BOARD OF TRUSTEES PUGET SOUND BENEFITS TRUST has sponsored the creation of one or more 401k plans.
| Measure | Date | Value |
|---|
| 2022 : PUGET SOUND BENEFITS TRUST 2022 401k financial data |
|---|
| Unrealized appreciation/depreciation of real estate assets | 2022-12-31 | $-567,043 |
| Total unrealized appreciation/depreciation of assets | 2022-12-31 | $-567,043 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $395,099 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $917,621 |
| Total income from all sources (including contributions) | 2022-12-31 | $4,379,074 |
| Total loss/gain on sale of assets | 2022-12-31 | $-17,836 |
| Total of all expenses incurred | 2022-12-31 | $5,124,306 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $4,662,931 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-12-31 | $4,997,519 |
| Value of total assets at end of year | 2022-12-31 | $6,721,128 |
| Value of total assets at beginning of year | 2022-12-31 | $7,988,882 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $461,375 |
| Total interest from all sources | 2022-12-31 | $115,489 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-12-31 | $10,203 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2022-12-31 | $10,203 |
| Administrative expenses professional fees incurred | 2022-12-31 | $84,631 |
| Was this plan covered by a fidelity bond | 2022-12-31 | Yes |
| Value of fidelity bond cover | 2022-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-12-31 | $377,782 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-12-31 | $187,711 |
| Other income not declared elsewhere | 2022-12-31 | $825 |
| Administrative expenses (other) incurred | 2022-12-31 | $35,217 |
| Liabilities. Value of operating payables at end of year | 2022-12-31 | $23,316 |
| Liabilities. Value of operating payables at beginning of year | 2022-12-31 | $210,521 |
| Total non interest bearing cash at end of year | 2022-12-31 | $233,640 |
| Total non interest bearing cash at beginning of year | 2022-12-31 | $405,577 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Value of net income/loss | 2022-12-31 | $-745,232 |
| Value of net assets at end of year (total assets less liabilities) | 2022-12-31 | $6,326,029 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-12-31 | $7,071,261 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
| Investment advisory and management fees | 2022-12-31 | $17,237 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-12-31 | $600,910 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-12-31 | $895,984 |
| Income. Interest from US Government securities | 2022-12-31 | $30,153 |
| Income. Interest from corporate debt instruments | 2022-12-31 | $81,257 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-12-31 | $277,989 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-12-31 | $139,398 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-12-31 | $139,398 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-12-31 | $4,079 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-12-31 | $1,149,599 |
| Asset value of US Government securities at end of year | 2022-12-31 | $2,078,973 |
| Asset value of US Government securities at beginning of year | 2022-12-31 | $2,729,267 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-12-31 | $-160,083 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2022-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
| Contributions received in cash from employer | 2022-12-31 | $4,997,519 |
| Employer contributions (assets) at end of year | 2022-12-31 | $444,293 |
| Employer contributions (assets) at beginning of year | 2022-12-31 | $409,531 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-12-31 | $3,513,332 |
| Asset. Corporate debt instrument preferred debt at end of year | 2022-12-31 | $925,964 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2022-12-31 | $1,508,278 |
| Asset. Corporate debt instrument debt (other) at end of year | 2022-12-31 | $1,781,577 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2022-12-31 | $1,713,136 |
| Contract administrator fees | 2022-12-31 | $324,290 |
| Liabilities. Value of benefit claims payable at end of year | 2022-12-31 | $371,783 |
| Liabilities. Value of benefit claims payable at beginning of year | 2022-12-31 | $707,100 |
| Did the plan have assets held for investment | 2022-12-31 | 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 | 2022-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-12-31 | No |
| Aggregate proceeds on sale of assets | 2022-12-31 | $6,082,921 |
| Aggregate carrying amount (costs) on sale of assets | 2022-12-31 | $6,100,757 |
| Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
| Accountancy firm name | 2022-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2022-12-31 | 410746749 |
| 2021 : PUGET SOUND BENEFITS TRUST 2021 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2021-12-31 | $-229,428 |
| Total unrealized appreciation/depreciation of assets | 2021-12-31 | $-229,428 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $917,621 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $779,070 |
| Total income from all sources (including contributions) | 2021-12-31 | $4,788,781 |
| Total loss/gain on sale of assets | 2021-12-31 | $40,901 |
| Total of all expenses incurred | 2021-12-31 | $5,512,653 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $5,044,501 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-12-31 | $4,632,383 |
| Value of total assets at end of year | 2021-12-31 | $7,988,882 |
| Value of total assets at beginning of year | 2021-12-31 | $8,574,203 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $468,152 |
| Total interest from all sources | 2021-12-31 | $156,824 |
| Total dividends received (eg from common stock, registered investment company shares) | 2021-12-31 | $10,874 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2021-12-31 | $10,874 |
| Administrative expenses professional fees incurred | 2021-12-31 | $76,531 |
| Was this plan covered by a fidelity bond | 2021-12-31 | Yes |
| Value of fidelity bond cover | 2021-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-12-31 | $187,711 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-12-31 | $116,734 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2021-12-31 | $0 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2021-12-31 | $0 |
| Other income not declared elsewhere | 2021-12-31 | $0 |
| Administrative expenses (other) incurred | 2021-12-31 | $36,287 |
| Liabilities. Value of operating payables at end of year | 2021-12-31 | $210,521 |
| Liabilities. Value of operating payables at beginning of year | 2021-12-31 | $217,970 |
| Total non interest bearing cash at end of year | 2021-12-31 | $405,577 |
| Total non interest bearing cash at beginning of year | 2021-12-31 | $716,350 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Value of net income/loss | 2021-12-31 | $-723,872 |
| Value of net assets at end of year (total assets less liabilities) | 2021-12-31 | $7,071,261 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-12-31 | $7,795,133 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
| Investment advisory and management fees | 2021-12-31 | $19,830 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-12-31 | $895,984 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-12-31 | $817,488 |
| Income. Interest from US Government securities | 2021-12-31 | $41,872 |
| Income. Interest from corporate debt instruments | 2021-12-31 | $114,939 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-12-31 | $139,398 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-12-31 | $289,310 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-12-31 | $289,310 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-12-31 | $13 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-12-31 | $1,192,979 |
| Asset value of US Government securities at end of year | 2021-12-31 | $2,729,267 |
| Asset value of US Government securities at beginning of year | 2021-12-31 | $2,642,303 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2021-12-31 | $177,227 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2021-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
| Contributions received in cash from employer | 2021-12-31 | $4,632,383 |
| Employer contributions (assets) at end of year | 2021-12-31 | $409,531 |
| Employer contributions (assets) at beginning of year | 2021-12-31 | $411,435 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-12-31 | $3,851,522 |
| Asset. Corporate debt instrument preferred debt at end of year | 2021-12-31 | $1,508,278 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2021-12-31 | $1,988,178 |
| Asset. Corporate debt instrument debt (other) at end of year | 2021-12-31 | $1,713,136 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2021-12-31 | $1,592,405 |
| Contract administrator fees | 2021-12-31 | $335,504 |
| Liabilities. Value of benefit claims payable at end of year | 2021-12-31 | $707,100 |
| Liabilities. Value of benefit claims payable at beginning of year | 2021-12-31 | $561,100 |
| Did the plan have assets held for investment | 2021-12-31 | 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 | 2021-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-12-31 | No |
| Aggregate proceeds on sale of assets | 2021-12-31 | $5,641,892 |
| Aggregate carrying amount (costs) on sale of assets | 2021-12-31 | $5,600,991 |
| Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
| Accountancy firm name | 2021-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2021-12-31 | 410746749 |
