BOARD OF TRUSTEES, MACHINISTS HEALTH & WELFARE TRUST has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan MACHINISTS HEALTH & WELFARE TRUST FUND
| Measure | Date | Value |
|---|
| 2022 : MACHINISTS HEALTH & WELFARE TRUST FUND 2022 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2022-07-31 | $-1,540,142 |
| Total unrealized appreciation/depreciation of assets | 2022-07-31 | $-1,540,142 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-07-31 | $3,322,632 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-07-31 | $1,886,169 |
| Total income from all sources (including contributions) | 2022-07-31 | $22,448,170 |
| Total loss/gain on sale of assets | 2022-07-31 | $-74,277 |
| Total of all expenses incurred | 2022-07-31 | $25,335,424 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-07-31 | $23,673,595 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-07-31 | $25,839,781 |
| Value of total assets at end of year | 2022-07-31 | $51,192,295 |
| Value of total assets at beginning of year | 2022-07-31 | $52,643,086 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-07-31 | $1,661,829 |
| Total interest from all sources | 2022-07-31 | $368,892 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-07-31 | $735,575 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-07-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2022-07-31 | $728,682 |
| Administrative expenses professional fees incurred | 2022-07-31 | $279,747 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2022-07-31 | $109,320 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2022-07-31 | $110,880 |
| Was this plan covered by a fidelity bond | 2022-07-31 | Yes |
| Value of fidelity bond cover | 2022-07-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2022-07-31 | No |
| Contributions received from participants | 2022-07-31 | $433,190 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2022-07-31 | $20,710,367 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-07-31 | $1,238,400 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-07-31 | $833,798 |
| Other income not declared elsewhere | 2022-07-31 | $45,753 |
| Administrative expenses (other) incurred | 2022-07-31 | $61,064 |
| Liabilities. Value of operating payables at end of year | 2022-07-31 | $55,436 |
| Liabilities. Value of operating payables at beginning of year | 2022-07-31 | $55,497 |
| Total non interest bearing cash at end of year | 2022-07-31 | $2,350,642 |
| Total non interest bearing cash at beginning of year | 2022-07-31 | $127,001 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-07-31 | No |
| Value of net income/loss | 2022-07-31 | $-2,887,254 |
| Value of net assets at end of year (total assets less liabilities) | 2022-07-31 | $47,869,663 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-07-31 | $50,756,917 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-07-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-07-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-07-31 | No |
| Investment advisory and management fees | 2022-07-31 | $86,035 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-07-31 | $30,585,843 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-07-31 | $30,416,711 |
| Income. Interest from US Government securities | 2022-07-31 | $79,910 |
| Income. Interest from corporate debt instruments | 2022-07-31 | $285,671 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-07-31 | $632,010 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-07-31 | $5,372,333 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-07-31 | $5,372,333 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-07-31 | $3,311 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-07-31 | $2,963,228 |
| Asset value of US Government securities at end of year | 2022-07-31 | $7,741,951 |
| Asset value of US Government securities at beginning of year | 2022-07-31 | $6,767,884 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-07-31 | $-2,927,412 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-07-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2022-07-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-07-31 | No |
| Contributions received in cash from employer | 2022-07-31 | $25,406,591 |
| Employer contributions (assets) at end of year | 2022-07-31 | $2,130,412 |
| Employer contributions (assets) at beginning of year | 2022-07-31 | $2,128,309 |
| Income. Dividends from preferred stock | 2022-07-31 | $6,893 |
| Asset. Corporate debt instrument preferred debt at end of year | 2022-07-31 | $2,390,768 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2022-07-31 | $2,479,884 |
| Asset. Corporate debt instrument debt (other) at end of year | 2022-07-31 | $4,012,949 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2022-07-31 | $4,406,286 |
| Contract administrator fees | 2022-07-31 | $1,234,983 |
| Liabilities. Value of benefit claims payable at end of year | 2022-07-31 | $3,267,196 |
| Liabilities. Value of benefit claims payable at beginning of year | 2022-07-31 | $1,830,672 |
| Did the plan have assets held for investment | 2022-07-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-07-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-07-31 | No |
| Aggregate proceeds on sale of assets | 2022-07-31 | $3,680,575 |
| Aggregate carrying amount (costs) on sale of assets | 2022-07-31 | $3,754,852 |
| Opinion of an independent qualified public accountant for this plan | 2022-07-31 | Unqualified |
| Accountancy firm name | 2022-07-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2022-07-31 | 410746749 |
| 2021 : MACHINISTS HEALTH & WELFARE TRUST FUND 2021 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2021-07-31 | $-426,177 |
| Total unrealized appreciation/depreciation of assets | 2021-07-31 | $-426,177 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-07-31 | $1,886,169 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-07-31 | $2,765,025 |
| Total income from all sources (including contributions) | 2021-07-31 | $29,410,043 |
| Total loss/gain on sale of assets | 2021-07-31 | $296,030 |
| Total of all expenses incurred | 2021-07-31 | $23,531,371 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-07-31 | $21,720,083 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-07-31 | $26,787,952 |
| Value of total assets at end of year | 2021-07-31 | $52,643,086 |
| Value of total assets at beginning of year | 2021-07-31 | $47,643,270 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-07-31 | $1,811,288 |
| Total interest from all sources | 2021-07-31 | $375,468 |
| Total dividends received (eg from common stock, registered investment company shares) | 2021-07-31 | $515,434 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-07-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2021-07-31 | $515,434 |
| Administrative expenses professional fees incurred | 2021-07-31 | $290,767 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2021-07-31 | $110,880 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2021-07-31 | $108,000 |
| Was this plan covered by a fidelity bond | 2021-07-31 | Yes |
| Value of fidelity bond cover | 2021-07-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2021-07-31 | No |
| Contributions received from participants | 2021-07-31 | $422,508 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2021-07-31 | $18,690,872 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-07-31 | $833,798 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-07-31 | $141,952 |
| Other income not declared elsewhere | 2021-07-31 | $4,260 |
| Administrative expenses (other) incurred | 2021-07-31 | $43,522 |
| Liabilities. Value of operating payables at end of year | 2021-07-31 | $55,497 |
| Liabilities. Value of operating payables at beginning of year | 2021-07-31 | $30,909 |
| Total non interest bearing cash at end of year | 2021-07-31 | $127,001 |
| Total non interest bearing cash at beginning of year | 2021-07-31 | $454,085 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-07-31 | No |
| Value of net income/loss | 2021-07-31 | $5,878,672 |
| Value of net assets at end of year (total assets less liabilities) | 2021-07-31 | $50,756,917 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-07-31 | $44,878,245 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-07-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-07-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-07-31 | No |
| Investment advisory and management fees | 2021-07-31 | $79,349 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-07-31 | $30,416,711 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-07-31 | $26,404,201 |
| Interest earned on other investments | 2021-07-31 | $6,682 |
| Income. Interest from US Government securities | 2021-07-31 | $98,476 |
| Income. Interest from corporate debt instruments | 2021-07-31 | $269,023 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-07-31 | $5,372,333 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-07-31 | $6,059,205 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-07-31 | $6,059,205 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-07-31 | $1,287 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-07-31 | $3,029,211 |
| Asset value of US Government securities at end of year | 2021-07-31 | $6,767,884 |
