AFOGNAK NATIVE CORPORATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan AFOGNAK NATIVE CORPORATION HEALTH AND WELFARE PLAN
401k plan membership statisitcs for AFOGNAK NATIVE CORPORATION HEALTH AND WELFARE PLAN
| Measure | Date | Value |
|---|
| 2023 : AFOGNAK NATIVE CORPORATION HEALTH AND WELFARE PLAN 2023 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-12-31 | $2,795,911 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-12-31 | $3,273,535 |
| Total income from all sources (including contributions) | 2023-12-31 | $20,840,767 |
| Total of all expenses incurred | 2023-12-31 | $19,997,594 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2023-12-31 | $18,233,470 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2023-12-31 | $20,797,559 |
| Value of total assets at end of year | 2023-12-31 | $5,792,621 |
| Value of total assets at beginning of year | 2023-12-31 | $5,427,072 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2023-12-31 | $1,764,124 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2023-12-31 | No |
| Was this plan covered by a fidelity bond | 2023-12-31 | Yes |
| Value of fidelity bond cover | 2023-12-31 | $10,000,000 |
| If this is an individual account plan, was there a blackout period | 2023-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2023-12-31 | No |
| Contributions received from participants | 2023-12-31 | $5,227,551 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2023-12-31 | $55,839 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2023-12-31 | $3,825 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2023-12-31 | $113,867 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2023-12-31 | $2,795,911 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2023-12-31 | $3,273,535 |
| Other income not declared elsewhere | 2023-12-31 | $43,208 |
| Administrative expenses (other) incurred | 2023-12-31 | $63,264 |
| Total non interest bearing cash at end of year | 2023-12-31 | $4,141,924 |
| Total non interest bearing cash at beginning of year | 2023-12-31 | $3,060,480 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-12-31 | No |
| Value of net income/loss | 2023-12-31 | $843,173 |
| Value of net assets at end of year (total assets less liabilities) | 2023-12-31 | $2,996,710 |
| Value of net assets at beginning of year (total assets less liabilities) | 2023-12-31 | $2,153,537 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2023-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2023-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2023-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2023-12-31 | $6,431,294 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2023-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2023-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2023-12-31 | No |
| Contributions received in cash from employer | 2023-12-31 | $15,514,169 |
| Employer contributions (assets) at end of year | 2023-12-31 | $1,646,872 |
| Employer contributions (assets) at beginning of year | 2023-12-31 | $2,252,725 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2023-12-31 | $11,802,176 |
| Contract administrator fees | 2023-12-31 | $1,656,892 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2023-12-31 | No |
| Did the plan have assets held for investment | 2023-12-31 | No |
| 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 | 2023-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2023-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2023-12-31 | Unqualified |
| Accountancy firm name | 2023-12-31 | CITRIN COOPERMAN & COMPANY, LLP |
| Accountancy firm EIN | 2023-12-31 | 222428965 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-01-01 | $2,795,911 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-01-01 | $3,273,535 |
| Total income from all sources (including contributions) | 2023-01-01 | $20,840,767 |
| Total of all expenses incurred | 2023-01-01 | $19,997,594 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2023-01-01 | $18,233,470 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2023-01-01 | $20,797,559 |
| Value of total assets at end of year | 2023-01-01 | $5,792,621 |
| Value of total assets at beginning of year | 2023-01-01 | $5,427,072 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2023-01-01 | $1,764,124 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2023-01-01 | No |
| Was this plan covered by a fidelity bond | 2023-01-01 | Yes |
| Value of fidelity bond cover | 2023-01-01 | $10,000,000 |
| If this is an individual account plan, was there a blackout period | 2023-01-01 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2023-01-01 | No |
| Contributions received from participants | 2023-01-01 | $5,227,551 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2023-01-01 | $55,839 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2023-01-01 | $3,825 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2023-01-01 | $113,867 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2023-01-01 | $2,795,911 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2023-01-01 | $3,273,535 |
| Other income not declared elsewhere | 2023-01-01 | $43,208 |
| Administrative expenses (other) incurred | 2023-01-01 | $63,264 |
| Total non interest bearing cash at end of year | 2023-01-01 | $4,141,924 |
| Total non interest bearing cash at beginning of year | 2023-01-01 | $3,060,480 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-01-01 | No |
| Value of net income/loss | 2023-01-01 | $843,173 |
| Value of net assets at end of year (total assets less liabilities) | 2023-01-01 | $2,996,710 |
| Value of net assets at beginning of year (total assets less liabilities) | 2023-01-01 | $2,153,537 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2023-01-01 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2023-01-01 | No |