| 2020 : PUGET SOUND BENEFITS TRUST 2020 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2020-12-31 | $162,594 |
| Total unrealized appreciation/depreciation of assets | 2020-12-31 | $162,594 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $779,070 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $2,040,898 |
| Total income from all sources (including contributions) | 2020-12-31 | $5,180,738 |
| Total loss/gain on sale of assets | 2020-12-31 | $50,902 |
| Total of all expenses incurred | 2020-12-31 | $5,065,528 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $4,614,106 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-12-31 | $4,648,280 |
| Value of total assets at end of year | 2020-12-31 | $8,574,203 |
| Value of total assets at beginning of year | 2020-12-31 | $9,720,821 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $451,422 |
| Total interest from all sources | 2020-12-31 | $155,066 |
| Total dividends received (eg from common stock, registered investment company shares) | 2020-12-31 | $13,058 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2020-12-31 | $13,058 |
| Administrative expenses professional fees incurred | 2020-12-31 | $81,533 |
| Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
| Value of fidelity bond cover | 2020-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-12-31 | $116,734 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-12-31 | $198,437 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2020-12-31 | $0 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-12-31 | $1,329,498 |
| Other income not declared elsewhere | 2020-12-31 | $4,959 |
| Administrative expenses (other) incurred | 2020-12-31 | $25,292 |
| Liabilities. Value of operating payables at end of year | 2020-12-31 | $217,970 |
| Liabilities. Value of operating payables at beginning of year | 2020-12-31 | $230,400 |
| Total non interest bearing cash at end of year | 2020-12-31 | $716,350 |
| Total non interest bearing cash at beginning of year | 2020-12-31 | $2,460,775 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Value of net income/loss | 2020-12-31 | $115,210 |
| Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $7,795,133 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $7,679,923 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
| Investment advisory and management fees | 2020-12-31 | $19,583 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-12-31 | $817,488 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-12-31 | $771,468 |
| Income. Interest from US Government securities | 2020-12-31 | $50,442 |
| Income. Interest from corporate debt instruments | 2020-12-31 | $104,306 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-12-31 | $289,310 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-12-31 | $123,495 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-12-31 | $123,495 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-12-31 | $318 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-12-31 | $1,332,632 |
| Asset value of US Government securities at end of year | 2020-12-31 | $2,642,303 |
| Asset value of US Government securities at beginning of year | 2020-12-31 | $2,513,918 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2020-12-31 | $145,879 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
| Contributions received in cash from employer | 2020-12-31 | $4,648,280 |
| Employer contributions (assets) at end of year | 2020-12-31 | $411,435 |
| Employer contributions (assets) at beginning of year | 2020-12-31 | $445,912 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-12-31 | $3,281,474 |
| Asset. Corporate debt instrument preferred debt at end of year | 2020-12-31 | $1,988,178 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2020-12-31 | $1,792,218 |
| Asset. Corporate debt instrument debt (other) at end of year | 2020-12-31 | $1,592,405 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2020-12-31 | $1,414,598 |
| Contract administrator fees | 2020-12-31 | $325,014 |
| Liabilities. Value of benefit claims payable at end of year | 2020-12-31 | $561,100 |
| Liabilities. Value of benefit claims payable at beginning of year | 2020-12-31 | $481,000 |
| Did the plan have assets held for investment | 2020-12-31 | 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 | 2020-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
| Aggregate proceeds on sale of assets | 2020-12-31 | $5,306,827 |
| Aggregate carrying amount (costs) on sale of assets | 2020-12-31 | $5,255,925 |
| Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Unqualified |
| Accountancy firm name | 2020-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2020-12-31 | 410746749 |
| 2019 : PUGET SOUND BENEFITS TRUST 2019 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-12-31 | $79,780 |
| Total unrealized appreciation/depreciation of assets | 2019-12-31 | $79,780 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $2,040,898 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $509,433 |
| Total income from all sources (including contributions) | 2019-12-31 | $5,372,009 |
| Total loss/gain on sale of assets | 2019-12-31 | $33,996 |
| Total of all expenses incurred | 2019-12-31 | $5,029,678 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $4,534,850 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $5,028,070 |
| Value of total assets at end of year | 2019-12-31 | $9,720,821 |
| Value of total assets at beginning of year | 2019-12-31 | $7,847,025 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $494,828 |
| Total interest from all sources | 2019-12-31 | $161,335 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-12-31 | $7,410 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2019-12-31 | $7,410 |
| Administrative expenses professional fees incurred | 2019-12-31 | $90,719 |
| Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
| Value of fidelity bond cover | 2019-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Contributions received from participants | 2019-12-31 | $6,476 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2019-12-31 | $3,330,115 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-12-31 | $198,437 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $221,109 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2019-12-31 | $1,329,498 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2019-12-31 | $0 |
| Administrative expenses (other) incurred | 2019-12-31 | $28,118 |
| Liabilities. Value of operating payables at end of year | 2019-12-31 | $230,400 |
| Liabilities. Value of operating payables at beginning of year | 2019-12-31 | $212,333 |
| Total non interest bearing cash at end of year | 2019-12-31 | $2,460,775 |
| Total non interest bearing cash at beginning of year | 2019-12-31 | $1,332,582 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Value of net income/loss | 2019-12-31 | $342,331 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $7,679,923 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $7,337,592 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Investment advisory and management fees | 2019-12-31 | $18,985 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-12-31 | $771,468 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-12-31 | $0 |
| Interest earned on other investments | 2019-12-31 | $8,759 |
| Income. Interest from US Government securities | 2019-12-31 | $57,832 |
| Income. Interest from corporate debt instruments | 2019-12-31 | $89,575 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-12-31 | $123,495 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-12-31 | $414,400 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-12-31 | $414,400 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-12-31 | $5,169 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $1,204,735 |
| Asset value of US Government securities at end of year | 2019-12-31 | $2,513,918 |
| Asset value of US Government securities at beginning of year | 2019-12-31 | $1,842,030 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2019-12-31 | $61,418 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Contributions received in cash from employer | 2019-12-31 | $5,021,594 |
| Employer contributions (assets) at end of year | 2019-12-31 | $445,912 |
| Employer contributions (assets) at beginning of year | 2019-12-31 | $415,424 |
| Asset. Corporate debt instrument preferred debt at end of year | 2019-12-31 | $1,792,218 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2019-12-31 | $1,344,033 |
| Asset. Corporate debt instrument debt (other) at end of year | 2019-12-31 | $1,414,598 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2019-12-31 | $2,277,447 |
| Contract administrator fees | 2019-12-31 | $357,006 |
| Liabilities. Value of benefit claims payable at end of year | 2019-12-31 | $481,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-12-31 | $297,100 |
| Did the plan have assets held for investment | 2019-12-31 | 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 | 2019-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
| Aggregate proceeds on sale of assets | 2019-12-31 | $15,065,605 |
| Aggregate carrying amount (costs) on sale of assets | 2019-12-31 | $15,031,609 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Unqualified |
| Accountancy firm name | 2019-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2019-12-31 | 410746749 |
| 2018 : PUGET SOUND BENEFITS TRUST 2018 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2018-12-31 | $-20,154 |