| Asset value of US Government securities at beginning of year | 2021-07-31 | $5,460,057 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2021-07-31 | $1,857,076 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-07-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2021-07-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-07-31 | No |
| Contributions received in cash from employer | 2021-07-31 | $26,365,444 |
| Employer contributions (assets) at end of year | 2021-07-31 | $2,128,309 |
| Employer contributions (assets) at beginning of year | 2021-07-31 | $2,170,973 |
| Asset. Corporate debt instrument preferred debt at end of year | 2021-07-31 | $2,479,884 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2021-07-31 | $2,801,127 |
| Asset. Corporate debt instrument debt (other) at end of year | 2021-07-31 | $4,406,286 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2021-07-31 | $4,043,670 |
| Contract administrator fees | 2021-07-31 | $1,397,650 |
| Liabilities. Value of benefit claims payable at end of year | 2021-07-31 | $1,830,672 |
| Liabilities. Value of benefit claims payable at beginning of year | 2021-07-31 | $2,734,116 |
| Did the plan have assets held for investment | 2021-07-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-07-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-07-31 | No |
| Aggregate proceeds on sale of assets | 2021-07-31 | $12,914,324 |
| Aggregate carrying amount (costs) on sale of assets | 2021-07-31 | $12,618,294 |
| Opinion of an independent qualified public accountant for this plan | 2021-07-31 | Unqualified |
| Accountancy firm name | 2021-07-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2021-07-31 | 410746749 |
| 2020 : MACHINISTS HEALTH & WELFARE TRUST FUND 2020 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2020-07-31 | $604,036 |
| Total unrealized appreciation/depreciation of assets | 2020-07-31 | $604,036 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-07-31 | $2,765,025 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-07-31 | $2,649,430 |
| Total income from all sources (including contributions) | 2020-07-31 | $32,212,884 |
| Total loss/gain on sale of assets | 2020-07-31 | $42,345 |
| Total of all expenses incurred | 2020-07-31 | $23,774,398 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-07-31 | $21,943,120 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-07-31 | $29,334,439 |
| Value of total assets at end of year | 2020-07-31 | $47,643,270 |
| Value of total assets at beginning of year | 2020-07-31 | $39,089,189 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-07-31 | $1,831,278 |
| Total interest from all sources | 2020-07-31 | $406,809 |
| Total dividends received (eg from common stock, registered investment company shares) | 2020-07-31 | $612,887 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-07-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2020-07-31 | $612,887 |
| Administrative expenses professional fees incurred | 2020-07-31 | $292,021 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2020-07-31 | $108,000 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2020-07-31 | $108,800 |
| Was this plan covered by a fidelity bond | 2020-07-31 | Yes |
| Value of fidelity bond cover | 2020-07-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2020-07-31 | No |
| Contributions received from participants | 2020-07-31 | $459,671 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2020-07-31 | $18,997,249 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-07-31 | $141,952 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-07-31 | $109,787 |
| Other income not declared elsewhere | 2020-07-31 | $1,164 |
| Administrative expenses (other) incurred | 2020-07-31 | $70,612 |
| Liabilities. Value of operating payables at end of year | 2020-07-31 | $30,909 |
| Liabilities. Value of operating payables at beginning of year | 2020-07-31 | $55,538 |
| Total non interest bearing cash at end of year | 2020-07-31 | $454,085 |
| Total non interest bearing cash at beginning of year | 2020-07-31 | $365,199 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-07-31 | No |
| Value of net income/loss | 2020-07-31 | $8,438,486 |
| Value of net assets at end of year (total assets less liabilities) | 2020-07-31 | $44,878,245 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-07-31 | $36,439,759 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-07-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-07-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-07-31 | No |
| Investment advisory and management fees | 2020-07-31 | $65,964 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-07-31 | $26,404,201 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-07-31 | $20,148,032 |
| Interest earned on other investments | 2020-07-31 | $8,189 |
| Income. Interest from US Government securities | 2020-07-31 | $98,158 |
| Income. Interest from corporate debt instruments | 2020-07-31 | $207,516 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-07-31 | $6,059,205 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-07-31 | $6,750,410 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-07-31 | $6,750,410 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-07-31 | $92,946 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-07-31 | $2,945,871 |
| Asset value of US Government securities at end of year | 2020-07-31 | $5,460,057 |
| Asset value of US Government securities at beginning of year | 2020-07-31 | $4,963,641 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2020-07-31 | $1,211,204 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-07-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2020-07-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-07-31 | No |
| Contributions received in cash from employer | 2020-07-31 | $28,874,768 |
| Employer contributions (assets) at end of year | 2020-07-31 | $2,170,973 |
| Employer contributions (assets) at beginning of year | 2020-07-31 | $2,380,617 |
| Asset. Corporate debt instrument preferred debt at end of year | 2020-07-31 | $2,801,127 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2020-07-31 | $1,837,723 |
| Asset. Corporate debt instrument debt (other) at end of year | 2020-07-31 | $4,043,670 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2020-07-31 | $2,424,980 |
| Contract administrator fees | 2020-07-31 | $1,402,681 |
| Liabilities. Value of benefit claims payable at end of year | 2020-07-31 | $2,734,116 |
| Liabilities. Value of benefit claims payable at beginning of year | 2020-07-31 | $2,593,892 |
| Did the plan have assets held for investment | 2020-07-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-07-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-07-31 | No |
| Aggregate proceeds on sale of assets | 2020-07-31 | $42,266,422 |
| Aggregate carrying amount (costs) on sale of assets | 2020-07-31 | $42,224,077 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2020-07-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2020-07-31 | Unqualified |
| Accountancy firm name | 2020-07-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2020-07-31 | 410746749 |
| 2019 : MACHINISTS HEALTH & WELFARE TRUST FUND 2019 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-07-31 | $323,867 |
| Total unrealized appreciation/depreciation of assets | 2019-07-31 | $323,867 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-07-31 | $2,649,430 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-07-31 | $2,214,050 |
| Total income from all sources (including contributions) | 2019-07-31 | $32,323,998 |
| Total loss/gain on sale of assets | 2019-07-31 | $14,835 |
| Total of all expenses incurred | 2019-07-31 | $24,812,155 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-07-31 | $22,990,361 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-07-31 | $30,346,354 |
| Value of total assets at end of year | 2019-07-31 | $39,089,189 |
| Value of total assets at beginning of year | 2019-07-31 | $31,141,966 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-07-31 | $1,821,794 |
| Total interest from all sources | 2019-07-31 | $397,225 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-07-31 | $486,704 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-07-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2019-07-31 | $477,663 |
| Administrative expenses professional fees incurred | 2019-07-31 | $264,844 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2019-07-31 | $108,800 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2019-07-31 | $107,680 |
| Was this plan covered by a fidelity bond | 2019-07-31 | Yes |
| Value of fidelity bond cover | 2019-07-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2019-07-31 | No |
| Contributions received from participants | 2019-07-31 | $620,108 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2019-07-31 | $19,971,553 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-07-31 | $109,787 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-07-31 | $235,810 |
| Other income not declared elsewhere | 2019-07-31 | $30,785 |
| Administrative expenses (other) incurred | 2019-07-31 | $59,422 |
| Liabilities. Value of operating payables at end of year | 2019-07-31 | $55,538 |
| Liabilities. Value of operating payables at beginning of year | 2019-07-31 | $52,723 |
| Total non interest bearing cash at end of year | 2019-07-31 | $365,199 |
| Total non interest bearing cash at beginning of year | 2019-07-31 | $147,014 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-07-31 | No |
