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DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 401k Plan overview

Plan NameDAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN
Plan identification number 520

DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN Benefits

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

401k Sponsoring company profile

DAIMLER TRUCK NORTH AMERICA has sponsored the creation of one or more 401k plans.

Company Name:DAIMLER TRUCK NORTH AMERICA
Employer identification number (EIN):930790608

Additional information about DAIMLER TRUCK NORTH AMERICA

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 0912343

More information about DAIMLER TRUCK NORTH AMERICA

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5202022-01-01
5202021-01-01
5202020-01-01
5202019-01-01
5202018-01-01
5202017-01-01GREG SALWIN
5202016-01-01GREG SALWIN
5202015-01-01MARK PAGET
5202014-01-01LARRY ABBIATTI
5202013-01-01LARRY ABBIATTI
5202012-01-01LARRY ABBIATTI
5202011-01-01LARRY ABBIATTI

Plan Statistics for DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN

401k plan membership statisitcs for DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN

Measure Date Value
2022: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-017,310
Total number of active participants reported on line 7a of the Form 55002022-01-017,422
Number of retired or separated participants receiving benefits2022-01-0112
Total of all active and inactive participants2022-01-017,434
2021: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-016,126
Total number of active participants reported on line 7a of the Form 55002021-01-017,310
Number of retired or separated participants receiving benefits2021-01-0144
Total of all active and inactive participants2021-01-017,354
2020: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-017,886
Total number of active participants reported on line 7a of the Form 55002020-01-016,126
Number of retired or separated participants receiving benefits2020-01-011,094
Total of all active and inactive participants2020-01-017,220
2019: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-017,339
Total number of active participants reported on line 7a of the Form 55002019-01-017,582
Number of retired or separated participants receiving benefits2019-01-01304
Total of all active and inactive participants2019-01-017,886
2018: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-016,971
Total number of active participants reported on line 7a of the Form 55002018-01-017,280
Number of retired or separated participants receiving benefits2018-01-0159
Total of all active and inactive participants2018-01-017,339
2017: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-016,177
Total number of active participants reported on line 7a of the Form 55002017-01-016,637
Number of retired or separated participants receiving benefits2017-01-01334
Total of all active and inactive participants2017-01-016,971
2016: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-018,852
Total number of active participants reported on line 7a of the Form 55002016-01-015,410
Number of retired or separated participants receiving benefits2016-01-01767
Total of all active and inactive participants2016-01-016,177
2015: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-016,768
Total number of active participants reported on line 7a of the Form 55002015-01-018,852
Number of retired or separated participants receiving benefits2015-01-01776
Total of all active and inactive participants2015-01-019,628
2014: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-018,148
Total number of active participants reported on line 7a of the Form 55002014-01-016,767
Number of retired or separated participants receiving benefits2014-01-011
Total of all active and inactive participants2014-01-016,768
2013: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-017,895
Total number of active participants reported on line 7a of the Form 55002013-01-016,612
Number of retired or separated participants receiving benefits2013-01-017
Number of other retired or separated participants entitled to future benefits2013-01-011,529
Total of all active and inactive participants2013-01-018,148
2012: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-015,393
Total number of active participants reported on line 7a of the Form 55002012-01-016,364
Number of retired or separated participants receiving benefits2012-01-011,531
Total of all active and inactive participants2012-01-017,895
2011: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-015,391
Total number of active participants reported on line 7a of the Form 55002011-01-014,261
Number of retired or separated participants receiving benefits2011-01-011,132
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-015,393