| Total unrealized appreciation/depreciation of assets | 2018-12-31 | $-20,154 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $509,433 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $587,918 |
| Total income from all sources (including contributions) | 2018-12-31 | $4,799,825 |
| Total loss/gain on sale of assets | 2018-12-31 | $-23,187 |
| Total of all expenses incurred | 2018-12-31 | $4,244,951 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $3,765,921 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $4,711,871 |
| Value of total assets at end of year | 2018-12-31 | $7,847,025 |
| Value of total assets at beginning of year | 2018-12-31 | $7,370,636 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $479,030 |
| Total interest from all sources | 2018-12-31 | $131,295 |
| Total dividends received (eg from common stock, registered investment company shares) | 2018-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-12-31 | No |
| Administrative expenses professional fees incurred | 2018-12-31 | $81,131 |
| Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
| Value of fidelity bond cover | 2018-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
| Contributions received from participants | 2018-12-31 | $18,370 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2018-12-31 | $2,722,830 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-12-31 | $221,109 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-12-31 | $51,356 |
| Administrative expenses (other) incurred | 2018-12-31 | $29,724 |
| Liabilities. Value of operating payables at end of year | 2018-12-31 | $212,333 |
| Liabilities. Value of operating payables at beginning of year | 2018-12-31 | $163,818 |
| Total non interest bearing cash at end of year | 2018-12-31 | $1,332,582 |
| Total non interest bearing cash at beginning of year | 2018-12-31 | $932,794 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Value of net income/loss | 2018-12-31 | $554,874 |
| Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $7,337,592 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $6,782,718 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
| Investment advisory and management fees | 2018-12-31 | $17,537 |
| Interest earned on other investments | 2018-12-31 | $11,743 |
| Income. Interest from US Government securities | 2018-12-31 | $20,083 |
| Income. Interest from corporate debt instruments | 2018-12-31 | $95,826 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-12-31 | $414,400 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-12-31 | $363,964 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-12-31 | $363,964 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-12-31 | $3,643 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $1,043,091 |
| Asset value of US Government securities at end of year | 2018-12-31 | $1,842,030 |
| Asset value of US Government securities at beginning of year | 2018-12-31 | $1,605,262 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2018-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
| Contributions received in cash from employer | 2018-12-31 | $4,693,501 |
| Employer contributions (assets) at end of year | 2018-12-31 | $415,424 |
| Employer contributions (assets) at beginning of year | 2018-12-31 | $597,346 |
| Asset. Corporate debt instrument preferred debt at end of year | 2018-12-31 | $1,344,033 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2018-12-31 | $1,253,771 |
| Asset. Corporate debt instrument debt (other) at end of year | 2018-12-31 | $2,277,447 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2018-12-31 | $2,566,143 |
| Contract administrator fees | 2018-12-31 | $350,638 |
| Liabilities. Value of benefit claims payable at end of year | 2018-12-31 | $297,100 |
| Liabilities. Value of benefit claims payable at beginning of year | 2018-12-31 | $424,100 |
| Did the plan have assets held for investment | 2018-12-31 | 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 | 2018-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-12-31 | No |
| Aggregate proceeds on sale of assets | 2018-12-31 | $2,977,431 |
| Aggregate carrying amount (costs) on sale of assets | 2018-12-31 | $3,000,618 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Unqualified |
| Accountancy firm name | 2018-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2018-12-31 | 410746749 |
| 2017 : PUGET SOUND BENEFITS TRUST 2017 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2017-12-31 | $-12,014 |
| Total unrealized appreciation/depreciation of assets | 2017-12-31 | $-12,014 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $587,918 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $453,864 |
| Total income from all sources (including contributions) | 2017-12-31 | $5,024,337 |
| Total loss/gain on sale of assets | 2017-12-31 | $-2,166 |
| Total of all expenses incurred | 2017-12-31 | $3,764,734 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $3,303,340 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $4,949,674 |
| Value of total assets at end of year | 2017-12-31 | $7,370,636 |
| Value of total assets at beginning of year | 2017-12-31 | $5,976,979 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $461,394 |
| Total interest from all sources | 2017-12-31 | $88,843 |
| Total dividends received (eg from common stock, registered investment company shares) | 2017-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-12-31 | No |
| Administrative expenses professional fees incurred | 2017-12-31 | $70,991 |
| Was this plan covered by a fidelity bond | 2017-12-31 | Yes |
| Value of fidelity bond cover | 2017-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
| Contributions received from participants | 2017-12-31 | $42,462 |
| Assets. Other investments not covered elsewhere at end of year | 2017-12-31 | $0 |
| Assets. Other investments not covered elsewhere at beginning of year | 2017-12-31 | $98,772 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2017-12-31 | $2,673,413 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-12-31 | $51,356 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-12-31 | $284,824 |
| Administrative expenses (other) incurred | 2017-12-31 | $28,920 |
| Liabilities. Value of operating payables at end of year | 2017-12-31 | $163,818 |
| Liabilities. Value of operating payables at beginning of year | 2017-12-31 | $93,064 |
| Total non interest bearing cash at end of year | 2017-12-31 | $932,794 |
| Total non interest bearing cash at beginning of year | 2017-12-31 | $1,429,471 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Value of net income/loss | 2017-12-31 | $1,259,603 |
| Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $6,782,718 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $5,523,115 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
| Investment advisory and management fees | 2017-12-31 | $13,959 |
| Interest earned on other investments | 2017-12-31 | $503 |
| Income. Interest from US Government securities | 2017-12-31 | $18,128 |
| Income. Interest from corporate debt instruments | 2017-12-31 | $67,992 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-12-31 | $363,964 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-12-31 | $249,662 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-12-31 | $249,662 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-12-31 | $2,220 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $629,927 |
| Asset value of US Government securities at end of year | 2017-12-31 | $1,605,262 |
| Asset value of US Government securities at beginning of year | 2017-12-31 | $1,526,608 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2017-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
| Contributions received in cash from employer | 2017-12-31 | $4,907,212 |
| Employer contributions (assets) at end of year | 2017-12-31 | $597,346 |
| Employer contributions (assets) at beginning of year | 2017-12-31 | $444,038 |
| Asset. Corporate debt instrument preferred debt at end of year | 2017-12-31 | $1,253,771 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2017-12-31 | $475,679 |
| Asset. Corporate debt instrument debt (other) at end of year | 2017-12-31 | $2,566,143 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2017-12-31 | $1,467,925 |
| Contract administrator fees | 2017-12-31 | $347,524 |
| Liabilities. Value of benefit claims payable at end of year | 2017-12-31 | $424,100 |
| Liabilities. Value of benefit claims payable at beginning of year | 2017-12-31 | $360,800 |
| Did the plan have assets held for investment | 2017-12-31 | 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 | 2017-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-12-31 | No |
| Aggregate proceeds on sale of assets | 2017-12-31 | $6,350,714 |
| Aggregate carrying amount (costs) on sale of assets | 2017-12-31 | $6,352,880 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Unqualified |
| Accountancy firm name | 2017-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2017-12-31 | 410746749 |
| 2016 : PUGET SOUND BENEFITS TRUST 2016 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2016-12-31 | $6,243 |
| Total unrealized appreciation/depreciation of assets | 2016-12-31 | $6,243 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $453,864 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $710,395 |
| Total income from all sources (including contributions) | 2016-12-31 | $5,456,831 |
| Total loss/gain on sale of assets | 2016-12-31 | $765 |