| Value of net income/loss | 2019-07-31 | $7,511,843 |
| Value of net assets at end of year (total assets less liabilities) | 2019-07-31 | $36,439,759 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-07-31 | $28,927,916 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-07-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-07-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-07-31 | No |
| Investment advisory and management fees | 2019-07-31 | $51,292 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-07-31 | $20,148,032 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-07-31 | $15,393,899 |
| Interest earned on other investments | 2019-07-31 | $4,239 |
| Income. Interest from US Government securities | 2019-07-31 | $61,504 |
| Income. Interest from corporate debt instruments | 2019-07-31 | $181,452 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-07-31 | $6,750,410 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-07-31 | $5,700,737 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-07-31 | $5,700,737 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-07-31 | $150,030 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-07-31 | $3,018,808 |
| Asset value of US Government securities at end of year | 2019-07-31 | $4,963,641 |
| Asset value of US Government securities at beginning of year | 2019-07-31 | $2,302,334 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2019-07-31 | $724,228 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-07-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2019-07-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-07-31 | No |
| Contributions received in cash from employer | 2019-07-31 | $29,726,246 |
| Employer contributions (assets) at end of year | 2019-07-31 | $2,380,617 |
| Employer contributions (assets) at beginning of year | 2019-07-31 | $2,578,583 |
| Income. Dividends from preferred stock | 2019-07-31 | $9,041 |
| Asset. Corporate debt instrument preferred debt at end of year | 2019-07-31 | $1,837,723 |
| Asset. Corporate debt instrument debt (other) at end of year | 2019-07-31 | $2,424,980 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2019-07-31 | $4,675,909 |
| Contract administrator fees | 2019-07-31 | $1,446,236 |
| Liabilities. Value of benefit claims payable at end of year | 2019-07-31 | $2,593,892 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-07-31 | $2,161,327 |
| Did the plan have assets held for investment | 2019-07-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-07-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-07-31 | No |
| Aggregate proceeds on sale of assets | 2019-07-31 | $41,017,578 |
| Aggregate carrying amount (costs) on sale of assets | 2019-07-31 | $41,002,743 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-07-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-07-31 | Unqualified |
| Accountancy firm name | 2019-07-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2019-07-31 | 410746749 |
| 2018 : MACHINISTS HEALTH & WELFARE TRUST FUND 2018 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2018-07-31 | $-173,176 |
| Total unrealized appreciation/depreciation of assets | 2018-07-31 | $-173,176 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-07-31 | $2,214,050 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-07-31 | $2,492,207 |
| Total income from all sources (including contributions) | 2018-07-31 | $31,239,982 |
| Total loss/gain on sale of assets | 2018-07-31 | $-22,152 |
| Total of all expenses incurred | 2018-07-31 | $26,462,346 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-07-31 | $24,551,172 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-07-31 | $30,744,242 |
| Value of total assets at end of year | 2018-07-31 | $31,141,966 |
| Value of total assets at beginning of year | 2018-07-31 | $26,642,487 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-07-31 | $1,911,174 |
| Total interest from all sources | 2018-07-31 | $265,926 |
| Total dividends received (eg from common stock, registered investment company shares) | 2018-07-31 | $317,332 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-07-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2018-07-31 | $309,170 |
| Administrative expenses professional fees incurred | 2018-07-31 | $80,397 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2018-07-31 | $107,680 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2018-07-31 | $109,240 |
| Was this plan covered by a fidelity bond | 2018-07-31 | Yes |
| Value of fidelity bond cover | 2018-07-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2018-07-31 | No |
| Contributions received from participants | 2018-07-31 | $625,857 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2018-07-31 | $21,191,258 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-07-31 | $235,810 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-07-31 | $658,172 |
| Other income not declared elsewhere | 2018-07-31 | $7,810 |
| Administrative expenses (other) incurred | 2018-07-31 | $55,047 |
| Liabilities. Value of operating payables at end of year | 2018-07-31 | $52,723 |
| Liabilities. Value of operating payables at beginning of year | 2018-07-31 | $60,480 |
| Total non interest bearing cash at end of year | 2018-07-31 | $147,014 |
| Total non interest bearing cash at beginning of year | 2018-07-31 | $513,536 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-07-31 | No |
| Value of net income/loss | 2018-07-31 | $4,777,636 |
| Value of net assets at end of year (total assets less liabilities) | 2018-07-31 | $28,927,916 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-07-31 | $24,150,280 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-07-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-07-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-07-31 | No |
| Investment advisory and management fees | 2018-07-31 | $44,895 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2018-07-31 | $15,393,899 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2018-07-31 | $11,135,024 |
| Interest earned on other investments | 2018-07-31 | $13,437 |
| Income. Interest from US Government securities | 2018-07-31 | $36,278 |
| Income. Interest from corporate debt instruments | 2018-07-31 | $136,936 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-07-31 | $5,700,737 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-07-31 | $6,642,476 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-07-31 | $6,642,476 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-07-31 | $79,275 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-07-31 | $3,359,914 |
| Asset value of US Government securities at end of year | 2018-07-31 | $2,302,334 |
| Asset value of US Government securities at beginning of year | 2018-07-31 | $1,633,435 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2018-07-31 | $100,000 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-07-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2018-07-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-07-31 | No |
| Contributions received in cash from employer | 2018-07-31 | $30,118,385 |
| Employer contributions (assets) at end of year | 2018-07-31 | $2,578,583 |
| Employer contributions (assets) at beginning of year | 2018-07-31 | $2,527,797 |
| Income. Dividends from preferred stock | 2018-07-31 | $8,162 |
| Asset. Corporate debt instrument debt (other) at end of year | 2018-07-31 | $4,675,909 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2018-07-31 | $3,422,807 |
| Contract administrator fees | 2018-07-31 | $1,730,835 |
| Liabilities. Value of benefit claims payable at end of year | 2018-07-31 | $2,161,327 |
| Liabilities. Value of benefit claims payable at beginning of year | 2018-07-31 | $2,431,727 |
| Did the plan have assets held for investment | 2018-07-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-07-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-07-31 | No |
| Aggregate proceeds on sale of assets | 2018-07-31 | $34,017,364 |
| Aggregate carrying amount (costs) on sale of assets | 2018-07-31 | $34,039,516 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-07-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-07-31 | Unqualified |
| Accountancy firm name | 2018-07-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2018-07-31 | 410746749 |
| 2017 : MACHINISTS HEALTH & WELFARE TRUST FUND 2017 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2017-07-31 | $-56,866 |
| Total unrealized appreciation/depreciation of assets | 2017-07-31 | $-56,866 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-07-31 | $2,492,207 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-07-31 | $3,218,189 |
| Total income from all sources (including contributions) | 2017-07-31 | $30,949,732 |
| Total loss/gain on sale of assets | 2017-07-31 | $-12,652 |
| Total of all expenses incurred | 2017-07-31 | $26,512,994 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-07-31 | $24,516,880 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-07-31 | $30,476,877 |
| Value of total assets at end of year | 2017-07-31 | $26,642,487 |
| Value of total assets at beginning of year | 2017-07-31 | $22,931,731 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-07-31 | $1,996,114 |
| Total interest from all sources | 2017-07-31 | $147,739 |
