HARRISON ELECTRICAL WORKERS TRUST FUND BOARD OF TRUSTEES has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan HARRISON ELECTRICAL WORKERS TRUST FUND
| Measure | Date | Value |
|---|
| 2022 : HARRISON ELECTRICAL WORKERS TRUST FUND 2022 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2022-12-31 | $-48,087,046 |
| Total unrealized appreciation/depreciation of assets | 2022-12-31 | $-48,087,046 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $33,897,202 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $32,159,370 |
| Total income from all sources (including contributions) | 2022-12-31 | $111,771,227 |
| Total loss/gain on sale of assets | 2022-12-31 | $1,389,867 |
| Total of all expenses incurred | 2022-12-31 | $145,181,346 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $140,638,619 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-12-31 | $156,575,877 |
| Value of total assets at end of year | 2022-12-31 | $359,423,576 |
| Value of total assets at beginning of year | 2022-12-31 | $391,095,863 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $4,542,727 |
| Total interest from all sources | 2022-12-31 | $3,874,857 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-12-31 | $4,009,731 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2022-12-31 | $1,108,380 |
| Administrative expenses professional fees incurred | 2022-12-31 | $211,787 |
| Was this plan covered by a fidelity bond | 2022-12-31 | Yes |
| Value of fidelity bond cover | 2022-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2022-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
| Contributions received from participants | 2022-12-31 | $4,870,776 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-12-31 | $3,516,846 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-12-31 | $2,755,416 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2022-12-31 | $369,573 |
| Other income not declared elsewhere | 2022-12-31 | $376,958 |
| Administrative expenses (other) incurred | 2022-12-31 | $1,568,686 |
| Liabilities. Value of operating payables at end of year | 2022-12-31 | $1,727,899 |
| Liabilities. Value of operating payables at beginning of year | 2022-12-31 | $1,654,509 |
| Total non interest bearing cash at end of year | 2022-12-31 | $13,081,122 |
| Total non interest bearing cash at beginning of year | 2022-12-31 | $9,635,862 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Value of net income/loss | 2022-12-31 | $-33,410,119 |
| Value of net assets at end of year (total assets less liabilities) | 2022-12-31 | $325,526,374 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-12-31 | $358,936,493 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
| Investment advisory and management fees | 2022-12-31 | $750,722 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-12-31 | $47,414,595 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-12-31 | $50,611,013 |
| Income. Interest from US Government securities | 2022-12-31 | $1,606,154 |
| Income. Interest from corporate debt instruments | 2022-12-31 | $2,144,033 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-12-31 | $6,701,119 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-12-31 | $1,341,595 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-12-31 | $1,341,595 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-12-31 | $124,670 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-12-31 | $51,188,865 |
| Asset value of US Government securities at end of year | 2022-12-31 | $68,923,768 |
| Asset value of US Government securities at beginning of year | 2022-12-31 | $72,589,962 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-12-31 | $-6,369,017 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2022-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
| Contributions received in cash from employer | 2022-12-31 | $151,705,101 |
| Employer contributions (assets) at end of year | 2022-12-31 | $15,399,862 |
| Employer contributions (assets) at beginning of year | 2022-12-31 | $13,334,411 |
| Income. Dividends from common stock | 2022-12-31 | $2,901,351 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-12-31 | $89,449,754 |
| Asset. Corporate debt instrument preferred debt at end of year | 2022-12-31 | $33,083,119 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2022-12-31 | $38,771,874 |
| Asset. Corporate debt instrument debt (other) at end of year | 2022-12-31 | $25,871,789 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2022-12-31 | $26,650,201 |
| Contract administrator fees | 2022-12-31 | $2,011,532 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2022-12-31 | $145,431,356 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2022-12-31 | $175,405,529 |
| Liabilities. Value of benefit claims payable at end of year | 2022-12-31 | $31,799,730 |
| Liabilities. Value of benefit claims payable at beginning of year | 2022-12-31 | $30,504,861 |
| Did the plan have assets held for investment | 2022-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-12-31 | No |
| Aggregate proceeds on sale of assets | 2022-12-31 | $100,384,781 |
| Aggregate carrying amount (costs) on sale of assets | 2022-12-31 | $98,994,914 |
| Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
| Accountancy firm name | 2022-12-31 | BJORKLUND & MONTPLAISIR, CPA'S |
| Accountancy firm EIN | 2022-12-31 | 931015766 |
| 2021 : HARRISON ELECTRICAL WORKERS TRUST FUND 2021 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2021-12-31 | $13,519,472 |