| Total of all expenses incurred | 2016-12-31 | $4,304,111 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $3,852,188 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $5,389,035 |
| Value of total assets at end of year | 2016-12-31 | $5,976,979 |
| Value of total assets at beginning of year | 2016-12-31 | $5,080,790 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $451,923 |
| Total interest from all sources | 2016-12-31 | $60,788 |
| Total dividends received (eg from common stock, registered investment company shares) | 2016-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
| Administrative expenses professional fees incurred | 2016-12-31 | $76,290 |
| Was this plan covered by a fidelity bond | 2016-12-31 | Yes |
| Value of fidelity bond cover | 2016-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
| Contributions received from participants | 2016-12-31 | $48,937 |
| Assets. Other investments not covered elsewhere at end of year | 2016-12-31 | $98,772 |
| Assets. Other investments not covered elsewhere at beginning of year | 2016-12-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-12-31 | $284,824 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-12-31 | $58,454 |
| Administrative expenses (other) incurred | 2016-12-31 | $47,045 |
| Liabilities. Value of operating payables at end of year | 2016-12-31 | $93,064 |
| Liabilities. Value of operating payables at beginning of year | 2016-12-31 | $202,395 |
| Total non interest bearing cash at end of year | 2016-12-31 | $1,429,471 |
| Total non interest bearing cash at beginning of year | 2016-12-31 | $775,719 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Value of net income/loss | 2016-12-31 | $1,152,720 |
| Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $5,523,115 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $4,370,395 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
| Investment advisory and management fees | 2016-12-31 | $11,484 |
| Interest earned on other investments | 2016-12-31 | $674 |
| Income. Interest from US Government securities | 2016-12-31 | $17,479 |
| Income. Interest from corporate debt instruments | 2016-12-31 | $42,619 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-12-31 | $249,662 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-12-31 | $475,708 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-12-31 | $475,708 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-12-31 | $16 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $643,407 |
| Asset value of US Government securities at end of year | 2016-12-31 | $1,526,608 |
| Asset value of US Government securities at beginning of year | 2016-12-31 | $1,524,331 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
| Contributions received in cash from employer | 2016-12-31 | $5,340,098 |
| Employer contributions (assets) at end of year | 2016-12-31 | $444,038 |
| Employer contributions (assets) at beginning of year | 2016-12-31 | $441,621 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-12-31 | $3,208,781 |
| Asset. Corporate debt instrument preferred debt at end of year | 2016-12-31 | $475,679 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2016-12-31 | $627,354 |
| Asset. Corporate debt instrument debt (other) at end of year | 2016-12-31 | $1,467,925 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2016-12-31 | $1,177,603 |
| Contract administrator fees | 2016-12-31 | $317,104 |
| Liabilities. Value of benefit claims payable at end of year | 2016-12-31 | $360,800 |
| Liabilities. Value of benefit claims payable at beginning of year | 2016-12-31 | $508,000 |
| Did the plan have assets held for investment | 2016-12-31 | 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 | 2016-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | No |
| Aggregate proceeds on sale of assets | 2016-12-31 | $4,056,263 |
| Aggregate carrying amount (costs) on sale of assets | 2016-12-31 | $4,055,498 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Unqualified |
| Accountancy firm name | 2016-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2016-12-31 | 410746749 |
| 2015 : PUGET SOUND BENEFITS TRUST 2015 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2015-12-31 | $-33,683 |
| Total unrealized appreciation/depreciation of assets | 2015-12-31 | $-33,683 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $710,395 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $722,555 |
| Total income from all sources (including contributions) | 2015-12-31 | $5,431,831 |
| Total loss/gain on sale of assets | 2015-12-31 | $-1,327 |
| Total of all expenses incurred | 2015-12-31 | $5,109,764 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $4,659,445 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-12-31 | $5,405,622 |
| Value of total assets at end of year | 2015-12-31 | $5,080,790 |
| Value of total assets at beginning of year | 2015-12-31 | $4,770,883 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $450,319 |
| Total interest from all sources | 2015-12-31 | $59,232 |
| Total dividends received (eg from common stock, registered investment company shares) | 2015-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-12-31 | No |
| Administrative expenses professional fees incurred | 2015-12-31 | $78,571 |
| Was this plan covered by a fidelity bond | 2015-12-31 | Yes |
| Value of fidelity bond cover | 2015-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
| Contributions received from participants | 2015-12-31 | $20,634 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-12-31 | $58,454 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-12-31 | $30,903 |
| Other income not declared elsewhere | 2015-12-31 | $1,987 |
| Administrative expenses (other) incurred | 2015-12-31 | $59,612 |
| Liabilities. Value of operating payables at end of year | 2015-12-31 | $202,395 |
| Liabilities. Value of operating payables at beginning of year | 2015-12-31 | $194,155 |
| Total non interest bearing cash at end of year | 2015-12-31 | $775,719 |
| Total non interest bearing cash at beginning of year | 2015-12-31 | $1,743,545 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Value of net income/loss | 2015-12-31 | $322,067 |
| Value of net assets at end of year (total assets less liabilities) | 2015-12-31 | $4,370,395 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-12-31 | $4,048,328 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
| Investment advisory and management fees | 2015-12-31 | $9,987 |
| Income. Interest from US Government securities | 2015-12-31 | $13,529 |
| Income. Interest from corporate debt instruments | 2015-12-31 | $45,703 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-12-31 | $475,708 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-12-31 | $169,487 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-12-31 | $169,487 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-12-31 | $587,870 |
| Asset value of US Government securities at end of year | 2015-12-31 | $1,524,331 |
| Asset value of US Government securities at beginning of year | 2015-12-31 | $621,989 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2015-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
| Contributions received in cash from employer | 2015-12-31 | $5,384,988 |
| Employer contributions (assets) at end of year | 2015-12-31 | $441,621 |
| Employer contributions (assets) at beginning of year | 2015-12-31 | $466,458 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-12-31 | $4,071,575 |
| Asset. Corporate debt instrument preferred debt at end of year | 2015-12-31 | $627,354 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2015-12-31 | $1,054,193 |
| Asset. Corporate debt instrument debt (other) at end of year | 2015-12-31 | $1,177,603 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2015-12-31 | $684,308 |
| Contract administrator fees | 2015-12-31 | $302,149 |
| Liabilities. Value of benefit claims payable at end of year | 2015-12-31 | $508,000 |
| Liabilities. Value of benefit claims payable at beginning of year | 2015-12-31 | $528,400 |
| Did the plan have assets held for investment | 2015-12-31 | 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 | 2015-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-12-31 | No |
| Aggregate proceeds on sale of assets | 2015-12-31 | $3,250,302 |
| Aggregate carrying amount (costs) on sale of assets | 2015-12-31 | $3,251,629 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-12-31 | Unqualified |
| Accountancy firm name | 2015-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2015-12-31 | 410746749 |
| 2014 : PUGET SOUND BENEFITS TRUST 2014 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2014-12-31 | $10,372 |
| Total unrealized appreciation/depreciation of assets | 2014-12-31 | $10,372 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $722,555 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $446,771 |
| Total income from all sources (including contributions) | 2014-12-31 | $5,888,014 |
| Total loss/gain on sale of assets | 2014-12-31 | $-37,374 |
| Total of all expenses incurred | 2014-12-31 | $5,355,492 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $4,840,907 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-12-31 | $5,860,626 |
| Value of total assets at end of year | 2014-12-31 | $4,770,883 |
| Value of total assets at beginning of year | 2014-12-31 | $3,962,577 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $514,585 |
| Total interest from all sources | 2014-12-31 | $54,365 |