| Total dividends received (eg from common stock, registered investment company shares) | 2017-07-31 | $240,662 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-07-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2017-07-31 | $236,882 |
| Administrative expenses professional fees incurred | 2017-07-31 | $81,668 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2017-07-31 | $109,240 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2017-07-31 | $0 |
| Was this plan covered by a fidelity bond | 2017-07-31 | Yes |
| Value of fidelity bond cover | 2017-07-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2017-07-31 | No |
| Contributions received from participants | 2017-07-31 | $656,294 |
| Assets. Other investments not covered elsewhere at end of year | 2017-07-31 | $0 |
| Assets. Other investments not covered elsewhere at beginning of year | 2017-07-31 | $0 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2017-07-31 | $21,250,352 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-07-31 | $658,172 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-07-31 | $557,448 |
| Other income not declared elsewhere | 2017-07-31 | $11,248 |
| Administrative expenses (other) incurred | 2017-07-31 | $84,037 |
| Liabilities. Value of operating payables at end of year | 2017-07-31 | $60,480 |
| Liabilities. Value of operating payables at beginning of year | 2017-07-31 | $120,762 |
| Total non interest bearing cash at end of year | 2017-07-31 | $513,536 |
| Total non interest bearing cash at beginning of year | 2017-07-31 | $357,387 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-07-31 | No |
| Value of net income/loss | 2017-07-31 | $4,436,738 |
| Value of net assets at end of year (total assets less liabilities) | 2017-07-31 | $24,150,280 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-07-31 | $19,713,542 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-07-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-07-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-07-31 | No |
| Investment advisory and management fees | 2017-07-31 | $37,444 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2017-07-31 | $11,135,024 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2017-07-31 | $13,483,053 |
| Income. Interest from US Government securities | 2017-07-31 | $20,242 |
| Income. Interest from corporate debt instruments | 2017-07-31 | $97,382 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-07-31 | $6,642,476 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-07-31 | $5,558,388 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-07-31 | $5,558,388 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-07-31 | $30,115 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-07-31 | $3,266,528 |
| Asset value of US Government securities at end of year | 2017-07-31 | $1,633,435 |
| Asset value of US Government securities at beginning of year | 2017-07-31 | $0 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2017-07-31 | $142,724 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-07-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2017-07-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-07-31 | No |
| Contributions received in cash from employer | 2017-07-31 | $29,820,583 |
| Employer contributions (assets) at end of year | 2017-07-31 | $2,527,797 |
| Employer contributions (assets) at beginning of year | 2017-07-31 | $2,975,455 |
| Income. Dividends from preferred stock | 2017-07-31 | $3,780 |
| Asset. Corporate debt instrument preferred debt at end of year | 2017-07-31 | $1,140,788 |
| Asset. Corporate debt instrument debt (other) at end of year | 2017-07-31 | $2,282,019 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2017-07-31 | $0 |
| Contract administrator fees | 2017-07-31 | $1,792,965 |
| Liabilities. Value of benefit claims payable at end of year | 2017-07-31 | $2,431,727 |
| Liabilities. Value of benefit claims payable at beginning of year | 2017-07-31 | $3,097,427 |
| Did the plan have assets held for investment | 2017-07-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-07-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-07-31 | No |
| Aggregate proceeds on sale of assets | 2017-07-31 | $50,854,904 |
| Aggregate carrying amount (costs) on sale of assets | 2017-07-31 | $50,867,556 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-07-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-07-31 | Unqualified |
| Accountancy firm name | 2017-07-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2017-07-31 | 410746749 |
| 2016 : MACHINISTS HEALTH & WELFARE TRUST FUND 2016 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2016-07-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-07-31 | $3,218,189 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-07-31 | $2,557,694 |
| Total income from all sources (including contributions) | 2016-07-31 | $30,687,125 |
| Total loss/gain on sale of assets | 2016-07-31 | $0 |
| Total of all expenses incurred | 2016-07-31 | $27,696,341 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-07-31 | $25,550,540 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-07-31 | $30,344,662 |
| Value of total assets at end of year | 2016-07-31 | $22,931,731 |
| Value of total assets at beginning of year | 2016-07-31 | $19,280,452 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-07-31 | $2,145,801 |
| Total interest from all sources | 2016-07-31 | $8,375 |
| Total dividends received (eg from common stock, registered investment company shares) | 2016-07-31 | $813,430 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-07-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2016-07-31 | $813,430 |
| Administrative expenses professional fees incurred | 2016-07-31 | $135,937 |
| Was this plan covered by a fidelity bond | 2016-07-31 | Yes |
| Value of fidelity bond cover | 2016-07-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2016-07-31 | No |
| Contributions received from participants | 2016-07-31 | $671,958 |
| Assets. Other investments not covered elsewhere at end of year | 2016-07-31 | $0 |
| Assets. Other investments not covered elsewhere at beginning of year | 2016-07-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-07-31 | $557,448 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-07-31 | $907,544 |
| Other income not declared elsewhere | 2016-07-31 | $5,357 |
| Administrative expenses (other) incurred | 2016-07-31 | $179,515 |
| Liabilities. Value of operating payables at end of year | 2016-07-31 | $120,762 |
| Liabilities. Value of operating payables at beginning of year | 2016-07-31 | $149,249 |
| Total non interest bearing cash at end of year | 2016-07-31 | $357,387 |
| Total non interest bearing cash at beginning of year | 2016-07-31 | $413,414 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-07-31 | No |
| Value of net income/loss | 2016-07-31 | $2,990,784 |
| Value of net assets at end of year (total assets less liabilities) | 2016-07-31 | $19,713,542 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-07-31 | $16,722,758 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-07-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-07-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-07-31 | No |
| Investment advisory and management fees | 2016-07-31 | $17,045 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2016-07-31 | $13,483,053 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2016-07-31 | $13,154,336 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-07-31 | $5,558,388 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-07-31 | $2,349,961 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-07-31 | $2,349,961 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-07-31 | $8,375 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-07-31 | $3,217,637 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2016-07-31 | $-484,699 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-07-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2016-07-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-07-31 | No |
| Contributions received in cash from employer | 2016-07-31 | $29,672,704 |
| Employer contributions (assets) at end of year | 2016-07-31 | $2,975,455 |
| Employer contributions (assets) at beginning of year | 2016-07-31 | $2,455,197 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-07-31 | $22,332,903 |
| Contract administrator fees | 2016-07-31 | $1,813,304 |
| Liabilities. Value of benefit claims payable at end of year | 2016-07-31 | $3,097,427 |
| Liabilities. Value of benefit claims payable at beginning of year | 2016-07-31 | $2,408,445 |
| Did the plan have assets held for investment | 2016-07-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-07-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-07-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-07-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-07-31 | Unqualified |
| Accountancy firm name | 2016-07-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2016-07-31 | 410746749 |
| 2015 : MACHINISTS HEALTH & WELFARE TRUST FUND 2015 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2015-07-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-07-31 | $2,557,694 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-07-31 | $3,689,186 |
| Total income from all sources (including contributions) | 2015-07-31 | $28,903,863 |