| Were any leases to which the plan was party in default or uncollectible | 2023-01-01 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2023-01-01 | $6,431,294 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2023-01-01 | No |
| Was there a failure to transmit to the plan any participant contributions | 2023-01-01 | No |
| Has the plan failed to provide any benefit when due under the plan | 2023-01-01 | No |
| Contributions received in cash from employer | 2023-01-01 | $15,514,169 |
| Employer contributions (assets) at end of year | 2023-01-01 | $1,646,872 |
| Employer contributions (assets) at beginning of year | 2023-01-01 | $2,252,725 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2023-01-01 | $11,802,176 |
| Contract administrator fees | 2023-01-01 | $1,656,892 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2023-01-01 | No |
| Did the plan have assets held for investment | 2023-01-01 | No |
| 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 | 2023-01-01 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2023-01-01 | No |
| Opinion of an independent qualified public accountant for this plan | 2023-01-01 | 1 |
| Accountancy firm name | 2023-01-01 | CITRIN COOPERMAN & COMPANY, LLP |
| Accountancy firm EIN | 2023-01-01 | 222428965 |
| 2022 : AFOGNAK NATIVE CORPORATION HEALTH AND WELFARE PLAN 2022 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $3,273,535 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $3,702,135 |
| Total income from all sources (including contributions) | 2022-12-31 | $23,416,525 |
| Total of all expenses incurred | 2022-12-31 | $22,404,720 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $21,190,169 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-12-31 | $23,150,005 |
| Value of total assets at end of year | 2022-12-31 | $5,427,072 |
| Value of total assets at beginning of year | 2022-12-31 | $4,843,867 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $1,214,551 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-12-31 | No |
| Administrative expenses professional fees incurred | 2022-12-31 | $33,850 |
| Was this plan covered by a fidelity bond | 2022-12-31 | Yes |
| Value of fidelity bond cover | 2022-12-31 | $5,000,000 |
| If this is an individual account plan, was there a blackout period | 2022-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
| Contributions received from participants | 2022-12-31 | $5,720,947 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2022-12-31 | $90,036 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-12-31 | $113,867 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-12-31 | $573,481 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2022-12-31 | $3,273,535 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2022-12-31 | $3,702,135 |
| Other income not declared elsewhere | 2022-12-31 | $266,520 |
| Administrative expenses (other) incurred | 2022-12-31 | $1,180,701 |
| Total non interest bearing cash at end of year | 2022-12-31 | $3,060,480 |
| Total non interest bearing cash at beginning of year | 2022-12-31 | $1,925,084 |
| 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 | $1,011,805 |
| Value of net assets at end of year (total assets less liabilities) | 2022-12-31 | $2,153,537 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-12-31 | $1,141,732 |
| 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 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-12-31 | $9,127,777 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | No |
| 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 | $17,339,022 |
| Employer contributions (assets) at end of year | 2022-12-31 | $2,252,725 |
| Employer contributions (assets) at beginning of year | 2022-12-31 | $2,345,302 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-12-31 | $12,062,392 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2022-12-31 | No |
| Did the plan have assets held for investment | 2022-12-31 | No |
| 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 |
| Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
| Accountancy firm name | 2022-12-31 | CITRIN COOPERMAN & COMPANY, LLP |
| Accountancy firm EIN | 2022-12-31 | 222428965 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-01-01 | $3,273,535 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-01-01 | $3,702,135 |
| Total income from all sources (including contributions) | 2022-01-01 | $23,416,525 |
| Total of all expenses incurred | 2022-01-01 | $22,404,720 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-01-01 | $21,190,169 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-01-01 | $23,150,005 |
| Value of total assets at end of year | 2022-01-01 | $5,427,072 |
| Value of total assets at beginning of year | 2022-01-01 | $4,843,867 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-01-01 | $1,214,551 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-01-01 | No |
| Administrative expenses professional fees incurred | 2022-01-01 | $33,850 |
| Was this plan covered by a fidelity bond | 2022-01-01 | Yes |
| Value of fidelity bond cover | 2022-01-01 | $5,000,000 |
| If this is an individual account plan, was there a blackout period | 2022-01-01 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2022-01-01 | No |
| Contributions received from participants | 2022-01-01 | $5,720,947 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2022-01-01 | $90,036 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-01-01 | $113,867 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-01-01 | $573,481 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2022-01-01 | $3,273,535 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2022-01-01 | $3,702,135 |
| Other income not declared elsewhere | 2022-01-01 | $266,520 |