| Total dividends received (eg from common stock, registered investment company shares) | 2014-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-12-31 | No |
| Administrative expenses professional fees incurred | 2014-12-31 | $105,105 |
| Was this plan covered by a fidelity bond | 2014-12-31 | Yes |
| Value of fidelity bond cover | 2014-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
| Contributions received from participants | 2014-12-31 | $24,180 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2014-12-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-12-31 | $30,903 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-12-31 | $309,933 |
| Other income not declared elsewhere | 2014-12-31 | $25 |
| Administrative expenses (other) incurred | 2014-12-31 | $81,494 |
| Liabilities. Value of operating payables at end of year | 2014-12-31 | $194,155 |
| Liabilities. Value of operating payables at beginning of year | 2014-12-31 | $123,871 |
| Total non interest bearing cash at end of year | 2014-12-31 | $1,743,545 |
| Total non interest bearing cash at beginning of year | 2014-12-31 | $709,527 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Value of net income/loss | 2014-12-31 | $532,522 |
| Value of net assets at end of year (total assets less liabilities) | 2014-12-31 | $4,048,328 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-12-31 | $3,515,806 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
| Investment advisory and management fees | 2014-12-31 | $7,614 |
| Income. Interest from US Government securities | 2014-12-31 | $5,796 |
| Income. Interest from corporate debt instruments | 2014-12-31 | $48,569 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-12-31 | $169,487 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-12-31 | $126,286 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-12-31 | $126,286 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-12-31 | $0 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-12-31 | $590,190 |
| Asset value of US Government securities at end of year | 2014-12-31 | $621,989 |
| Asset value of US Government securities at beginning of year | 2014-12-31 | $405,062 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2014-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
| Contributions received in cash from employer | 2014-12-31 | $5,836,446 |
| Employer contributions (assets) at end of year | 2014-12-31 | $466,458 |
| Employer contributions (assets) at beginning of year | 2014-12-31 | $439,151 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-12-31 | $4,250,717 |
| Asset. Corporate debt instrument preferred debt at end of year | 2014-12-31 | $1,054,193 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2014-12-31 | $1,528,001 |
| Asset. Corporate debt instrument debt (other) at end of year | 2014-12-31 | $684,308 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2014-12-31 | $444,617 |
| Contract administrator fees | 2014-12-31 | $320,372 |
| Liabilities. Value of benefit claims payable at end of year | 2014-12-31 | $528,400 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-12-31 | $322,900 |
| Did the plan have assets held for investment | 2014-12-31 | 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 | 2014-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-12-31 | No |
| Aggregate proceeds on sale of assets | 2014-12-31 | $2,513,931 |
| Aggregate carrying amount (costs) on sale of assets | 2014-12-31 | $2,551,305 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-12-31 | Unqualified |
| Accountancy firm name | 2014-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2014-12-31 | 410746749 |
| 2013 : PUGET SOUND BENEFITS TRUST 2013 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2013-12-31 | $47 |
| Total unrealized appreciation/depreciation of assets | 2013-12-31 | $47 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $446,771 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $926,125 |
| Total income from all sources (including contributions) | 2013-12-31 | $5,226,186 |
| Total loss/gain on sale of assets | 2013-12-31 | $-52,031 |
| Total of all expenses incurred | 2013-12-31 | $5,292,125 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $4,820,693 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-12-31 | $5,194,374 |
| Value of total assets at end of year | 2013-12-31 | $3,962,577 |
| Value of total assets at beginning of year | 2013-12-31 | $4,507,870 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $471,432 |
| Total interest from all sources | 2013-12-31 | $83,796 |
| Total dividends received (eg from common stock, registered investment company shares) | 2013-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-12-31 | No |
| Administrative expenses professional fees incurred | 2013-12-31 | $94,852 |
| Was this plan covered by a fidelity bond | 2013-12-31 | Yes |
| Value of fidelity bond cover | 2013-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
| Contributions received from participants | 2013-12-31 | $12,117 |
| Assets. Other investments not covered elsewhere at end of year | 2013-12-31 | $0 |
| Assets. Other investments not covered elsewhere at beginning of year | 2013-12-31 | $310,350 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2013-12-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-12-31 | $309,933 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-12-31 | $286,214 |
| Administrative expenses (other) incurred | 2013-12-31 | $46,130 |
| Liabilities. Value of operating payables at end of year | 2013-12-31 | $123,871 |
| Liabilities. Value of operating payables at beginning of year | 2013-12-31 | $184,825 |
| Total non interest bearing cash at end of year | 2013-12-31 | $709,527 |
| Total non interest bearing cash at beginning of year | 2013-12-31 | $791,225 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Value of net income/loss | 2013-12-31 | $-65,939 |
| Value of net assets at end of year (total assets less liabilities) | 2013-12-31 | $3,515,806 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $3,581,745 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
| Investment advisory and management fees | 2013-12-31 | $10,381 |
| Interest earned on other investments | 2013-12-31 | $0 |
| Income. Interest from US Government securities | 2013-12-31 | $3,535 |
| Income. Interest from corporate debt instruments | 2013-12-31 | $80,234 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-12-31 | $126,286 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-12-31 | $211,642 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-12-31 | $211,642 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-12-31 | $27 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-12-31 | $528,214 |
| Asset value of US Government securities at end of year | 2013-12-31 | $405,062 |
| Asset value of US Government securities at beginning of year | 2013-12-31 | $304,861 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2013-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
| Contributions received in cash from employer | 2013-12-31 | $5,182,257 |
| Employer contributions (assets) at end of year | 2013-12-31 | $439,151 |
| Employer contributions (assets) at beginning of year | 2013-12-31 | $413,227 |
| Income. Dividends from preferred stock | 2013-12-31 | $0 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-12-31 | $4,292,479 |
| Asset. Corporate debt instrument preferred debt at end of year | 2013-12-31 | $1,528,001 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2013-12-31 | $1,196,183 |
| Asset. Corporate debt instrument debt (other) at end of year | 2013-12-31 | $444,617 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2013-12-31 | $994,168 |
| Contract administrator fees | 2013-12-31 | $320,069 |
| Liabilities. Value of benefit claims payable at end of year | 2013-12-31 | $322,900 |
| Liabilities. Value of benefit claims payable at beginning of year | 2013-12-31 | $741,300 |
| Did the plan have assets held for investment | 2013-12-31 | 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 | 2013-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-12-31 | No |
| Aggregate proceeds on sale of assets | 2013-12-31 | $5,446,428 |
| Aggregate carrying amount (costs) on sale of assets | 2013-12-31 | $5,498,459 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-12-31 | Unqualified |
| Accountancy firm name | 2013-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2013-12-31 | 410746749 |
| 2012 : PUGET SOUND BENEFITS TRUST 2012 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2012-12-31 | $15,403 |
| Total unrealized appreciation/depreciation of assets | 2012-12-31 | $15,403 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $926,125 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $831,224 |
| Total income from all sources (including contributions) | 2012-12-31 | $5,141,010 |
| Total loss/gain on sale of assets | 2012-12-31 | $-46,081 |
| Total of all expenses incurred | 2012-12-31 | $6,096,592 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $5,630,015 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $5,054,962 |
| Value of total assets at end of year | 2012-12-31 | $4,507,870 |
| Value of total assets at beginning of year | 2012-12-31 | $5,368,551 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $466,577 |
| Total interest from all sources | 2012-12-31 | $116,277 |
| Total dividends received (eg from common stock, registered investment company shares) | 2012-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
| Administrative expenses professional fees incurred | 2012-12-31 | $106,866 |