| Total loss/gain on sale of assets | 2015-07-31 | $0 |
| Total of all expenses incurred | 2015-07-31 | $27,678,552 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-07-31 | $25,425,610 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-07-31 | $28,402,765 |
| Value of total assets at end of year | 2015-07-31 | $19,280,452 |
| Value of total assets at beginning of year | 2015-07-31 | $19,186,633 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-07-31 | $2,252,942 |
| Total interest from all sources | 2015-07-31 | $363 |
| Total dividends received (eg from common stock, registered investment company shares) | 2015-07-31 | $720,145 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-07-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2015-07-31 | $720,145 |
| Administrative expenses professional fees incurred | 2015-07-31 | $121,731 |
| Was this plan covered by a fidelity bond | 2015-07-31 | Yes |
| Value of fidelity bond cover | 2015-07-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2015-07-31 | No |
| Contributions received from participants | 2015-07-31 | $742,144 |
| Assets. Other investments not covered elsewhere at end of year | 2015-07-31 | $0 |
| Assets. Other investments not covered elsewhere at beginning of year | 2015-07-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-07-31 | $907,544 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-07-31 | $4,731,238 |
| Other income not declared elsewhere | 2015-07-31 | $79,565 |
| Administrative expenses (other) incurred | 2015-07-31 | $245,192 |
| Liabilities. Value of operating payables at end of year | 2015-07-31 | $149,249 |
| Liabilities. Value of operating payables at beginning of year | 2015-07-31 | $186,785 |
| Total non interest bearing cash at end of year | 2015-07-31 | $413,414 |
| Total non interest bearing cash at beginning of year | 2015-07-31 | $315,390 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-07-31 | No |
| Value of net income/loss | 2015-07-31 | $1,225,311 |
| Value of net assets at end of year (total assets less liabilities) | 2015-07-31 | $16,722,758 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-07-31 | $15,497,447 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-07-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-07-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-07-31 | No |
| Investment advisory and management fees | 2015-07-31 | $6,410 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2015-07-31 | $13,154,336 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2015-07-31 | $9,609,337 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-07-31 | $2,349,961 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-07-31 | $2,371,177 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-07-31 | $2,371,177 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-07-31 | $363 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-07-31 | $3,282,539 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2015-07-31 | $-298,975 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-07-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2015-07-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-07-31 | No |
| Contributions received in cash from employer | 2015-07-31 | $27,660,621 |
| Employer contributions (assets) at end of year | 2015-07-31 | $2,455,197 |
| Employer contributions (assets) at beginning of year | 2015-07-31 | $2,159,491 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-07-31 | $22,143,071 |
| Contract administrator fees | 2015-07-31 | $1,879,609 |
| Liabilities. Value of benefit claims payable at end of year | 2015-07-31 | $2,408,445 |
| Liabilities. Value of benefit claims payable at beginning of year | 2015-07-31 | $3,502,401 |
| Did the plan have assets held for investment | 2015-07-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-07-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-07-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-07-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-07-31 | Unqualified |
| Accountancy firm name | 2015-07-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2015-07-31 | 410746749 |
| 2014 : MACHINISTS HEALTH & WELFARE TRUST FUND 2014 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2014-07-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-07-31 | $3,689,186 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-07-31 | $605,705 |
| Total income from all sources (including contributions) | 2014-07-31 | $27,857,311 |
| Total loss/gain on sale of assets | 2014-07-31 | $0 |
| Total of all expenses incurred | 2014-07-31 | $27,907,491 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-07-31 | $25,639,271 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-07-31 | $27,429,551 |
| Value of total assets at end of year | 2014-07-31 | $19,186,633 |
| Value of total assets at beginning of year | 2014-07-31 | $16,153,332 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-07-31 | $2,268,220 |
| Total interest from all sources | 2014-07-31 | $1,026 |
| Total dividends received (eg from common stock, registered investment company shares) | 2014-07-31 | $407,211 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-07-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2014-07-31 | $407,211 |
| Administrative expenses professional fees incurred | 2014-07-31 | $148,043 |
| Was this plan covered by a fidelity bond | 2014-07-31 | Yes |
| Value of fidelity bond cover | 2014-07-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2014-07-31 | No |
| Contributions received from participants | 2014-07-31 | $738,603 |
| Assets. Other investments not covered elsewhere at end of year | 2014-07-31 | $0 |
| Assets. Other investments not covered elsewhere at beginning of year | 2014-07-31 | $4,500,679 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-07-31 | $4,731,238 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-07-31 | $5,216 |
| Other income not declared elsewhere | 2014-07-31 | $15,311 |
| Administrative expenses (other) incurred | 2014-07-31 | $186,318 |
| Liabilities. Value of operating payables at end of year | 2014-07-31 | $186,785 |
| Liabilities. Value of operating payables at beginning of year | 2014-07-31 | $595,601 |
| Total non interest bearing cash at end of year | 2014-07-31 | $315,390 |
| Total non interest bearing cash at beginning of year | 2014-07-31 | $109,119 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-07-31 | No |
| Value of net income/loss | 2014-07-31 | $-50,180 |
| Value of net assets at end of year (total assets less liabilities) | 2014-07-31 | $15,497,447 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-07-31 | $15,547,627 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-07-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-07-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-07-31 | No |
| Investment advisory and management fees | 2014-07-31 | $6,425 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2014-07-31 | $9,609,337 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2014-07-31 | $9,385,567 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-07-31 | $2,371,177 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-07-31 | $0 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-07-31 | $0 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-07-31 | $1,026 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-07-31 | $3,374,128 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2014-07-31 | $4,212 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-07-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2014-07-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-07-31 | No |
| Contributions received in cash from employer | 2014-07-31 | $26,690,948 |
| Employer contributions (assets) at end of year | 2014-07-31 | $2,159,491 |
| Employer contributions (assets) at beginning of year | 2014-07-31 | $2,152,751 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-07-31 | $22,265,143 |
| Contract administrator fees | 2014-07-31 | $1,927,434 |
| Liabilities. Value of benefit claims payable at end of year | 2014-07-31 | $3,502,401 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-07-31 | $10,104 |
| Did the plan have assets held for investment | 2014-07-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-07-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-07-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-07-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-07-31 | Unqualified |
| Accountancy firm name | 2014-07-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2014-07-31 | 410746749 |
| 2013 : MACHINISTS HEALTH & WELFARE TRUST FUND 2013 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2013-07-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-07-31 | $605,705 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-07-31 | $4,518,792 |
| Total income from all sources (including contributions) | 2013-07-31 | $27,141,375 |
| Total loss/gain on sale of assets | 2013-07-31 | $0 |
| Total of all expenses incurred | 2013-07-31 | $22,827,366 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-07-31 | $22,357,746 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-07-31 | $26,791,329 |
| Value of total assets at end of year | 2013-07-31 | $16,153,332 |
| Value of total assets at beginning of year | 2013-07-31 | $15,752,410 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-07-31 | $469,620 |