| Administrative expenses (other) incurred | 2022-01-01 | $1,180,701 |
| Total non interest bearing cash at end of year | 2022-01-01 | $3,060,480 |
| Total non interest bearing cash at beginning of year | 2022-01-01 | $1,925,084 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-01-01 | No |
| Value of net income/loss | 2022-01-01 | $1,011,805 |
| Value of net assets at end of year (total assets less liabilities) | 2022-01-01 | $2,153,537 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-01-01 | $1,141,732 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-01-01 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-01-01 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-01-01 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-01-01 | $9,127,777 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-01-01 | No |
| Was there a failure to transmit to the plan any participant contributions | 2022-01-01 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-01-01 | No |
| Contributions received in cash from employer | 2022-01-01 | $17,339,022 |
| Employer contributions (assets) at end of year | 2022-01-01 | $2,252,725 |
| Employer contributions (assets) at beginning of year | 2022-01-01 | $2,345,302 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-01-01 | $12,062,392 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2022-01-01 | No |
| Did the plan have assets held for investment | 2022-01-01 | No |
| 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 | 2022-01-01 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-01-01 | No |
| Opinion of an independent qualified public accountant for this plan | 2022-01-01 | 1 |
| Accountancy firm name | 2022-01-01 | CITRIN COOPERMAN & COMPANY, LLP |
| Accountancy firm EIN | 2022-01-01 | 222428965 |
| 2021 : AFOGNAK NATIVE CORPORATION HEALTH AND WELFARE PLAN 2021 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $3,702,135 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $3,832,344 |
| Total income from all sources (including contributions) | 2021-12-31 | $24,465,537 |
| Total of all expenses incurred | 2021-12-31 | $23,397,661 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $22,214,740 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-12-31 | $24,371,612 |
| Value of total assets at end of year | 2021-12-31 | $4,843,867 |
| Value of total assets at beginning of year | 2021-12-31 | $3,906,200 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $1,182,921 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-12-31 | No |
| Administrative expenses professional fees incurred | 2021-12-31 | $31,000 |
| Was this plan covered by a fidelity bond | 2021-12-31 | Yes |
| Value of fidelity bond cover | 2021-12-31 | $5,000,000 |
| If this is an individual account plan, was there a blackout period | 2021-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
| Contributions received from participants | 2021-12-31 | $6,001,584 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2021-12-31 | $135,817 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-12-31 | $573,481 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2021-12-31 | $3,702,135 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2021-12-31 | $3,832,344 |
| Other income not declared elsewhere | 2021-12-31 | $93,925 |
| Administrative expenses (other) incurred | 2021-12-31 | $1,151,921 |
| Total non interest bearing cash at end of year | 2021-12-31 | $1,925,084 |
| Total non interest bearing cash at beginning of year | 2021-12-31 | $1,271,476 |
| 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 | $1,067,876 |
| Value of net assets at end of year (total assets less liabilities) | 2021-12-31 | $1,141,732 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-12-31 | $73,856 |
| 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 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-12-31 | $9,702,718 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-12-31 | No |
| 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 | $18,234,211 |
| Employer contributions (assets) at end of year | 2021-12-31 | $2,345,302 |
| Employer contributions (assets) at beginning of year | 2021-12-31 | $2,634,724 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-12-31 | $12,512,022 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2021-12-31 | No |
| Did the plan have assets held for investment | 2021-12-31 | No |
| 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 |
| Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
| Accountancy firm name | 2021-12-31 | CITRIN COOPERMAN & COMPANY, LLP |
| Accountancy firm EIN | 2021-12-31 | 222428965 |
| 2020 : AFOGNAK NATIVE CORPORATION HEALTH AND WELFARE PLAN 2020 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $3,832,344 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $4,037,192 |
| Total income from all sources (including contributions) | 2020-12-31 | $27,431,553 |
| Total of all expenses incurred | 2020-12-31 | $27,059,606 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $25,542,276 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-12-31 | $27,431,553 |
| Value of total assets at end of year | 2020-12-31 | $3,906,200 |
| Value of total assets at beginning of year | 2020-12-31 | $3,739,101 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $1,517,330 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-12-31 | No |
| Administrative expenses professional fees incurred | 2020-12-31 | $30,066 |
| Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
| Value of fidelity bond cover | 2020-12-31 | $2,000,000 |
| If this is an individual account plan, was there a blackout period | 2020-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