| Total unrealized appreciation/depreciation of assets | 2021-12-31 | $13,519,472 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $32,159,370 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $28,477,062 |
| Total income from all sources (including contributions) | 2021-12-31 | $189,881,809 |
| Total loss/gain on sale of assets | 2021-12-31 | $19,567,213 |
| Total of all expenses incurred | 2021-12-31 | $141,151,831 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $136,896,067 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-12-31 | $143,803,818 |
| Value of total assets at end of year | 2021-12-31 | $391,095,863 |
| Value of total assets at beginning of year | 2021-12-31 | $338,683,577 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $4,255,764 |
| Total interest from all sources | 2021-12-31 | $3,272,868 |
| Total dividends received (eg from common stock, registered investment company shares) | 2021-12-31 | $4,126,548 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2021-12-31 | $1,046,623 |
| Administrative expenses professional fees incurred | 2021-12-31 | $221,783 |
| Was this plan covered by a fidelity bond | 2021-12-31 | Yes |
| Value of fidelity bond cover | 2021-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2021-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
| Contributions received from participants | 2021-12-31 | $4,841,441 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-12-31 | $2,755,416 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-12-31 | $1,994,258 |
| Other income not declared elsewhere | 2021-12-31 | $242,149 |
| Administrative expenses (other) incurred | 2021-12-31 | $1,297,125 |
| Liabilities. Value of operating payables at end of year | 2021-12-31 | $1,654,509 |
| Liabilities. Value of operating payables at beginning of year | 2021-12-31 | $1,468,088 |
| Total non interest bearing cash at end of year | 2021-12-31 | $9,635,862 |
| Total non interest bearing cash at beginning of year | 2021-12-31 | $11,283,612 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Value of net income/loss | 2021-12-31 | $48,729,978 |
| Value of net assets at end of year (total assets less liabilities) | 2021-12-31 | $358,936,493 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-12-31 | $310,206,515 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
| Investment advisory and management fees | 2021-12-31 | $751,958 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-12-31 | $50,611,013 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-12-31 | $53,258,775 |
| Income. Interest from US Government securities | 2021-12-31 | $1,338,771 |
| Income. Interest from corporate debt instruments | 2021-12-31 | $1,933,832 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-12-31 | $1,341,595 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-12-31 | $1,203,476 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-12-31 | $1,203,476 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-12-31 | $265 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-12-31 | $48,781,843 |
| Asset value of US Government securities at end of year | 2021-12-31 | $72,589,962 |
| Asset value of US Government securities at beginning of year | 2021-12-31 | $60,278,701 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2021-12-31 | $5,349,741 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2021-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
| Contributions received in cash from employer | 2021-12-31 | $138,962,377 |
| Employer contributions (assets) at end of year | 2021-12-31 | $13,334,411 |
| Employer contributions (assets) at beginning of year | 2021-12-31 | $12,899,196 |
| Income. Dividends from common stock | 2021-12-31 | $3,079,925 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-12-31 | $88,114,224 |
| Asset. Corporate debt instrument preferred debt at end of year | 2021-12-31 | $38,771,874 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2021-12-31 | $33,993,865 |
| Asset. Corporate debt instrument debt (other) at end of year | 2021-12-31 | $26,650,201 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2021-12-31 | $17,027,954 |
| Contract administrator fees | 2021-12-31 | $1,984,898 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2021-12-31 | $175,405,529 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2021-12-31 | $146,743,740 |
| Liabilities. Value of benefit claims payable at end of year | 2021-12-31 | $30,504,861 |
| Liabilities. Value of benefit claims payable at beginning of year | 2021-12-31 | $27,008,974 |
| Did the plan have assets held for investment | 2021-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-12-31 | No |
| Aggregate proceeds on sale of assets | 2021-12-31 | $116,732,124 |
| Aggregate carrying amount (costs) on sale of assets | 2021-12-31 | $97,164,911 |
| Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
| Accountancy firm name | 2021-12-31 | BJORKLUND & MONTPLAISIR, CPA'S |
| Accountancy firm EIN | 2021-12-31 | 931015766 |
| 2020 : HARRISON ELECTRICAL WORKERS TRUST FUND 2020 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2020-12-31 | $17,310,864 |
| Total unrealized appreciation/depreciation of assets | 2020-12-31 | $17,310,864 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $28,477,062 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $28,873,794 |
| Total income from all sources (including contributions) | 2020-12-31 | $173,116,031 |
| Total loss/gain on sale of assets | 2020-12-31 | $3,643,626 |