| Total interest from all sources | 2013-07-31 | $39,971 |
| Total dividends received (eg from common stock, registered investment company shares) | 2013-07-31 | $214,417 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-07-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2013-07-31 | $214,417 |
| Administrative expenses professional fees incurred | 2013-07-31 | $91,163 |
| Was this plan covered by a fidelity bond | 2013-07-31 | Yes |
| Value of fidelity bond cover | 2013-07-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2013-07-31 | No |
| Contributions received from participants | 2013-07-31 | $859,955 |
| Assets. Other investments not covered elsewhere at end of year | 2013-07-31 | $4,500,679 |
| Assets. Other investments not covered elsewhere at beginning of year | 2013-07-31 | $3,997,112 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2013-07-31 | $13,132 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-07-31 | $5,216 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-07-31 | $4,705 |
| Other income not declared elsewhere | 2013-07-31 | $2,976 |
| Administrative expenses (other) incurred | 2013-07-31 | $43,995 |
| Liabilities. Value of operating payables at end of year | 2013-07-31 | $595,601 |
| Liabilities. Value of operating payables at beginning of year | 2013-07-31 | $4,509,119 |
| Total non interest bearing cash at end of year | 2013-07-31 | $109,119 |
| Total non interest bearing cash at beginning of year | 2013-07-31 | $98,385 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-07-31 | No |
| Value of net income/loss | 2013-07-31 | $4,314,009 |
| Value of net assets at end of year (total assets less liabilities) | 2013-07-31 | $15,547,627 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-07-31 | $11,233,618 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-07-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-07-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-07-31 | No |
| Investment advisory and management fees | 2013-07-31 | $10,249 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2013-07-31 | $9,385,567 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2013-07-31 | $9,485,852 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-07-31 | $39,971 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-07-31 | $22,344,614 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2013-07-31 | $92,682 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-07-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2013-07-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-07-31 | No |
| Contributions received in cash from employer | 2013-07-31 | $25,931,374 |
| Employer contributions (assets) at end of year | 2013-07-31 | $2,152,751 |
| Employer contributions (assets) at beginning of year | 2013-07-31 | $2,166,356 |
| Contract administrator fees | 2013-07-31 | $324,213 |
| Liabilities. Value of benefit claims payable at end of year | 2013-07-31 | $10,104 |
| Liabilities. Value of benefit claims payable at beginning of year | 2013-07-31 | $9,673 |
| Did the plan have assets held for investment | 2013-07-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-07-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-07-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-07-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-07-31 | Unqualified |
| Accountancy firm name | 2013-07-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2013-07-31 | 410746749 |
| 2012 : MACHINISTS HEALTH & WELFARE TRUST FUND 2012 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2012-07-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-07-31 | $4,518,792 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-07-31 | $4,223,616 |
| Total income from all sources (including contributions) | 2012-07-31 | $25,475,599 |
| Total loss/gain on sale of assets | 2012-07-31 | $0 |
| Total of all expenses incurred | 2012-07-31 | $24,748,709 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-07-31 | $24,290,724 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-07-31 | $25,070,744 |
| Value of total assets at end of year | 2012-07-31 | $15,752,410 |
| Value of total assets at beginning of year | 2012-07-31 | $14,730,344 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-07-31 | $457,985 |
| Total interest from all sources | 2012-07-31 | $32,248 |
| Total dividends received (eg from common stock, registered investment company shares) | 2012-07-31 | $258,411 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-07-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2012-07-31 | $258,411 |
| Administrative expenses professional fees incurred | 2012-07-31 | $72,713 |
| Was this plan covered by a fidelity bond | 2012-07-31 | Yes |
| Value of fidelity bond cover | 2012-07-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2012-07-31 | No |
| Contributions received from participants | 2012-07-31 | $882,315 |
| Assets. Other investments not covered elsewhere at end of year | 2012-07-31 | $3,997,112 |
| Assets. Other investments not covered elsewhere at beginning of year | 2012-07-31 | $3,224,807 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2012-07-31 | $11,665 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-07-31 | $4,705 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-07-31 | $6,303 |
| Other income not declared elsewhere | 2012-07-31 | $27,161 |
| Administrative expenses (other) incurred | 2012-07-31 | $39,332 |
| Liabilities. Value of operating payables at end of year | 2012-07-31 | $4,509,119 |
| Liabilities. Value of operating payables at beginning of year | 2012-07-31 | $4,209,133 |
| Total non interest bearing cash at end of year | 2012-07-31 | $98,385 |
| Total non interest bearing cash at beginning of year | 2012-07-31 | $183,355 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-07-31 | No |
| Value of net income/loss | 2012-07-31 | $726,890 |
| Value of net assets at end of year (total assets less liabilities) | 2012-07-31 | $11,233,618 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-07-31 | $10,506,728 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-07-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-07-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-07-31 | No |
| Investment advisory and management fees | 2012-07-31 | $12,402 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2012-07-31 | $9,485,852 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2012-07-31 | $9,143,818 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-07-31 | $32,248 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2012-07-31 | $0 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-07-31 | $24,279,059 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2012-07-31 | $87,035 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-07-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2012-07-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-07-31 | No |
| Contributions received in cash from employer | 2012-07-31 | $24,188,429 |
| Employer contributions (assets) at end of year | 2012-07-31 | $2,166,356 |
| Employer contributions (assets) at beginning of year | 2012-07-31 | $2,172,061 |
| Contract administrator fees | 2012-07-31 | $333,538 |
| Liabilities. Value of benefit claims payable at end of year | 2012-07-31 | $9,673 |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-07-31 | $14,483 |
| Did the plan have assets held for investment | 2012-07-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-07-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-07-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-07-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-07-31 | Unqualified |
| Accountancy firm name | 2012-07-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2012-07-31 | 410746749 |
| 2011 : MACHINISTS HEALTH & WELFARE TRUST FUND 2011 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-07-31 | $4,223,616 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-07-31 | $4,333,384 |
| Total income from all sources (including contributions) | 2011-07-31 | $24,488,077 |
| Total of all expenses incurred | 2011-07-31 | $24,313,828 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-07-31 | $23,847,890 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-07-31 | $23,860,011 |
| Value of total assets at end of year | 2011-07-31 | $14,730,344 |
| Value of total assets at beginning of year | 2011-07-31 | $14,665,863 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-07-31 | $465,938 |
| Total interest from all sources | 2011-07-31 | $30,163 |
| Total dividends received (eg from common stock, registered investment company shares) | 2011-07-31 | $287,301 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-07-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2011-07-31 | $287,301 |
| Administrative expenses professional fees incurred | 2011-07-31 | $81,925 |
| Was this plan covered by a fidelity bond | 2011-07-31 | Yes |
| Value of fidelity bond cover | 2011-07-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2011-07-31 | No |
| Contributions received from participants | 2011-07-31 | $763,444 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-07-31 | $3,231,110 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-07-31 | $3,078,176 |
| Other income not declared elsewhere | 2011-07-31 | $5,884 |