Financial Data on DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN

Measure Date Value
2015 : DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2015-12-31$0
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$934,624
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$11,579,252
Total income from all sources (including contributions)2015-12-31$149,662,597
Total of all expenses incurred2015-12-31$152,225,853
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$145,426,477
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$149,659,078
Value of total assets at end of year2015-12-31$934,624
Value of total assets at beginning of year2015-12-31$14,142,508
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$6,799,376
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$3,519
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$3,519
Administrative expenses professional fees incurred2015-12-31$135,814
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$14,266,309
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-12-31$-11,259,420
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$123
Administrative expenses (other) incurred2015-12-31$1,246,060
Liabilities. Value of operating payables at end of year2015-12-31$934,624
Liabilities. Value of operating payables at beginning of year2015-12-31$319,832
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-2,563,256
Value of net assets at end of year (total assets less liabilities)2015-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$2,563,256
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Investment advisory and management fees2015-12-31$32,639
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$14,022,968
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$13,915,399
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$135,392,769
Employer contributions (assets) at end of year2015-12-31$934,624
Employer contributions (assets) at beginning of year2015-12-31$119,417
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$142,770,498
Contract administrator fees2015-12-31$5,384,863
Liabilities. Value of benefit claims payable at end of year2015-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$11,259,420
Did the plan have assets held for investment2015-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31MOSS ADAMS LLP
Accountancy firm EIN2015-12-31910189318
2014 : DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-12-31$1,929
Total unrealized appreciation/depreciation of assets2014-12-31$1,929
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$11,579,252
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$8,891,222
Total income from all sources (including contributions)2014-12-31$140,925,901
Total of all expenses incurred2014-12-31$151,752,581
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$145,545,272
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$140,922,793
Value of total assets at end of year2014-12-31$14,142,508
Value of total assets at beginning of year2014-12-31$22,281,158
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$6,207,309
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$1,179
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$1,179
Administrative expenses professional fees incurred2014-12-31$146,719
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$13,282,639
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-12-31$2,601,851
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$123
Administrative expenses (other) incurred2014-12-31$491,146
Liabilities. Value of operating payables at end of year2014-12-31$319,832
Liabilities. Value of operating payables at beginning of year2014-12-31$233,653
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-10,826,680
Value of net assets at end of year (total assets less liabilities)2014-12-31$2,563,256
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$13,389,936
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Investment advisory and management fees2014-12-31$32,842
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$14,022,968
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$22,151,123
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$11,947,303
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$127,640,154
Employer contributions (assets) at end of year2014-12-31$119,417
Employer contributions (assets) at beginning of year2014-12-31$130,035
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$130,996,118
Contract administrator fees2014-12-31$5,536,602
Liabilities. Value of benefit claims payable at end of year2014-12-31$11,259,420
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$8,657,569
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31MOSS ADAMS LLP
Accountancy firm EIN2014-12-31910189318
2013 : DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$8,891,222
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$10,499,563
Total income from all sources (including contributions)2013-12-31$143,164,795
Total of all expenses incurred2013-12-31$139,843,978
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$133,563,711
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$143,158,967
Value of total assets at end of year2013-12-31$22,281,158
Value of total assets at beginning of year2013-12-31$20,568,682
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$6,280,267
Total interest from all sources2013-12-31$5,571
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$257
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$257
Administrative expenses professional fees incurred2013-12-31$156,815
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$12,424,729
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$57,951
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$-1,776,740
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$82,500
Administrative expenses (other) incurred2013-12-31$597,704
Liabilities. Value of operating payables at end of year2013-12-31$233,653
Liabilities. Value of operating payables at beginning of year2013-12-31$65,254