| Contributions received from participants | 2020-12-31 | $6,289,053 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2020-12-31 | $120,884 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2020-12-31 | $107,817 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2020-12-31 | $3,832,344 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-12-31 | $4,037,192 |
| Administrative expenses (other) incurred | 2020-12-31 | $1,487,264 |
| Total non interest bearing cash at end of year | 2020-12-31 | $1,271,476 |
| Total non interest bearing cash at beginning of year | 2020-12-31 | $1,082,897 |
| 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 | $371,947 |
| Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $73,856 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $-298,091 |
| 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 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-12-31 | $8,010,100 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | No |
| 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 | $21,021,616 |
| Employer contributions (assets) at end of year | 2020-12-31 | $2,634,724 |
| Employer contributions (assets) at beginning of year | 2020-12-31 | $2,656,204 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-12-31 | $17,424,359 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2020-12-31 | No |
| Did the plan have assets held for investment | 2020-12-31 | No |
| 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 |
| Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Unqualified |
| Accountancy firm name | 2020-12-31 | CITRIN COOPERMAN & COMPANY, LLP |
| Accountancy firm EIN | 2020-12-31 | 222428965 |
| 2019 : AFOGNAK NATIVE CORPORATION HEALTH AND WELFARE PLAN 2019 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $4,037,192 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $3,381,176 |
| Total income from all sources (including contributions) | 2019-12-31 | $24,649,453 |
| Total of all expenses incurred | 2019-12-31 | $27,441,613 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $25,930,666 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $24,515,408 |
| Value of total assets at end of year | 2019-12-31 | $3,739,101 |
| Value of total assets at beginning of year | 2019-12-31 | $5,875,245 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $1,510,947 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Administrative expenses professional fees incurred | 2019-12-31 | $28,118 |
| Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
| Value of fidelity bond cover | 2019-12-31 | $5,000,000 |
| If this is an individual account plan, was there a blackout period | 2019-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Contributions received from participants | 2019-12-31 | $5,738,261 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2019-12-31 | $68,514 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2019-12-31 | $373,594 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2019-12-31 | $4,037,192 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2019-12-31 | $3,381,176 |
| Other income not declared elsewhere | 2019-12-31 | $134,045 |
| Administrative expenses (other) incurred | 2019-12-31 | $1,482,829 |
| Total non interest bearing cash at end of year | 2019-12-31 | $1,082,897 |
| Total non interest bearing cash at beginning of year | 2019-12-31 | $3,595,299 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Value of net income/loss | 2019-12-31 | $-2,792,160 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $-298,091 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $2,494,069 |
| 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 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $6,773,750 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | No |
| 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 | $18,708,633 |
| Employer contributions (assets) at end of year | 2019-12-31 | $2,656,204 |
| Employer contributions (assets) at beginning of year | 2019-12-31 | $2,279,946 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $18,783,322 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2019-12-31 | No |
| Did the plan have assets held for investment | 2019-12-31 | No |
| 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 |
| 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 | HOMES, LOWRY, HORN & JOHNSON, LTD. |
| Accountancy firm EIN | 2019-12-31 | 540975470 |
| 2018 : AFOGNAK NATIVE CORPORATION HEALTH AND WELFARE PLAN 2018 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $3,381,176 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $2,370,042 |
| Total income from all sources (including contributions) | 2018-12-31 | $20,770,181 |
| Total of all expenses incurred | 2018-12-31 | $22,240,589 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $20,840,574 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $20,770,181 |
| Value of total assets at end of year | 2018-12-31 | $5,875,245 |
| Value of total assets at beginning of year | 2018-12-31 | $6,334,519 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $1,400,015 |
| 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 | $29,684 |
| Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
| Value of fidelity bond cover | 2018-12-31 | $5,000,000 |
| If this is an individual account plan, was there a blackout period | 2018-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
| Contributions received from participants | 2018-12-31 | $5,373,523 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2018-12-31 | $78,668 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2018-12-31 | $88,485 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2018-12-31 | $3,381,176 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2018-12-31 | $2,370,042 |
| Administrative expenses (other) incurred | 2018-12-31 | $1,370,331 |