| Was this plan covered by a fidelity bond | 2012-12-31 | Yes |
| Value of fidelity bond cover | 2012-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
| Contributions received from participants | 2012-12-31 | $17,431 |
| Assets. Other investments not covered elsewhere at end of year | 2012-12-31 | $310,350 |
| Assets. Other investments not covered elsewhere at beginning of year | 2012-12-31 | $492,890 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2012-12-31 | $5,104,902 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-12-31 | $286,214 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-12-31 | $737,819 |
| Other income not declared elsewhere | 2012-12-31 | $449 |
| Administrative expenses (other) incurred | 2012-12-31 | $44,877 |
| Liabilities. Value of operating payables at end of year | 2012-12-31 | $184,825 |
| Liabilities. Value of operating payables at beginning of year | 2012-12-31 | $141,524 |
| Total non interest bearing cash at end of year | 2012-12-31 | $791,225 |
| Total non interest bearing cash at beginning of year | 2012-12-31 | $310,443 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Value of net income/loss | 2012-12-31 | $-955,582 |
| Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $3,581,745 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $4,537,327 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
| Investment advisory and management fees | 2012-12-31 | $13,571 |
| Interest earned on other investments | 2012-12-31 | $16,476 |
| Income. Interest from US Government securities | 2012-12-31 | $3,033 |
| Income. Interest from corporate debt instruments | 2012-12-31 | $96,492 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-12-31 | $211,642 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-12-31 | $186,078 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-12-31 | $186,078 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-12-31 | $276 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2012-12-31 | $0 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2012-12-31 | $0 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-12-31 | $515,964 |
| Asset value of US Government securities at end of year | 2012-12-31 | $304,861 |
| Asset value of US Government securities at beginning of year | 2012-12-31 | $616,591 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
| Contributions received in cash from employer | 2012-12-31 | $5,037,531 |
| Employer contributions (assets) at end of year | 2012-12-31 | $413,227 |
| Employer contributions (assets) at beginning of year | 2012-12-31 | $429,386 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $9,149 |
| Asset. Corporate debt instrument preferred debt at end of year | 2012-12-31 | $1,196,183 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2012-12-31 | $1,881,530 |
| Asset. Corporate debt instrument debt (other) at end of year | 2012-12-31 | $994,168 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2012-12-31 | $713,814 |
| Contract administrator fees | 2012-12-31 | $301,263 |
| Liabilities. Value of benefit claims payable at end of year | 2012-12-31 | $741,300 |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-12-31 | $689,700 |
| Did the plan have assets held for investment | 2012-12-31 | 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 | 2012-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
| Aggregate proceeds on sale of assets | 2012-12-31 | $5,272,219 |
| Aggregate carrying amount (costs) on sale of assets | 2012-12-31 | $5,318,300 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Unqualified |
| Accountancy firm name | 2012-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2012-12-31 | 410746749 |
| 2011 : PUGET SOUND BENEFITS TRUST 2011 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2011-12-31 | $-7,690 |
| Total unrealized appreciation/depreciation of assets | 2011-12-31 | $-7,690 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $831,224 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $1,456,885 |
| Total income from all sources (including contributions) | 2011-12-31 | $5,347,647 |
| Total loss/gain on sale of assets | 2011-12-31 | $-54,341 |
| Total of all expenses incurred | 2011-12-31 | $4,749,821 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $4,313,691 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $5,273,149 |
| Value of total assets at end of year | 2011-12-31 | $5,368,551 |
| Value of total assets at beginning of year | 2011-12-31 | $5,396,386 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $436,130 |
| Total interest from all sources | 2011-12-31 | $136,416 |
| Total dividends received (eg from common stock, registered investment company shares) | 2011-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
| Administrative expenses professional fees incurred | 2011-12-31 | $78,213 |
| Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
| Value of fidelity bond cover | 2011-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
| Contributions received from participants | 2011-12-31 | $53,512 |
| Assets. Other investments not covered elsewhere at end of year | 2011-12-31 | $492,890 |
| Assets. Other investments not covered elsewhere at beginning of year | 2011-12-31 | $427,239 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2011-12-31 | $3,762,599 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-12-31 | $737,819 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-12-31 | $60,486 |
| Other income not declared elsewhere | 2011-12-31 | $113 |
| Administrative expenses (other) incurred | 2011-12-31 | $20,992 |
| Liabilities. Value of operating payables at end of year | 2011-12-31 | $141,524 |
| Liabilities. Value of operating payables at beginning of year | 2011-12-31 | $146,785 |
| Total non interest bearing cash at end of year | 2011-12-31 | $310,443 |
| Total non interest bearing cash at beginning of year | 2011-12-31 | $1,074,564 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Value of net income/loss | 2011-12-31 | $597,826 |
| Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $4,537,327 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $3,939,501 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
| Investment advisory and management fees | 2011-12-31 | $19,777 |
| Interest earned on other investments | 2011-12-31 | $11,514 |
| Income. Interest from US Government securities | 2011-12-31 | $9,736 |
| Income. Interest from corporate debt instruments | 2011-12-31 | $115,008 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-12-31 | $186,078 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-12-31 | $96,810 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-12-31 | $96,810 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-12-31 | $158 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2011-12-31 | $0 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2011-12-31 | $0 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-12-31 | $551,092 |
| Asset value of US Government securities at end of year | 2011-12-31 | $616,591 |
| Asset value of US Government securities at beginning of year | 2011-12-31 | $912,385 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
| Contributions received in cash from employer | 2011-12-31 | $5,219,637 |
| Employer contributions (assets) at end of year | 2011-12-31 | $429,386 |
| Employer contributions (assets) at beginning of year | 2011-12-31 | $437,106 |
| Asset. Corporate debt instrument preferred debt at end of year | 2011-12-31 | $1,881,530 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2011-12-31 | $1,430,567 |
| Asset. Corporate debt instrument debt (other) at end of year | 2011-12-31 | $713,814 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2011-12-31 | $957,229 |
| Contract administrator fees | 2011-12-31 | $317,148 |
| Liabilities. Value of benefit claims payable at end of year | 2011-12-31 | $689,700 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-12-31 | $1,310,100 |
| Did the plan have assets held for investment | 2011-12-31 | 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 | 2011-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
| Aggregate proceeds on sale of assets | 2011-12-31 | $6,099,343 |
| Aggregate carrying amount (costs) on sale of assets | 2011-12-31 | $6,153,684 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Unqualified |
| Accountancy firm name | 2011-12-31 | CLIFTONLARSONALLEN LLP |
| Accountancy firm EIN | 2011-12-31 | 410746749 |
| 2010 : PUGET SOUND BENEFITS TRUST 2010 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2010-12-31 | $-27,335 |
| Total unrealized appreciation/depreciation of assets | 2010-12-31 | $-27,335 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $1,456,885 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $1,182,601 |
| Total income from all sources (including contributions) | 2010-12-31 | $5,480,851 |
| Total loss/gain on sale of assets | 2010-12-31 | $-12,209 |
| Total of all expenses incurred | 2010-12-31 | $4,934,442 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $4,507,785 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $5,375,850 |
| Value of total assets at end of year | 2010-12-31 | $5,396,386 |
| Value of total assets at beginning of year | 2010-12-31 | $4,575,693 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $426,657 |
| Total interest from all sources | 2010-12-31 | $144,545 |
| Total dividends received (eg from common stock, registered investment company shares) | 2010-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