| Administrative expenses (other) incurred | 2011-07-31 | $58,441 |
| Liabilities. Value of operating payables at end of year | 2011-07-31 | $4,209,133 |
| Liabilities. Value of operating payables at beginning of year | 2011-07-31 | $4,273,384 |
| Total non interest bearing cash at end of year | 2011-07-31 | $183,355 |
| Total non interest bearing cash at beginning of year | 2011-07-31 | $220,881 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-07-31 | No |
| Value of net income/loss | 2011-07-31 | $174,249 |
| Value of net assets at end of year (total assets less liabilities) | 2011-07-31 | $10,506,728 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-07-31 | $10,332,479 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-07-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-07-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-07-31 | No |
| Investment advisory and management fees | 2011-07-31 | $12,788 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2011-07-31 | $9,143,818 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2011-07-31 | $9,380,541 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-07-31 | $30,163 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2011-07-31 | $0 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2011-07-31 | $0 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-07-31 | $23,847,890 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2011-07-31 | $304,718 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-07-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2011-07-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-07-31 | No |
| Contributions received in cash from employer | 2011-07-31 | $23,096,567 |
| Employer contributions (assets) at end of year | 2011-07-31 | $2,172,061 |
| Employer contributions (assets) at beginning of year | 2011-07-31 | $1,986,265 |
| Contract administrator fees | 2011-07-31 | $312,784 |
| Liabilities. Value of benefit claims payable at end of year | 2011-07-31 | $14,483 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-07-31 | $60,000 |
| Did the plan have assets held for investment | 2011-07-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-07-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-07-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-07-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-07-31 | Unqualified |
| Accountancy firm name | 2011-07-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2011-07-31 | 410746749 |
| KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 1512 |
| Policy instance | 3 |
| Insurance contract or identification number | 1512 | | Number of Individuals Covered | 39 | | Insurance policy start date | 2021-08-01 | | Insurance policy end date | 2022-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $251,412 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
| Policy contract number | 0044500 |
| Policy instance | 1 |
| Insurance contract or identification number | 0044500 | | Number of Individuals Covered | 113 | | Insurance policy start date | 2021-08-01 | | Insurance policy end date | 2022-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $853,683 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 ) |
| Policy contract number | WA05291W |
| Policy instance | 2 |
| Insurance contract or identification number | WA05291W | | Number of Individuals Covered | 960 | | Insurance policy start date | 2021-08-01 | | Insurance policy end date | 2022-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D | | 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 Carrier | USD $332,072 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 48038 ) |
| Policy contract number | 006261 |
| Policy instance | 4 |
| Insurance contract or identification number | 006261 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $15,288 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
| Policy contract number | 0316500 |
| Policy instance | 5 |
| Insurance contract or identification number | 0316500 | | Number of Individuals Covered | 91 | | Insurance policy start date | 2021-08-01 | | Insurance policy end date | 2022-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $637,630 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 95893 ) |
| Policy contract number | 005557 |
| Policy instance | 6 |
| Insurance contract or identification number | 005557 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $24,833 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 40000014 |
| Policy instance | 7 |
| Insurance contract or identification number | 40000014 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $6,923 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ASURIS NORTHWEST HEALTH (National Association of Insurance Commissioners NAIC id number: 47350 ) |
| Policy contract number | 40000514 |
| Policy instance | 8 |
| Insurance contract or identification number | 40000514 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $7,008 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | SL10225 |
| Policy instance | 9 |
| Insurance contract or identification number | SL10225 | | Number of Individuals Covered | 1178 | | Insurance policy start date | 2021-08-01 | | Insurance policy end date | 2022-07-31 | | Total amount of commissions paid to insurance broker | USD $16,041 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $802,034 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,041 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 40000414 |
| Policy instance | 10 |
| Insurance contract or identification number | 40000414 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $41,592 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 1512 |
| Policy instance | 3 |
| Insurance contract or identification number | 1512 | | Number of Individuals Covered | 49 | | Insurance policy start date | 2020-08-01 | | Insurance policy end date | 2021-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $296,168 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 ) |
| Policy contract number | WA05291W |
| Policy instance | 2 |
| Insurance contract or identification number | WA05291W | | Number of Individuals Covered | 959 | | Insurance policy start date | 2020-08-01 | | Insurance policy end date | 2021-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $353,312 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
| Policy contract number | 0044500 |
| Policy instance | 1 |
| Insurance contract or identification number | 0044500 | | Number of Individuals Covered | 116 | | Insurance policy start date | 2020-08-01 | | Insurance policy end date | 2021-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $828,169 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ASURIS NORTHWEST HEALTH (National Association of Insurance Commissioners NAIC id number: 47350 ) |
| Policy contract number | 40000514 |
| Policy instance | 8 |
| Insurance contract or identification number | 40000514 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $7,008 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 48038 ) |
| Policy contract number | 006261 |
| Policy instance | 4 |
| Insurance contract or identification number | 006261 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $16,986 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
| Policy contract number | 0316500 |
| Policy instance | 5 |
| Insurance contract or identification number | 0316500 | | Number of Individuals Covered | 91 | | Insurance policy start date | 2020-08-01 | | Insurance policy end date | 2021-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $588,591 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 95893 ) |
| Policy contract number | 005557 |
| Policy instance | 6 |
| Insurance contract or identification number | 005557 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $30,611 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 40000014 |
| Policy instance | 7 |
| Insurance contract or identification number | 40000014 | | Number of Individuals Covered | 14 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $7,169 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | SL10225 |
| Policy instance | 9 |
| Insurance contract or identification number | SL10225 | | Number of Individuals Covered | 1291 | | Insurance policy start date | 2020-08-01 | | Insurance policy end date | 2021-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $867,526 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 40000414 |
| Policy instance | 10 |
| Insurance contract or identification number | 40000414 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | MEDIGAP | | 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 Carrier | USD $38,532 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 48038 ) |
| Policy contract number | 006261 |
| Policy instance | 4 |
| Insurance contract or identification number | 006261 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2019-08-01 | | Insurance policy end date | 2020-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $18,574 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
| Policy contract number | 0316500 |
| Policy instance | 5 |
| Insurance contract or identification number | 0316500 | | Number of Individuals Covered | 87 | | Insurance policy start date | 2019-08-01 | | Insurance policy end date | 2020-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $489,038 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 95893 ) |