| Total non interest bearing cash at end of year | 2018-12-31 | $3,595,299 |
| Total non interest bearing cash at beginning of year | 2018-12-31 | $6,210,769 |
| 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 | $-1,470,408 |
| Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $2,494,069 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $3,964,477 |
| 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 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $5,405,601 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | No |
| 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 | $15,317,990 |
| Employer contributions (assets) at end of year | 2018-12-31 | $2,279,946 |
| Employer contributions (assets) at beginning of year | 2018-12-31 | $123,750 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-12-31 | $15,346,488 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2018-12-31 | No |
| Did the plan have assets held for investment | 2018-12-31 | No |
| 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 |
| 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 | HOMES, LOWRY, HORN & JOHNSON, LTD. |
| Accountancy firm EIN | 2018-12-31 | 540975470 |
| 2017 : AFOGNAK NATIVE CORPORATION HEALTH AND WELFARE PLAN 2017 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $2,370,042 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $2,955,467 |
| Total income from all sources (including contributions) | 2017-12-31 | $21,446,600 |
| Total of all expenses incurred | 2017-12-31 | $19,191,219 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $17,857,080 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $21,324,514 |
| Value of total assets at end of year | 2017-12-31 | $6,334,519 |
| Value of total assets at beginning of year | 2017-12-31 | $4,664,563 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $1,334,139 |
| 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 | $35,961 |
| Was this plan covered by a fidelity bond | 2017-12-31 | Yes |
| Value of fidelity bond cover | 2017-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2017-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
| Contributions received from participants | 2017-12-31 | $4,963,451 |
| Participant contributions at beginning of year | 2017-12-31 | $370,698 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2017-12-31 | $88,135 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2017-12-31 | $2,370,042 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2017-12-31 | $2,955,467 |
| Other income not declared elsewhere | 2017-12-31 | $122,086 |
| Administrative expenses (other) incurred | 2017-12-31 | $1,298,178 |
| Total non interest bearing cash at end of year | 2017-12-31 | $6,210,769 |
| Total non interest bearing cash at beginning of year | 2017-12-31 | $2,507,921 |
| 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 | $2,255,381 |
| Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $3,964,477 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $1,709,096 |
| 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 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $4,704,146 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | No |
| 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 | $16,272,928 |
| Employer contributions (assets) at end of year | 2017-12-31 | $123,750 |
| Employer contributions (assets) at beginning of year | 2017-12-31 | $1,785,944 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-12-31 | $13,152,934 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2017-12-31 | No |
| Did the plan have assets held for investment | 2017-12-31 | No |
| 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 |
| 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 | HOMES, LOWRY, HORN & JOHNSON, LTD. |
| Accountancy firm EIN | 2017-12-31 | 540975470 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 7 |
| Insurance contract or identification number | 681004G | | Number of Individuals Covered | 2154 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $22,629 | | Total amount of fees paid to insurance company | USD $7,837 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | LIFE-BTRM | | Welfare Benefit Premiums Paid to Carrier | USD $293,982 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFEWISE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 94188 ) |
| Policy contract number | AK201656 |
| Policy instance | 14 |
| Insurance contract or identification number | AK201656 | | Number of Individuals Covered | 1299 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $668,175 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 9260109 |
| Policy instance | 1 |
| Insurance contract or identification number | 9260109 | | Number of Individuals Covered | 280 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $782 | | Other welfare benefits provided | LEGAL | | Welfare Benefit Premiums Paid to Carrier | USD $73,689 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) |
| Policy contract number | 94162 |
| Policy instance | 2 |
| Insurance contract or identification number | 94162 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $83,187 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0165999 |
| Policy instance | 3 |
| Insurance contract or identification number | 0165999 | | Number of Individuals Covered | 577 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $659 | | Total amount of fees paid to insurance company | USD $5,279 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $175,135 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0165998 |
| Policy instance | 4 |
| Insurance contract or identification number | 0165998 | | Number of Individuals Covered | 688 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $327 | | Total amount of fees paid to insurance company | USD $2,781 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $87,547 | | 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 | 681004G |