| Total of all expenses incurred | 2020-12-31 | $126,849,972 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $123,068,002 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-12-31 | $138,297,501 |
| Value of total assets at end of year | 2020-12-31 | $338,683,577 |
| Value of total assets at beginning of year | 2020-12-31 | $292,814,250 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $3,781,970 |
| Total interest from all sources | 2020-12-31 | $2,852,005 |
| Total dividends received (eg from common stock, registered investment company shares) | 2020-12-31 | $3,377,923 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2020-12-31 | $983,187 |
| Administrative expenses professional fees incurred | 2020-12-31 | $103,776 |
| Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
| Value of fidelity bond cover | 2020-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2020-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
| Contributions received from participants | 2020-12-31 | $4,869,518 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-12-31 | $1,994,258 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-12-31 | $2,063,445 |
| Other income not declared elsewhere | 2020-12-31 | $25,481 |
| Administrative expenses (other) incurred | 2020-12-31 | $1,156,215 |
| Liabilities. Value of operating payables at end of year | 2020-12-31 | $1,468,088 |
| Liabilities. Value of operating payables at beginning of year | 2020-12-31 | $1,272,178 |
| Total non interest bearing cash at end of year | 2020-12-31 | $11,283,612 |
| Total non interest bearing cash at beginning of year | 2020-12-31 | $12,035,970 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Value of net income/loss | 2020-12-31 | $46,266,059 |
| Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $310,206,515 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $263,940,456 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
| Investment advisory and management fees | 2020-12-31 | $608,729 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-12-31 | $53,258,775 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-12-31 | $36,787,038 |
| Income. Interest from US Government securities | 2020-12-31 | $1,351,569 |
| Income. Interest from corporate debt instruments | 2020-12-31 | $1,491,924 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-12-31 | $1,203,476 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-12-31 | $2,229,965 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-12-31 | $2,229,965 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-12-31 | $8,512 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-12-31 | $47,167,278 |
| Asset value of US Government securities at end of year | 2020-12-31 | $60,278,701 |
| Asset value of US Government securities at beginning of year | 2020-12-31 | $72,323,654 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2020-12-31 | $7,608,631 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
| Contributions received in cash from employer | 2020-12-31 | $133,427,983 |
| Employer contributions (assets) at end of year | 2020-12-31 | $12,899,196 |
| Employer contributions (assets) at beginning of year | 2020-12-31 | $12,008,030 |
| Income. Dividends from common stock | 2020-12-31 | $2,394,736 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-12-31 | $75,900,724 |
| Asset. Corporate debt instrument preferred debt at end of year | 2020-12-31 | $33,993,865 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2020-12-31 | $23,048,432 |
| Asset. Corporate debt instrument debt (other) at end of year | 2020-12-31 | $17,027,954 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2020-12-31 | $10,832,870 |
| Contract administrator fees | 2020-12-31 | $1,913,250 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2020-12-31 | $146,743,740 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2020-12-31 | $121,484,846 |
| Liabilities. Value of benefit claims payable at end of year | 2020-12-31 | $27,008,974 |
| Liabilities. Value of benefit claims payable at beginning of year | 2020-12-31 | $27,601,616 |
| Did the plan have assets held for investment | 2020-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
| Aggregate proceeds on sale of assets | 2020-12-31 | $122,926,841 |
| Aggregate carrying amount (costs) on sale of assets | 2020-12-31 | $119,283,215 |
| Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Unqualified |
| Accountancy firm name | 2020-12-31 | BJORKLUND & MONTPLAISIR, CPA'S |
| Accountancy firm EIN | 2020-12-31 | 931015766 |
| 2019 : HARRISON ELECTRICAL WORKERS TRUST FUND 2019 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-12-31 | $25,936,135 |
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-12-31 | $25,936,135 |
| Total unrealized appreciation/depreciation of assets | 2019-12-31 | $25,936,135 |
| Total unrealized appreciation/depreciation of assets | 2019-12-31 | $25,936,135 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $28,873,794 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $28,873,794 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $25,197,613 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $25,197,613 |
| Total income from all sources (including contributions) | 2019-12-31 | $177,349,280 |
| Total income from all sources (including contributions) | 2019-12-31 | $177,349,280 |
| Total loss/gain on sale of assets | 2019-12-31 | $3,881,579 |
| Total loss/gain on sale of assets | 2019-12-31 | $3,881,579 |
| Total of all expenses incurred | 2019-12-31 | $125,168,608 |