| Policy contract number | 005557 |
| Policy instance | 6 |
| Insurance contract or identification number | 005557 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2019-08-01 | | Insurance policy end date | 2020-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $31,157 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 40000014 |
| Policy instance | 7 |
| Insurance contract or identification number | 40000014 | | Number of Individuals Covered | 22 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | MEDIGAP | | 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 Carrier | USD $45,942 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ASURIS NORTHWEST HEALTH (National Association of Insurance Commissioners NAIC id number: 47350 ) |
| Policy contract number | 40000514 |
| Policy instance | 8 |
| Insurance contract or identification number | 40000514 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $6,941 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 1512 |
| Policy instance | 3 |
| Insurance contract or identification number | 1512 | | Number of Individuals Covered | 48 | | Insurance policy start date | 2019-08-01 | | Insurance policy end date | 2020-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $297,462 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 ) |
| Policy contract number | WA05291W |
| Policy instance | 2 |
| Insurance contract or identification number | WA05291W | | Number of Individuals Covered | 1303 | | Insurance policy start date | 2019-08-01 | | Insurance policy end date | 2020-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $367,487 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
| Policy contract number | 0044500 |
| Policy instance | 1 |
| Insurance contract or identification number | 0044500 | | Number of Individuals Covered | 123 | | Insurance policy start date | 2019-08-01 | | Insurance policy end date | 2020-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $788,637 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | SL10225 |
| Policy instance | 9 |
| Insurance contract or identification number | SL10225 | | Number of Individuals Covered | 1619 | | Insurance policy start date | 2019-08-01 | | Insurance policy end date | 2020-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $877,350 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
| Policy contract number | 0044500 |
| Policy instance | 2 |
| Insurance contract or identification number | 0044500 | | Number of Individuals Covered | 125 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2019-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $732,057 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 ) |
| Policy contract number | WA05291W |
| Policy instance | 3 |
| Insurance contract or identification number | WA05291W | | Number of Individuals Covered | 1170 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2019-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $369,847 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 1512 |
| Policy instance | 4 |
| Insurance contract or identification number | 1512 | | Number of Individuals Covered | 57 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2019-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $332,918 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 48038 ) |
| Policy contract number | 006261 |
| Policy instance | 5 |
| Insurance contract or identification number | 006261 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2019-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $27,697 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
| Policy contract number | 0316500 |
| Policy instance | 6 |
| Insurance contract or identification number | 0316500 | | Number of Individuals Covered | 84 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2019-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $486,126 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 95893 ) |
| Policy contract number | 005557 |
| Policy instance | 7 |
| Insurance contract or identification number | 005557 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2019-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $33,658 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 40000014 |
| Policy instance | 8 |
| Insurance contract or identification number | 40000014 | | Number of Individuals Covered | 15 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $11,620 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | L02946 |
| Policy instance | 1 |
| Insurance contract or identification number | L02946 | | Number of Individuals Covered | 60 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2018-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $172,193 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | SL10225 |
| Policy instance | 12 |
| Insurance contract or identification number | SL10225 | | Number of Individuals Covered | 1511 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2019-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $867,706 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 40000914 |
| Policy instance | 11 |
| Insurance contract or identification number | 40000914 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $1,992 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ASURIS NORTHWEST HEALTH (National Association of Insurance Commissioners NAIC id number: 47350 ) |
| Policy contract number | 40000514 |
| Policy instance | 10 |
| Insurance contract or identification number | 40000514 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $8,443 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 40000414 |
| Policy instance | 9 |
| Insurance contract or identification number | 40000414 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $48,284 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
| Policy contract number | 0044500 |
| Policy instance | 2 |
| Insurance contract or identification number | 0044500 | | Number of Individuals Covered | 111 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-07-31 | | Total amount of commissions paid to insurance broker | USD $17,718 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $753,477 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 ) |
| Policy contract number | WA05291W |
| Policy instance | 3 |
| Insurance contract or identification number | WA05291W | | Number of Individuals Covered | 1231 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-07-31 | | Total amount of commissions paid to insurance broker | USD $21,834 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $419,873 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 1512 |
| Policy instance | 4 |
| Insurance contract or identification number | 1512 | | Number of Individuals Covered | 75 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $385,580 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 48038 ) |
| Policy contract number | 006261 |
| Policy instance | 5 |
| Insurance contract or identification number | 006261 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $30,826 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 95893 ) |
| Policy contract number | 005557 |
| Policy instance | 7 |
| Insurance contract or identification number | 005557 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $38,230 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
| Policy contract number | 0316500 |
| Policy instance | 6 |
| Insurance contract or identification number | 0316500 | | Number of Individuals Covered | 84 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-07-31 | | Total amount of commissions paid to insurance broker | USD $12,464 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $499,157 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 40000014 |
| Policy instance | 8 |
| Insurance contract or identification number | 40000014 | | Number of Individuals Covered | 16 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $12,848 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ASURIS NORTHWEST HEALTH (National Association of Insurance Commissioners NAIC id number: 47350 ) |
| Policy contract number | 40000514 |
| Policy instance | 10 |
| Insurance contract or identification number | 40000514 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $11,039 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 40000914 |
| Policy instance | 11 |
| Insurance contract or identification number | 40000914 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $2,988 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 ) |
| Policy contract number | SL10225 |
| Policy instance | 12 |
| Insurance contract or identification number | SL10225 | | Number of Individuals Covered | 1550 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $838,344 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | L02946 |
| Policy instance | 1 |
| Insurance contract or identification number | L02946 | | Number of Individuals Covered | 60 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-07-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $325,490 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 40000414 |
| Policy instance | 9 |
| Insurance contract or identification number | 40000414 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $57,564 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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