| Policy instance | 5 |
| Insurance contract or identification number | 681004G | | Number of Individuals Covered | 2155 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $3,596 | | Total amount of fees paid to insurance company | USD $1,245 | | Other welfare benefits provided | AD&D-BAS | | Welfare Benefit Premiums Paid to Carrier | USD $46,720 | | 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 | 681004G |
| Policy instance | 6 |
| Insurance contract or identification number | 681004G | | Number of Individuals Covered | 1491 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $4,311 | | Total amount of fees paid to insurance company | USD $1,493 | | Other welfare benefits provided | AD&D-SUPP | | Welfare Benefit Premiums Paid to Carrier | USD $56,005 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 07557A |
| Policy instance | 12 |
| Insurance contract or identification number | 07557A | | Number of Individuals Covered | 188 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $104,308 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | EVACUATION COVERAGE | | Welfare Benefit Premiums Paid to Carrier | USD $2,607,705 | | 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 | 681004G |
| Policy instance | 8 |
| Insurance contract or identification number | 681004G | | Number of Individuals Covered | 502 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $5,412 | | Total amount of fees paid to insurance company | USD $1,873 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | LIFE-SDEP | | Welfare Benefit Premiums Paid to Carrier | USD $70,312 | | 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 | 681004G |
| Policy instance | 9 |
| Insurance contract or identification number | 681004G | | Number of Individuals Covered | 794 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $22,146 | | Total amount of fees paid to insurance company | USD $7,669 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | LIFE-VOL | | Welfare Benefit Premiums Paid to Carrier | USD $287,705 | | 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 | 681004G |
| Policy instance | 10 |
| Insurance contract or identification number | 681004G | | Number of Individuals Covered | 2123 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $42,979 | | Total amount of fees paid to insurance company | USD $14,882 | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | LTD-ABIL | | Welfare Benefit Premiums Paid to Carrier | USD $558,358 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0216636 |
| Policy instance | 11 |
| Insurance contract or identification number | 0216636 | | Number of Individuals Covered | 1290 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $6,066 | | Total amount of fees paid to insurance company | USD $15,684 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,241,524 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
| Policy contract number | GTU5466336 |
| Policy instance | 13 |
| Insurance contract or identification number | GTU5466336 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $1,927 | | Total amount of fees paid to insurance company | USD $642 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $12,849 | | 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 | 681004G |
| Policy instance | 7 |
| Insurance contract or identification number | 681004G | | Number of Individuals Covered | 1321 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $3,782 | | Total amount of fees paid to insurance company | USD $1,411 | | Other welfare benefits provided | AD&D-SUPP | | Welfare Benefit Premiums Paid to Carrier | USD $58,765 | | 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 | 681004G |
| Policy instance | 8 |
| Insurance contract or identification number | 681004G | | Number of Individuals Covered | 2193 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $22,471 | | Total amount of fees paid to insurance company | USD $8,386 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | LIFE-BTRM | | Welfare Benefit Premiums Paid to Carrier | USD $349,170 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 16-011032-000 |
| Policy instance | 1 |
| Insurance contract or identification number | 16-011032-000 | | Number of Individuals Covered | 1298 | | 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 $10,733 | | Welfare Benefit Premiums Paid to Carrier | USD $843,687 | | 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 | 681004G |
| Policy instance | 6 |
| Insurance contract or identification number | 681004G | | Number of Individuals Covered | 2193 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $1,644 | | Total amount of fees paid to insurance company | USD $614 | | Other welfare benefits provided | AD&D-BAS | | Welfare Benefit Premiums Paid to Carrier | USD $25,546 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0165998 |
| Policy instance | 5 |
| Insurance contract or identification number | 0165998 | | Number of Individuals Covered | 1138 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $511 | | Total amount of fees paid to insurance company | USD $2,016 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $93,954 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) |
| Policy contract number | 94162 |
| Policy instance | 3 |
| Insurance contract or identification number | 94162 | | Number of Individuals Covered | 9 | | 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 $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $173,871 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 9260109 |
| Policy instance | 2 |
