Total income from all sources (including contributions)2022-05-31$30,869,928
Total loss/gain on sale of assets2022-05-31$-843,697
Total of all expenses incurred2022-05-31$32,463,166
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-05-31$30,922,063
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-05-31$33,386,702
Value of total assets at end of year2022-05-31$80,228,048
Value of total assets at beginning of year2022-05-31$84,908,173
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-05-31$1,541,103
Total interest from all sources2022-05-31$1,342,980
Total dividends received (eg from common stock, registered investment company shares)2022-05-31$389,008
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-05-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-05-31$389,008
Assets. Real estate other than employer real property at end of year2022-05-31$38,780
Assets. Real estate other than employer real property at beginning of year2022-05-31$38,780
Administrative expenses professional fees incurred2022-05-31$167,825
Was this plan covered by a fidelity bond2022-05-31Yes
Value of fidelity bond cover2022-05-31$500,000
If this is an individual account plan, was there a blackout period2022-05-31No
Were there any nonexempt tranactions with any party-in-interest2022-05-31No
Contributions received from participants2022-05-31$797,286
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-05-31$469,563
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-05-31$3,120,981
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-05-31$1,316,820
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-05-31$1,883,492
Other income not declared elsewhere2022-05-31$913,353
Administrative expenses (other) incurred2022-05-31$632,254
Liabilities. Value of operating payables at end of year2022-05-31$162,039
Liabilities. Value of operating payables at beginning of year2022-05-31$107,925
Total non interest bearing cash at end of year2022-05-31$1,838,051
Total non interest bearing cash at beginning of year2022-05-31$1,689,362
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-05-31No
Value of net income/loss2022-05-31$-1,593,238
Value of net assets at end of year (total assets less liabilities)2022-05-31$59,196,837
Value of net assets at beginning of year (total assets less liabilities)2022-05-31$60,790,075
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-05-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-05-31No
Were any leases to which the plan was party in default or uncollectible2022-05-31No
Investment advisory and management fees2022-05-31$223,075
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-05-31$7,747,239
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-05-31$8,103,107
Interest earned on other investments2022-05-31$71,353
Income. Interest from US Government securities2022-05-31$751,393
Income. Interest from corporate debt instruments2022-05-31$501,509
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-05-31$13,787,841
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-05-31$11,777,372
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-05-31$11,777,372
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-05-31$18,725
Expenses. Payments to insurance carriers foe the provision of benefits2022-05-31$12,082,742
Asset value of US Government securities at end of year2022-05-31$34,172,035
Asset value of US Government securities at beginning of year2022-05-31$37,084,885
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-05-31Yes
Was there a failure to transmit to the plan any participant contributions2022-05-31No
Has the plan failed to provide any benefit when due under the plan2022-05-31No
Contributions received in cash from employer2022-05-31$32,589,416
Employer contributions (assets) at end of year2022-05-31$3,470,176
Employer contributions (assets) at beginning of year2022-05-31$4,329,282
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-05-31$18,839,321
Asset. Corporate debt instrument preferred debt at end of year2022-05-31$15,108,840
Asset. Corporate debt instrument preferred debt at beginning of year2022-05-31$17,978,000
Asset. Corporate debt instrument debt (other) at end of year2022-05-31$3,563,674
Asset. Corporate debt instrument debt (other) at beginning of year2022-05-31$728,365
Contract administrator fees2022-05-31$517,949
Liabilities. Value of benefit claims payable at end of year2022-05-31$19,552,352
Liabilities. Value of benefit claims payable at beginning of year2022-05-31$22,126,681
Assets. Value of buildings and other operty used in plan operation at end of year2022-05-31$31,849
Assets. Value of buildings and other operty used in plan operation at beginning of year2022-05-31$58,039
Did the plan have assets held for investment2022-05-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-05-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-05-31No
Aggregate proceeds on sale of assets2022-05-31$65,027,045
Aggregate carrying amount (costs) on sale of assets2022-05-31$65,870,742
Opinion of an independent qualified public accountant for this plan2022-05-31Unqualified
Accountancy firm name2022-05-31INEICH & COMPANY, LLP
Accountancy firm EIN2022-05-31562552172

Form 5500 Responses for SAN MATEO ELECTRICAL WORKERS HEALTH PLAN

2021: SAN MATEO ELECTRICAL WORKERS HEALTH PLAN 2021 form 5500 responses
2021-06-01Type of plan entityMulti-employer plan
2021-06-01Submission has been amendedNo
2021-06-01This submission is the final filingNo
2021-06-01This return/report is a short plan year return/report (less than 12 months)No
2021-06-01Plan is a collectively bargained planYes
2021-06-01Plan funding arrangement – TrustYes
2021-06-01Plan benefit arrangement – InsuranceYes
2021-06-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number277955
Policy instance 1
Insurance contract or identification number277955
Number of Individuals Covered829
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $174,399
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 number2776
Policy instance 2
Insurance contract or identification number2776
Number of Individuals Covered1282
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
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 $2,103,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number8972
Policy instance 3
Insurance contract or identification number8972
Number of Individuals Covered333
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $5,572,725
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED BEHAVIORAL HEALTH DBA OPTUM (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number15508
Policy instance 4
Insurance contract or identification number15508
Number of Individuals Covered1082
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
Other welfare benefits providedBEHAVIORAL HEALTH & EMPLOYEE ASSISTANCE PROGRAM
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 $53,844
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number722499-EXRSK
Policy instance 5
Insurance contract or identification number722499-EXRSK
Number of Individuals Covered859
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
Other welfare benefits providedEXCESS LOSS
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 $2,412,154
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 number12059939
Policy instance 6
Insurance contract or identification number12059939
Number of Individuals Covered963
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
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 $130,126
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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