| Administrative expenses professional fees incurred | 2010-12-31 | $160,285 |
| Was this plan covered by a fidelity bond | 2010-12-31 | Yes |
| Value of fidelity bond cover | 2010-12-31 | $500,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
| Contributions received from participants | 2010-12-31 | $78,429 |
| Assets. Other investments not covered elsewhere at end of year | 2010-12-31 | $427,239 |
| Assets. Other investments not covered elsewhere at beginning of year | 2010-12-31 | $153,278 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2010-12-31 | $4,027,242 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2010-12-31 | $60,486 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2010-12-31 | $44,830 |
| Administrative expenses (other) incurred | 2010-12-31 | $21,926 |
| Liabilities. Value of operating payables at end of year | 2010-12-31 | $146,785 |
| Liabilities. Value of operating payables at beginning of year | 2010-12-31 | $181,501 |
| Total non interest bearing cash at end of year | 2010-12-31 | $1,074,564 |
| Total non interest bearing cash at beginning of year | 2010-12-31 | $817,862 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Value of net income/loss | 2010-12-31 | $546,409 |
| Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $3,939,501 |
| Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $3,393,092 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2010-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
| Investment advisory and management fees | 2010-12-31 | $18,134 |
| Interest earned on other investments | 2010-12-31 | $14,783 |
| Income. Interest from US Government securities | 2010-12-31 | $14,107 |
| Income. Interest from corporate debt instruments | 2010-12-31 | $115,476 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2010-12-31 | $96,810 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2010-12-31 | $272,915 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2010-12-31 | $272,915 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2010-12-31 | $179 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2010-12-31 | $0 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2010-12-31 | $0 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2010-12-31 | $480,543 |
| Asset value of US Government securities at end of year | 2010-12-31 | $912,385 |
| Asset value of US Government securities at beginning of year | 2010-12-31 | $892,127 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
| Contributions received in cash from employer | 2010-12-31 | $5,297,421 |
| Employer contributions (assets) at end of year | 2010-12-31 | $437,106 |
| Employer contributions (assets) at beginning of year | 2010-12-31 | $475,939 |
| Asset. Corporate debt instrument preferred debt at end of year | 2010-12-31 | $1,430,567 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2010-12-31 | $1,235,990 |
| Asset. Corporate debt instrument debt (other) at end of year | 2010-12-31 | $957,229 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2010-12-31 | $682,752 |
| Contract administrator fees | 2010-12-31 | $226,312 |
| Liabilities. Value of benefit claims payable at end of year | 2010-12-31 | $1,310,100 |
| Liabilities. Value of benefit claims payable at beginning of year | 2010-12-31 | $1,001,100 |
| Did the plan have assets held for investment | 2010-12-31 | 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 | 2010-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-12-31 | No |
| Aggregate proceeds on sale of assets | 2010-12-31 | $2,176,571 |
| Aggregate carrying amount (costs) on sale of assets | 2010-12-31 | $2,188,780 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Unqualified |
| Accountancy firm name | 2010-12-31 | LOCKITCH, CLEMENTS & RICE, P.S. |
| Accountancy firm EIN | 2010-12-31 | 910903661 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 890091G |
| Policy instance | 3 |
| Insurance contract or identification number | 890091G | | Number of Individuals Covered | 309 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | 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 | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | 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 $24,946 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 247293 |
| Policy instance | 2 |
| Insurance contract or identification number | 247293 | | Number of Individuals Covered | 236 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $15,105 | | 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 $305,957 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 15105 | | Additional information about fees paid to insurance broker | SPECIFIC | | Insurance broker organization code? | 3 |
|
| GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
| Policy contract number | 0330000 |
| Policy instance | 1 |
| Insurance contract or identification number | 0330000 | | Number of Individuals Covered | 112 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | 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 $818,859 | | 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 | 0330000 |
| Policy instance | 1 |
| Insurance contract or identification number | 0330000 | | Number of Individuals Covered | 112 | | 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 $874,376 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 247293 |
| Policy instance | 2 |
| Insurance contract or identification number | 247293 | | Number of Individuals Covered | 228 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $14,983 | | 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 $299,666 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 14983 | | Additional information about fees paid to insurance broker | SPECIFIC | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 890091G |
| Policy instance | 3 |
| Insurance contract or identification number | 890091G | | Number of Individuals Covered | 308 | | 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 | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | 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 $24,812 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 890091G |
| Policy instance | 3 |
| Insurance contract or identification number | 890091G | | Number of Individuals Covered | 325 | | 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 | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | 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 $22,398 | | 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 | 0330000 |
| Policy instance | 1 |
| Insurance contract or identification number | 0330000 | | Number of Individuals Covered | 113 | | 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 $937,149 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 247293 |
| Policy instance | 2 |
| Insurance contract or identification number | 247293 | | Number of Individuals Covered | 226 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $16,401 | | 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 $328,017 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 16401 | | Additional information about fees paid to insurance broker | SPECIFIC | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX967799 |
| Policy instance | 4 |
| Insurance contract or identification number | FLX967799 | | Number of Individuals Covered | 306 | | 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 | Yes | | 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 $10,045 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 969303 |
| Policy instance | 3 |
| Insurance contract or identification number | OK 969303 | | Number of Individuals Covered | 306 | | 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 | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | 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 $2,735 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 247293 |
| Policy instance | 2 |
| Insurance contract or identification number | 247293 | | Number of Individuals Covered | 224 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $16,468 | | 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 $329,366 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 16468 | | Additional information about fees paid to insurance broker | SPECIFIC | | Insurance broker organization code? | 3 |
|
| GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
| Policy contract number | 0330000 |
| Policy instance | 1 |
| Insurance contract or identification number | 0330000 | | Number of Individuals Covered | 111 | | 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 | 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 $859,377 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 965328 |
| Policy instance | 5 |
| Insurance contract or identification number | LK 965328 | | Number of Individuals Covered | 120 | | 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 | Yes | | 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 $25,948 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX967799 |
| Policy instance | 4 |
| Insurance contract or identification number | FLX967799 | | Number of Individuals Covered | 289 | | 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 | Yes | | 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 $8,455 | | 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 | 0330000 |
| Policy instance | 1 |
| Insurance contract or identification number | 0330000 | | Number of Individuals Covered | 96 | | 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 $678,282 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 247293 |