| Insurance contract or identification number | 9260109 | | Number of Individuals Covered | 226 | | 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 $1,125 | | Other welfare benefits provided | LEGAL | | Welfare Benefit Premiums Paid to Carrier | USD $58,926 | | 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 | 681004G |
| Policy instance | 9 |
| Insurance contract or identification number | 681004G | | Number of Individuals Covered | 539 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $5,532 | | Total amount of fees paid to insurance company | USD $2,064 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | LIFE-SDEP | | Welfare Benefit Premiums Paid to Carrier | USD $85,965 | | 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 | 681004G |
| Policy instance | 10 |
| Insurance contract or identification number | 681004G | | Number of Individuals Covered | 809 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $22,647 | | Total amount of fees paid to insurance company | USD $8,452 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | LIFE-VOL | | Welfare Benefit Premiums Paid to Carrier | USD $351,903 | | 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 | 681004G |
| Policy instance | 11 |
| Insurance contract or identification number | 681004G | | Number of Individuals Covered | 2166 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $42,189 | | Total amount of fees paid to insurance company | USD $15,746 | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | LTD-ABIL | | Welfare Benefit Premiums Paid to Carrier | USD $655,573 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0165999 |
| Policy instance | 4 |
| Insurance contract or identification number | 0165999 | | Number of Individuals Covered | 921 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $887 | | Total amount of fees paid to insurance company | USD $3,653 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $176,782 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
| Policy contract number | GTU5466336 |
| Policy instance | 18 |
| Insurance contract or identification number | GTU5466336 | | Number of Individuals Covered | 440 | | 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 $0 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $1,636 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PREMERA BLUE CROSS BLUE SHIELD OF ALASKA, INC. (National Association of Insurance Commissioners NAIC id number: 11677 ) |
| Policy contract number | AXHX5376 |
| Policy instance | 17 |
| Insurance contract or identification number | AXHX5376 | | Number of Individuals Covered | 64 | | 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 $4,158 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $907,900 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PREMERA BLUE CROSS BLUE SHIELD OF ALASKA, INC. (National Association of Insurance Commissioners NAIC id number: 11677 ) |
| Policy contract number | AXPX5259 |
| Policy instance | 16 |
| Insurance contract or identification number | AXPX5259 | | Number of Individuals Covered | 84 | | 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 $8,065 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,761,155 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 07557A |
| Policy instance | 15 |
| Insurance contract or identification number | 07557A | | Number of Individuals Covered | 142 | | 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 $83,750 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | EVACUATION COVERAGE | | Welfare Benefit Premiums Paid to Carrier | USD $2,093,762 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 2004047 |
| Policy instance | 14 |
| Insurance contract or identification number | 2004047 | | Number of Individuals Covered | 1298 | | 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 $0 | | Other welfare benefits provided | TRANSPLANT | | Welfare Benefit Premiums Paid to Carrier | USD $139,813 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0216636 |
| Policy instance | 13 |
| Insurance contract or identification number | 0216636 | | Number of Individuals Covered | 2562 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $37,559 | | Total amount of fees paid to insurance company | USD $117 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,248,337 | | 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 | 681004G |
| Policy instance | 12 |
| Insurance contract or identification number | 681004G | | Number of Individuals Covered | 2192 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $4,115 | | Total amount of fees paid to insurance company | USD $1,536 | | Other welfare benefits provided | WD-NST | | Welfare Benefit Premiums Paid to Carrier | USD $63,937 | | 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 | 681004G |
| Policy instance | 8 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 7 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 6 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0165998 |
| Policy instance | 5 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0165999 |
| Policy instance | 4 |
| HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) |
| Policy contract number | 94162 |
| Policy instance | 3 |
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 9260109 |
| Policy instance | 2 |
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 16-011032-000 |
| Policy instance | 1 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 9 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 10 |
| ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
| Policy contract number | GTU5466336 |
| Policy instance | 18 |
| PREMERA BLUE CROSS BLUE SHIELD OF ALASKA, INC. (National Association of Insurance Commissioners NAIC id number: 11677 ) |
| Policy contract number | AXHX5376 |
| Policy instance | 17 |
| PREMERA BLUE CROSS BLUE SHIELD OF ALASKA, INC. (National Association of Insurance Commissioners NAIC id number: 11677 ) |