| Total of all expenses incurred | 2019-12-31 | $125,168,608 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $121,346,219 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $121,346,219 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $137,356,304 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $137,356,304 |
| Value of total assets at end of year | 2019-12-31 | $292,814,250 |
| Value of total assets at end of year | 2019-12-31 | $292,814,250 |
| Value of total assets at beginning of year | 2019-12-31 | $236,957,397 |
| Value of total assets at beginning of year | 2019-12-31 | $236,957,397 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $3,822,389 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $3,822,389 |
| Total interest from all sources | 2019-12-31 | $2,902,474 |
| Total interest from all sources | 2019-12-31 | $2,902,474 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-12-31 | $3,584,416 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-12-31 | $3,584,416 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2019-12-31 | $1,105,910 |
| Total dividends received from registered investment company shares (eg mutual funds) | 2019-12-31 | $1,105,910 |
| Administrative expenses professional fees incurred | 2019-12-31 | $199,583 |
| Administrative expenses professional fees incurred | 2019-12-31 | $199,583 |
| Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
| Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
| Value of fidelity bond cover | 2019-12-31 | $500,000 |
| Value of fidelity bond cover | 2019-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2019-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2019-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Contributions received from participants | 2019-12-31 | $4,445,015 |
| Contributions received from participants | 2019-12-31 | $4,445,015 |
| Assets. Other investments not covered elsewhere at beginning of year | 2019-12-31 | $101,115 |
| Assets. Other investments not covered elsewhere at beginning of year | 2019-12-31 | $101,115 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-12-31 | $2,063,445 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-12-31 | $2,063,445 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $2,127,813 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $2,127,813 |
| Other income not declared elsewhere | 2019-12-31 | $43,142 |
| Other income not declared elsewhere | 2019-12-31 | $43,142 |
| Administrative expenses (other) incurred | 2019-12-31 | $1,253,392 |
| Administrative expenses (other) incurred | 2019-12-31 | $1,253,392 |
| Liabilities. Value of operating payables at end of year | 2019-12-31 | $1,272,178 |
| Liabilities. Value of operating payables at end of year | 2019-12-31 | $1,272,178 |
| Liabilities. Value of operating payables at beginning of year | 2019-12-31 | $1,437,158 |
| Liabilities. Value of operating payables at beginning of year | 2019-12-31 | $1,437,158 |
| Total non interest bearing cash at end of year | 2019-12-31 | $12,035,970 |
| Total non interest bearing cash at end of year | 2019-12-31 | $12,035,970 |
| Total non interest bearing cash at beginning of year | 2019-12-31 | $12,766,570 |
| Total non interest bearing cash at beginning of year | 2019-12-31 | $12,766,570 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Value of net income/loss | 2019-12-31 | $52,180,672 |
| Value of net income/loss | 2019-12-31 | $52,180,672 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $263,940,456 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $263,940,456 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $211,759,784 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $211,759,784 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Investment advisory and management fees | 2019-12-31 | $542,656 |
| Investment advisory and management fees | 2019-12-31 | $542,656 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-12-31 | $36,787,038 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-12-31 | $36,787,038 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-12-31 | $30,011,443 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-12-31 | $30,011,443 |
| Income. Interest from US Government securities | 2019-12-31 | $1,607,773 |
| Income. Interest from US Government securities | 2019-12-31 | $1,607,773 |
| Income. Interest from corporate debt instruments | 2019-12-31 | $1,234,910 |
| Income. Interest from corporate debt instruments | 2019-12-31 | $1,234,910 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-12-31 | $2,229,965 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-12-31 | $2,229,965 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-12-31 | $2,192,104 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-12-31 | $2,192,104 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-12-31 | $2,192,104 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-12-31 | $2,192,104 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-12-31 | $59,791 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-12-31 | $59,791 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $44,053,658 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $44,053,658 |
| Asset value of US Government securities at end of year | 2019-12-31 | $72,323,654 |
| Asset value of US Government securities at end of year | 2019-12-31 | $72,323,654 |
| Asset value of US Government securities at beginning of year | 2019-12-31 | $59,603,524 |
