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BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 401k Plan overview

Plan NameBROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN
Plan identification number 501

BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

BROOKFIELD HOMES HOLDINGS LLC has sponsored the creation of one or more 401k plans.

Company Name:BROOKFIELD HOMES HOLDINGS LLC
Employer identification number (EIN):930787379
NAIC Classification:236110

Additional information about BROOKFIELD HOMES HOLDINGS LLC

Jurisdiction of Incorporation: California Secretary of State
Incorporation Date: 2011-12-31
Company Identification Number: 201200310012
Legal Registered Office Address: 12265 EL CAMINO REAL STE 180

SAN DIEGO
United States of America (USA)
92130

More information about BROOKFIELD HOMES HOLDINGS LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012019-01-01DALLAS HENAULT2020-07-23
5012018-01-01DALLAS HENAULT2019-10-08
5012017-01-01
5012016-01-01
5012015-01-01MARK HOPKINS MARK HOPKINS2016-07-04
5012015-01-01
5012014-01-01BONITA GREENER
5012013-01-01BONITA GREENER BONITA GREENER2014-09-22
5012012-01-01BONITA GREENER BONITA GREENER2013-10-08
5012011-01-01BONITA GREENER
5012010-01-01BONITA GREENER
5012009-02-01BONITA GREENER
5012009-02-01BONITA GREENER
5012009-01-01BONITA GREENER
5012009-01-01BONITA GREENER
5012008-08-01BONITA GREENER

Plan Statistics for BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN

401k plan membership statisitcs for BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN

Measure Date Value
2019: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01683
Total number of active participants reported on line 7a of the Form 55002019-01-010
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-010
Number of employers contributing to the scheme2019-01-010
2018: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01572
Total number of active participants reported on line 7a of the Form 55002018-01-01683
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01683
Number of employers contributing to the scheme2018-01-010
2017: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01680
Total number of active participants reported on line 7a of the Form 55002017-01-01572
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01572
2016: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01534
Total number of active participants reported on line 7a of the Form 55002016-01-01594
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01594
2015: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01441
Total number of active participants reported on line 7a of the Form 55002015-01-01534
Number of retired or separated participants receiving benefits2015-01-015
Total of all active and inactive participants2015-01-01539
Total participants2015-01-01539
Number of other retired or separated participants entitled to future benefits2015-01-010
2014: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01316
Total number of active participants reported on line 7a of the Form 55002014-01-01430
Number of retired or separated participants receiving benefits2014-01-0111
Total of all active and inactive participants2014-01-01441
Total participants2014-01-01441
2013: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01282
Total number of active participants reported on line 7a of the Form 55002013-01-01313
Number of retired or separated participants receiving benefits2013-01-013
Total of all active and inactive participants2013-01-01316
Total participants2013-01-01316
2012: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01258
Total number of active participants reported on line 7a of the Form 55002012-01-01279
Number of retired or separated participants receiving benefits2012-01-013
Total of all active and inactive participants2012-01-01282
Total participants2012-01-01282
2011: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01262
Total number of active participants reported on line 7a of the Form 55002011-01-01245
Number of retired or separated participants receiving benefits2011-01-0113
Total of all active and inactive participants2011-01-01258
Total participants2011-01-01258
2010: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01293
Total number of active participants reported on line 7a of the Form 55002010-01-01243
Number of retired or separated participants receiving benefits2010-01-0119
Total of all active and inactive participants2010-01-01262
Total participants2010-01-01262
2009: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-02-01345
Total number of active participants reported on line 7a of the Form 55002009-02-01242
Number of retired or separated participants receiving benefits2009-02-0132
Total of all active and inactive participants2009-02-01274
Total participants2009-02-01274
Total participants, beginning-of-year2009-01-01285
Total number of active participants reported on line 7a of the Form 55002009-01-01258
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01258
2008: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2008 401k membership
Total participants, beginning-of-year2008-08-01414
Total number of active participants reported on line 7a of the Form 55002008-08-01268
Number of retired or separated participants receiving benefits2008-08-0125
Total of all active and inactive participants2008-08-01293
Total participants2008-08-01293