| Policy contract number | AXPX5259 |
| Policy instance | 16 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 07557A |
| Policy instance | 15 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 417007412280 |
| Policy instance | 14 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0216636 |
| Policy instance | 13 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 12 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 11 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 12 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 13 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | 07557A |
| Policy instance | 14 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0216636 |
| Policy instance | 15 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 417007412280 |
| Policy instance | 16 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 07557A |
| Policy instance | 17 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 07557B001 |
| Policy instance | 18 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 11 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 10 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 9 |
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 16-011032-000 |
| Policy instance | 1 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0302893 |
| Policy instance | 2 |
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 9260109 |
| Policy instance | 3 |
| HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) |
| Policy contract number | 94162 |
| Policy instance | 4 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0165999 |
| Policy instance | 5 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0165998 |
| Policy instance | 6 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 7 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 8 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 10 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 11 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 13 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0165999 |
| Policy instance | 5 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | 07557A |
| Policy instance | 14 |
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 0006865070 |
| Policy instance | 17 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 417007412280 |
| Policy instance | 16 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 9 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 8 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 12 |
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 16-011032-000 |
| Policy instance | 1 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0302893 |
| Policy instance | 2 |
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 9260109 |
| Policy instance | 3 |
| HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) |
| Policy contract number | 94162 |
| Policy instance | 4 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0165998 |
| Policy instance | 6 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 7 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0216636 |
| Policy instance | 15 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0302893 |
| Policy instance | 2 |
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 16011032000 |
| Policy instance | 1 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 07557A |
| Policy instance | 15 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 14 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 13 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 12 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 11 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 10 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 9 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 8 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0165998 |
| Policy instance | 7 |
| HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) |
| Policy contract number | 94162 |
| Policy instance | 5 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0165999 |
| Policy instance | 6 |
| HEALTH NEW ENGLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95673 ) |
| Policy contract number | 115272 |
| Policy instance | 4 |
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 9260109 |
| Policy instance | 3 |
| HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) |
| Policy contract number | 94162 |
| Policy instance | 8 |
| BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 ) |
| Policy contract number | 49404 |
| Policy instance | 7 |
| HEALTH NEW ENGLAND, INC. (National Association of Insurance Commissioners NAIC id number: 95673 ) |
| Policy contract number | 115272 |
| Policy instance | 6 |
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 9260109 |
| Policy instance | 5 |
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 0006865070 |
| Policy instance | 4 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | R0302893 |
| Policy instance | 3 |
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 16011032000 |
| Policy instance | 2 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0165999 |
| Policy instance | 9 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0165998 |
| Policy instance | 10 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 11 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 12 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 13 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 14 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 16 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 17 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 499691 |
| Policy instance | 1 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681004G |
| Policy instance | 15 |