| Asset value of US Government securities at beginning of year | 2019-12-31 | $59,603,524 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2019-12-31 | $3,645,230 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2019-12-31 | $3,645,230 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | Yes |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Contributions received in cash from employer | 2019-12-31 | $132,911,289 |
| Contributions received in cash from employer | 2019-12-31 | $132,911,289 |
| Employer contributions (assets) at end of year | 2019-12-31 | $12,008,030 |
| Employer contributions (assets) at end of year | 2019-12-31 | $12,008,030 |
| Employer contributions (assets) at beginning of year | 2019-12-31 | $11,553,531 |
| Employer contributions (assets) at beginning of year | 2019-12-31 | $11,553,531 |
| Income. Dividends from common stock | 2019-12-31 | $2,478,506 |
| Income. Dividends from common stock | 2019-12-31 | $2,478,506 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $77,292,561 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $77,292,561 |
| Asset. Corporate debt instrument preferred debt at end of year | 2019-12-31 | $23,048,432 |
| Asset. Corporate debt instrument preferred debt at end of year | 2019-12-31 | $23,048,432 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2019-12-31 | $20,849,302 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2019-12-31 | $20,849,302 |
| Asset. Corporate debt instrument debt (other) at end of year | 2019-12-31 | $10,832,870 |
| Asset. Corporate debt instrument debt (other) at end of year | 2019-12-31 | $10,832,870 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2019-12-31 | $9,532,649 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2019-12-31 | $9,532,649 |
| Contract administrator fees | 2019-12-31 | $1,826,758 |
| Contract administrator fees | 2019-12-31 | $1,826,758 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2019-12-31 | $121,484,846 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2019-12-31 | $121,484,846 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2019-12-31 | $88,219,346 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2019-12-31 | $88,219,346 |
| Liabilities. Value of benefit claims payable at end of year | 2019-12-31 | $27,601,616 |
| Liabilities. Value of benefit claims payable at end of year | 2019-12-31 | $27,601,616 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-12-31 | $23,760,455 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-12-31 | $23,760,455 |
| Did the plan have assets held for investment | 2019-12-31 | Yes |
| Did the plan have assets held for investment | 2019-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
| Aggregate proceeds on sale of assets | 2019-12-31 | $84,277,264 |
| Aggregate proceeds on sale of assets | 2019-12-31 | $84,277,264 |
| Aggregate carrying amount (costs) on sale of assets | 2019-12-31 | $80,395,685 |
| Aggregate carrying amount (costs) on sale of assets | 2019-12-31 | $80,395,685 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Unqualified |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Unqualified |
| Accountancy firm name | 2019-12-31 | BJORKLUND & MONTPLAISIR, CPA'S |
| Accountancy firm name | 2019-12-31 | BJORKLUND & MONTPLAISIR, CPA'S |
| Accountancy firm EIN | 2019-12-31 | 931015766 |
| Accountancy firm EIN | 2019-12-31 | 931015766 |
| 2018 : HARRISON ELECTRICAL WORKERS TRUST FUND 2018 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2018-12-31 | $-16,738,109 |
| Total unrealized appreciation/depreciation of assets | 2018-12-31 | $-16,738,109 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $25,197,613 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $21,493,019 |
| Total income from all sources (including contributions) | 2018-12-31 | $115,477,894 |
| Total loss/gain on sale of assets | 2018-12-31 | $3,712,756 |
| Total of all expenses incurred | 2018-12-31 | $109,154,036 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $105,537,658 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $125,221,403 |
| Value of total assets at end of year | 2018-12-31 | $236,957,397 |
| Value of total assets at beginning of year | 2018-12-31 | $226,928,945 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $3,616,378 |
| Total interest from all sources | 2018-12-31 | $2,688,963 |
| Total dividends received (eg from common stock, registered investment company shares) | 2018-12-31 | $3,059,023 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2018-12-31 | $868,384 |
| Administrative expenses professional fees incurred | 2018-12-31 | $233,004 |
| Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
| Value of fidelity bond cover | 2018-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2018-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
| Contributions received from participants | 2018-12-31 | $4,755,499 |
| Assets. Other investments not covered elsewhere at end of year | 2018-12-31 | $101,115 |
| Assets. Other investments not covered elsewhere at beginning of year | 2018-12-31 | $408,431 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-12-31 | $2,127,813 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-12-31 | $1,158,037 |
| Other income not declared elsewhere | 2018-12-31 | $143 |
| Administrative expenses (other) incurred | 2018-12-31 | $1,111,898 |
| Liabilities. Value of operating payables at end of year | 2018-12-31 | $1,437,158 |
| Liabilities. Value of operating payables at beginning of year | 2018-12-31 | $1,410,317 |
| Total non interest bearing cash at end of year | 2018-12-31 | $12,766,570 |