| Policy instance | 2 |
| Insurance contract or identification number | 247293 | | Number of Individuals Covered | 217 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $15,263 | | 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 $305,254 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 15263 | | Additional information about fees paid to insurance broker | SPECIFIC | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 969303 |
| Policy instance | 3 |
| Insurance contract or identification number | OK 969303 | | Number of Individuals Covered | 289 | | 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 | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | 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 $1,852 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 965328 |
| Policy instance | 5 |
| Insurance contract or identification number | LK 965328 | | Number of Individuals Covered | 289 | | 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 | Yes | | 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 $21,554 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 965328 |
| Policy instance | 5 |
| Insurance contract or identification number | LK 965328 | | Number of Individuals Covered | 105 | | 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 | Yes | | 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 $19,565 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX967799 |
| Policy instance | 4 |
| Insurance contract or identification number | FLX967799 | | Number of Individuals Covered | 260 | | 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 | Yes | | 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 $7,375 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 969303 |
| Policy instance | 3 |
| Insurance contract or identification number | OK 969303 | | Number of Individuals Covered | 260 | | 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 | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | 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 $1,909 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 247293 |
| Policy instance | 2 |
| Insurance contract or identification number | 247293 | | Number of Individuals Covered | 238 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $14,722 | | 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 $294,433 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 13384 | | Additional information about fees paid to insurance broker | SPECIFIC | | Insurance broker organization code? | 3 | | Insurance broker name | INTERREMEDY INSURANCE SERVICES LLC |
|
| GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
| Policy contract number | 0330000 |
| Policy instance | 1 |
| Insurance contract or identification number | 0330000 | | Number of Individuals Covered | 44 | | 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 $231,594 | | 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 | 0330000 |
| Policy instance | 1 |
| Insurance contract or identification number | 0330000 | | Number of Individuals Covered | 36 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $229,775 | | 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 | SL10005 |
| Policy instance | 2 |
| Insurance contract or identification number | SL10005 | | Number of Individuals Covered | 247 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $316,877 | | 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 | G2863 |
| Policy instance | 3 |
| Insurance contract or identification number | G2863 | | Number of Individuals Covered | 285 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | 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 $11,204 | | 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 | CL4151 |
| Policy instance | 4 |
| Insurance contract or identification number | CL4151 | | Number of Individuals Covered | 121 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | Yes | | 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 $32,527 | | 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 | 0330000 |
| Policy instance | 1 |
| Insurance contract or identification number | 0330000 | | Number of Individuals Covered | 47 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $219,519 | | 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 | SL10005 |
| Policy instance | 2 |
| Insurance contract or identification number | SL10005 | | Number of Individuals Covered | 272 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $305,414 | | 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 | CL4151 |
| Policy instance | 4 |
| Insurance contract or identification number | CL4151 | | Number of Individuals Covered | 135 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | Yes | | 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 $36,399 | | 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 | G2863 |
| Policy instance | 3 |
| Insurance contract or identification number | G2863 | | Number of Individuals Covered | 309 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | 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 $12,348 | | 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 | 0330000 |
| Policy instance | 1 |
| Insurance contract or identification number | 0330000 | | Number of Individuals Covered | 32 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $166,190 | | 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 | G2863 |
| Policy instance | 2 |
| Insurance contract or identification number | G2863 | | Number of Individuals Covered | 327 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | ACCIDENTAL DEATH AND DISMEMBERMENT | | 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 $12,432 | | 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 | SL10005 |
| Policy instance | 3 |
| Insurance contract or identification number | SL10005 | | Number of Individuals Covered | 303 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $325,729 | | 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 | CL4151 |
| Policy instance | 4 |
| Insurance contract or identification number | CL4151 | | Number of Individuals Covered | 134 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | Yes | | 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 $36,826 | | 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 | G2863 |
| Policy instance | 2 |
| Insurance contract or identification number | G2863 | | Number of Individuals Covered | 460 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | ACCIDENTAL DEATH AND DISMEMBERMENT | | 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 $50,889 | | 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 | SL10005 |
| Policy instance | 3 |
| Insurance contract or identification number | SL10005 | | Number of Individuals Covered | 294 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $283,432 | | 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 | 0330000 |
| Policy instance | 1 |
| Insurance contract or identification number | 0330000 | | Number of Individuals Covered | 38 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $171,368 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47341 ) |
| Policy contract number | 146 |
| Policy instance | 3 |
| Insurance contract or identification number | 146 | | Number of Individuals Covered | 313 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | Yes | | 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 | | 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 | SL10005 |
| Policy instance | 2 |
| Insurance contract or identification number | SL10005 | | Number of Individuals Covered | 299 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $276,626 | | 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 | 0330000 |
| Policy instance | 1 |
| Insurance contract or identification number | 0330000 | | Number of Individuals Covered | 49 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $190,643 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47341 ) |
| Policy contract number | 146 |
| Policy instance | 5 |
| Insurance contract or identification number | 146 | | Number of Individuals Covered | 752 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | Yes | | 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 | | 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 | CL4151 |
| Policy instance | 4 |
| Insurance contract or identification number | CL4151 | | Number of Individuals Covered | 152 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | 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 $44,142 | | 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 | G2863/C4151 |
| Policy instance | 3 |
| Insurance contract or identification number | G2863/C4151 | | Number of Individuals Covered | 338 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | 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 $14,616 | | 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 | SL10005 |
| Policy instance | 2 |
| Insurance contract or identification number | SL10005 | | Number of Individuals Covered | 324 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $290,924 | | 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 | 0330000 |
| Policy instance | 1 |
| Insurance contract or identification number | 0330000 | | Number of Individuals Covered | 34 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | No | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $122,756 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