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$3,320,817
Value of net assets at end of year (total assets less liabilities)2013-12-31$13,389,936
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$10,069,119
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Investment advisory and management fees2013-12-31$33,192
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$22,151,123
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$20,486,182
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$5,571
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$11,141,873
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31Yes
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$130,676,287
Employer contributions (assets) at end of year2013-12-31$130,035
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$124,198,578
Contract administrator fees2013-12-31$5,492,556
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31No
Liabilities. Value of benefit claims payable at end of year2013-12-31$8,657,569
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$10,434,309
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31MOSS ADAMS LLP
Accountancy firm EIN2013-12-31910189318
2012 : DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$10,499,563
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$8,470,776
Total income from all sources (including contributions)2012-12-31$140,555,925
Total of all expenses incurred2012-12-31$138,391,758
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$131,950,039
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$140,545,394
Value of total assets at end of year2012-12-31$20,568,682
Value of total assets at beginning of year2012-12-31$16,375,728
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$6,441,719
Total interest from all sources2012-12-31$5,869
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$4,662
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$4,662
Administrative expenses professional fees incurred2012-12-31$126,625
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$13,364,679
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$82,500
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-12-31$2,018,658
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$82,500
Administrative expenses (other) incurred2012-12-31$1,452,869
Liabilities. Value of operating payables at end of year2012-12-31$65,254
Liabilities. Value of operating payables at beginning of year2012-12-31$55,125
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$2,164,167
Value of net assets at end of year (total assets less liabilities)2012-12-31$10,069,119
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$7,904,952
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Investment advisory and management fees2012-12-31$32,225
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$20,486,182
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$0
Value of interest in common/collective trusts at end of year2012-12-31$0
Value of interest in common/collective trusts at beginning of year2012-12-31$9,795,391
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$6,580,337
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$6,580,337
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$5,869
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$11,761,619
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31Yes
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$127,098,215
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$118,169,762
Contract administrator fees2012-12-31$4,830,000
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31No
Liabilities. Value of benefit claims payable at end of year2012-12-31$10,434,309
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$8,415,651
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31MOSS ADAMS LLP
Accountancy firm EIN2012-12-31910189318
2011 : DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2011 401k financial data
Total transfer of assets to this plan2011-12-31$17,689,281
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$8,470,776
Total income from all sources (including contributions)2011-12-31$112,087,619
Total of all expenses incurred2011-12-31$121,871,948
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$117,562,274
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$112,083,624
Value of total assets at end of year2011-12-31$16,375,728
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$4,309,674
Total interest from all sources2011-12-31$3,311
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Administrative expenses professional fees incurred2011-12-31$133,267
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$5,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$9,767,487
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$10,367,969
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-12-31$8,415,651
Administrative expenses (other) incurred2011-12-31$32,304
Liabilities. Value of operating payables at end of year2011-12-31$55,125
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-9,784,329
Value of net assets at end of year (total assets less liabilities)2011-12-31$7,904,952
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Investment advisory and management fees2011-12-31$31,286
Value of interest in common/collective trusts at end of year2011-12-31$9,795,391
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$6,580,337
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$3,311
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$7,952,372
Net investment gain or loss from common/collective trusts2011-12-31$684
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$91,948,168
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$101,194,251
Contract administrator fees2011-12-31$4,112,817
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Liabilities. Value of benefit claims payable at end of year2011-12-31$8,415,651
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31MOSS ADAMS LLP
Accountancy firm EIN2011-12-31910189318