Form 5500 Responses for BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN

2019: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01This submission is the final filingYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-02-01Type of plan entitySingle employer plan
2009-02-01Submission has been amendedNo
2009-02-01This submission is the final filingNo
2009-02-01This return/report is a short plan year return/report (less than 12 months)No
2009-02-01Plan is a collectively bargained planNo
2009-02-01Plan funding arrangement – General assets of the sponsorYes
2009-02-01Plan benefit arrangement – InsuranceYes
2009-02-01Plan benefit arrangement – General assets of the sponsorYes
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes
2008: BROOKFIELD RESIDENTIAL PROPERTIES EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2008 form 5500 responses
2008-08-01Type of plan entitySingle employer plan
2008-08-01Submission has been amendedNo
2008-08-01This submission is the final filingNo
2008-08-01This return/report is a short plan year return/report (less than 12 months)No
2008-08-01Plan is a collectively bargained planNo
2008-08-01Plan funding arrangement – General assets of the sponsorYes
2008-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number119135
Policy instance 2
Insurance contract or identification number119135
Number of Individuals Covered1775
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $836,943
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 )
Policy contract number8275
Policy instance 1
Insurance contract or identification number8275
Number of Individuals Covered64
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $370,738
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 number0119135
Policy instance 2
Insurance contract or identification number0119135
Number of Individuals Covered1604
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $781,071
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 )
Policy contract number8275
Policy instance 1
Insurance contract or identification number8275
Number of Individuals Covered62
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $359,564
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 )
Policy contract number8275
Policy instance 1
Insurance contract or identification number8275
Number of Individuals Covered56
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $262,306
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 number0119135
Policy instance 2
Insurance contract or identification number0119135
Number of Individuals Covered1344
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $709,838
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 )
Policy contract number8275
Policy instance 2
Insurance contract or identification number8275
Number of Individuals Covered36
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $171,151
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 number0119135
Policy instance 1
Insurance contract or identification number0119135
Number of Individuals Covered1207
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $523,869
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 )
Policy contract number8275
Policy instance 2
Insurance contract or identification number8275
Number of Individuals Covered26
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $97,434
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 number0119135
Policy instance 1
Insurance contract or identification number0119135
Number of Individuals Covered812
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $367,236
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 )
Policy contract number8275
Policy instance 2
Insurance contract or identification number8275
Number of Individuals Covered15
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $77,338
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 number0119135
Policy instance 1
Insurance contract or identification number0119135
Number of Individuals Covered709
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $305,439
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 number0141110
Policy instance 1
Insurance contract or identification number0141110
Number of Individuals Covered260
Insurance policy start date2011-02-01
Insurance policy end date2012-07-31
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedEMPLOYEE ASSISTANCE PLAN
Welfare Benefit Premiums Paid to CarrierUSD $126,577
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 number0119135
Policy instance 2
Insurance contract or identification number0119135
Number of Individuals Covered590
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $251,336
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number44672
Policy instance 3
Insurance contract or identification number44672
Number of Individuals Covered340
Insurance policy start date2011-02-01
Insurance policy end date2012-07-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $205,842
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 )
Policy contract number8275
Policy instance 4
Insurance contract or identification number8275
Number of Individuals Covered18
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $83,298
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number44672
Policy instance 4
Insurance contract or identification number44672
Number of Individuals Covered322
Insurance policy start date2010-02-01
Insurance policy end date2011-01-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $127,129
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number720159
Policy instance 3
Insurance contract or identification number720159
Number of Individuals Covered584
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $98,366
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,670,230
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 number0141110
Policy instance 2
Insurance contract or identification number0141110
Number of Individuals Covered242
Insurance policy start date2010-02-01
Insurance policy end date2011-01-31
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedEMPLOYEE ASSISTANCE PLAN
Welfare Benefit Premiums Paid to CarrierUSD $71,947
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 number0119135
Policy instance 1
Insurance contract or identification number0119135
Number of Individuals Covered554
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $252,203
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 )
Policy contract number8275
Policy instance 5
Insurance contract or identification number8275
Number of Individuals Covered23
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $110,390
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number720159
Policy instance 1
Insurance contract or identification number720159
Number of Individuals Covered578
Insurance policy start date2010-03-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $83,145
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,916,573
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $83,145
Amount paid for insurance broker fees83145
Additional information about fees paid to insurance brokerBROKER
Insurance broker organization code?3
Insurance broker nameT & H BENEFITS LLC
CONNETICUT GENERAL (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number3208052
Policy instance 2
Insurance contract or identification number3208052
Number of Individuals Covered369
Insurance policy start date2009-02-01
Insurance policy end date2010-01-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $275,705
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 )
Policy contract number8275
Policy instance 4
Insurance contract or identification number8275
Number of Individuals Covered26
Insurance policy start date2010-04-01
Insurance policy end date2010-12-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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 number0141110
Policy instance 8
Insurance contract or identification number0141110
Insurance policy start date2009-02-01
Insurance policy end date2010-01-31
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedEMPLOYEE ASSISTANCE PLAN
Welfare Benefit Premiums Paid to CarrierUSD $72,982
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 number16663 1
Policy instance 7
Insurance contract or identification number16663 1
Number of Individuals Covered38
Insurance policy start date2010-03-01
Insurance policy end date2010-03-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,879
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNETICUT GENERAL (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number3208052
Policy instance 3
Insurance contract or identification number3208052
Number of Individuals Covered355
Insurance policy start date2010-02-01
Insurance policy end date2010-02-28
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,469
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 number0119135
Policy instance 5
Insurance contract or identification number0119135
Number of Individuals Covered590
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $265,421
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number44672
Policy instance 6
Insurance contract or identification number44672
Number of Individuals Covered329
Insurance policy start date2009-02-01
Insurance policy end date2010-01-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $129,986
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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