Form 5500 Responses for DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN

2022: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan is a collectively bargained planYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan is a collectively bargained planYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan is a collectively bargained planYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan is a collectively bargained planYes
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: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan is a collectively bargained planYes
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: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan is a collectively bargained planYes
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: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan is a collectively bargained planYes
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: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan is a collectively bargained planYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: DAIMLER TRUCK NORTH AMERICA LLC UNION WELFARE BENEFITS PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01First time form 5500 has been submittedYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0117550
Policy instance 3
Insurance contract or identification number0117550
Number of Individuals Covered10904
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $95
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $4,075,421
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees95
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number156322
Policy instance 2
Insurance contract or identification number156322
Number of Individuals Covered722
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $343,968
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number1328
Policy instance 1
Insurance contract or identification number1328
Number of Individuals Covered1015
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,738,351
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?4
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number1328
Policy instance 1
Insurance contract or identification number1328
Number of Individuals Covered1124
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $8
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,709,934
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees8
Additional information about fees paid to insurance brokerNON MONETARY COMPENSATION
Insurance broker organization code?4
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number156322
Policy instance 2
Insurance contract or identification number156322
Number of Individuals Covered746
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $355,605
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 number0117550
Policy instance 3
Insurance contract or identification number0117550
Number of Individuals Covered10530
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $55
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $3,197,567
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees55
Additional information about fees paid to insurance brokerNON MONETARY COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number156322
Policy instance 2
Insurance contract or identification number156322
Number of Individuals Covered626
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $365,912
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number1328
Policy instance 1
Insurance contract or identification number1328
Number of Individuals Covered1109
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $7
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,128,560
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees7
Insurance broker organization code?4
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0117550
Policy instance 3
Insurance contract or identification number0117550
Number of Individuals Covered15212
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $53
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $4,846,891
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees53
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0117550
Policy instance 3
Insurance contract or identification number0117550
Number of Individuals Covered16555
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 $77
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $4,431,508
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees77
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number156322
Policy instance 2
Insurance contract or identification number156322
Number of Individuals Covered790
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
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $395,300
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number1328
Policy instance 1
Insurance contract or identification number1328
Number of Individuals Covered1188
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 $565
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,463,573
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees565
Additional information about fees paid to insurance broker1ST QUARTER DOUBLE RETENTION BONUS
Insurance broker organization code?4
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number1328
Policy instance 1
Insurance contract or identification number1328
Number of Individuals Covered1242
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
Welfare Benefit Premiums Paid to CarrierUSD $4,660,181
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 number0117550
Policy instance 3
Insurance contract or identification number0117550
Number of Individuals Covered25272
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 $79
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $6,846,589
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees79
Insurance broker organization code?4
Insurance broker nameAON RISK INS SERVICES WEST INC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number156322
Policy instance 2
Insurance contract or identification number156322
Number of Individuals Covered705
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
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $382,466
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number1328
Policy instance 1
Insurance contract or identification number1328
Number of Individuals Covered1415
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,893,440
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 number0117550
Policy instance 3
Insurance contract or identification number0117550
Number of Individuals Covered8840
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $11,802
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,756,280
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees11802
Insurance broker organization code?4
Insurance broker nameAON CONSULTING INC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number156322
Policy instance 2
Insurance contract or identification number156322
Number of Individuals Covered613
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $253,878
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 number0117550
Policy instance 3
Insurance contract or identification number0117550
Number of Individuals Covered16382
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $9,740
Total amount of fees paid to insurance companyUSD $18
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,525,120
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,740
Amount paid for insurance broker fees18
Additional information about fees paid to insurance brokerNONMONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameAON RISK INS SERVICES WEST INC
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract number156322
Policy instance 2
Insurance contract or identification number156322
Number of Individuals Covered630
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $10,700
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $255,722
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,700
Insurance broker organization code?3
Insurance broker nameAON CONSULTING INC
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number1328
Policy instance 1
Insurance contract or identification number1328
Number of Individuals Covered1483
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,224,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number1328
Policy instance 1
Insurance contract or identification number1328
Number of Individuals Covered1509
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,884,425
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberORO13906
Policy instance 2
Insurance contract or identification numberORO13906
Number of Individuals Covered650
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $276,605
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 number0117550
Policy instance 3
Insurance contract or identification number0117550
Number of Individuals Covered14557
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $10
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,612,340
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees10
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameAON RISK INS SERVICES WEST INC
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberORO13906
Policy instance 2
Insurance contract or identification numberORO13906
Number of Individuals Covered800
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $340,900
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 number0117550
Policy instance 3
Insurance contract or identification number0117550
Number of Individuals Covered13751
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,409,090
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number1328
Policy instance 1
Insurance contract or identification number1328
Number of Individuals Covered1633
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,011,629
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number00305A
Policy instance 3
Insurance contract or identification number00305A
Number of Individuals Covered31
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $472,213
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberORO13906
Policy instance 2
Insurance contract or identification numberORO13906
Number of Individuals Covered637
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $249,760
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number1328
Policy instance 1
Insurance contract or identification number1328
Number of Individuals Covered1503
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,712,522
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 number0117550
Policy instance 4
Insurance contract or identification number0117550
Number of Individuals Covered11474
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,513,211
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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