| Total non interest bearing cash at beginning of year | 2018-12-31 | $7,865,800 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Value of net income/loss | 2018-12-31 | $6,323,858 |
| Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $211,759,784 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $205,435,926 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
| Investment advisory and management fees | 2018-12-31 | $497,525 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2018-12-31 | $30,011,443 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2018-12-31 | $28,779,452 |
| Income. Interest from US Government securities | 2018-12-31 | $1,156,792 |
| Income. Interest from corporate debt instruments | 2018-12-31 | $1,465,377 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-12-31 | $2,192,104 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-12-31 | $2,690,678 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-12-31 | $2,690,678 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-12-31 | $66,794 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $40,593,890 |
| Asset value of US Government securities at end of year | 2018-12-31 | $59,603,524 |
| Asset value of US Government securities at beginning of year | 2018-12-31 | $34,886,245 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2018-12-31 | $-2,466,285 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2018-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
| Contributions received in cash from employer | 2018-12-31 | $120,465,904 |
| Employer contributions (assets) at end of year | 2018-12-31 | $11,553,531 |
| Employer contributions (assets) at beginning of year | 2018-12-31 | $10,921,388 |
| Income. Dividends from common stock | 2018-12-31 | $2,190,639 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-12-31 | $64,943,768 |
| Asset. Corporate debt instrument preferred debt at end of year | 2018-12-31 | $20,849,302 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2018-12-31 | $24,020,387 |
| Asset. Corporate debt instrument debt (other) at end of year | 2018-12-31 | $9,532,649 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2018-12-31 | $17,630,845 |
| Contract administrator fees | 2018-12-31 | $1,773,951 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2018-12-31 | $88,219,346 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2018-12-31 | $98,567,682 |
| Liabilities. Value of benefit claims payable at end of year | 2018-12-31 | $23,760,455 |
| Liabilities. Value of benefit claims payable at beginning of year | 2018-12-31 | $20,082,702 |
| Did the plan have assets held for investment | 2018-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-12-31 | No |
| Aggregate proceeds on sale of assets | 2018-12-31 | $126,488,319 |
| Aggregate carrying amount (costs) on sale of assets | 2018-12-31 | $122,775,563 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Unqualified |
| Accountancy firm name | 2018-12-31 | BJORKLUND & MONTPLAISIR, CPA'S |
| Accountancy firm EIN | 2018-12-31 | 931015766 |
| 2017 : HARRISON ELECTRICAL WORKERS TRUST FUND 2017 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2017-12-31 | $9,243,669 |
| Total unrealized appreciation/depreciation of assets | 2017-12-31 | $9,243,669 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $21,493,019 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $23,683,490 |
| Total income from all sources (including contributions) | 2017-12-31 | $134,794,640 |
| Total loss/gain on sale of assets | 2017-12-31 | $5,316,856 |
| Total of all expenses incurred | 2017-12-31 | $100,227,126 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $96,688,137 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $112,286,196 |
| Value of total assets at end of year | 2017-12-31 | $226,928,945 |
| Value of total assets at beginning of year | 2017-12-31 | $194,551,902 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $3,538,989 |
| Total interest from all sources | 2017-12-31 | $2,597,636 |
| Total dividends received (eg from common stock, registered investment company shares) | 2017-12-31 | $2,521,280 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2017-12-31 | $681,805 |
| Administrative expenses professional fees incurred | 2017-12-31 | $194,237 |
| Was this plan covered by a fidelity bond | 2017-12-31 | Yes |
| Value of fidelity bond cover | 2017-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2017-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
| Contributions received from participants | 2017-12-31 | $4,706,460 |
| Assets. Other investments not covered elsewhere at end of year | 2017-12-31 | $408,431 |
| Assets. Other investments not covered elsewhere at beginning of year | 2017-12-31 | $887,051 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-12-31 | $1,158,037 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-12-31 | $1,899,786 |
| Other income not declared elsewhere | 2017-12-31 | $789 |
| Administrative expenses (other) incurred | 2017-12-31 | $1,121,645 |
| Liabilities. Value of operating payables at end of year | 2017-12-31 | $1,410,317 |
| Liabilities. Value of operating payables at beginning of year | 2017-12-31 | $765,316 |
| Total non interest bearing cash at end of year | 2017-12-31 | $7,865,800 |
| Total non interest bearing cash at beginning of year | 2017-12-31 | $4,103,825 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Value of net income/loss | 2017-12-31 | $34,567,514 |
| Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $205,435,926 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $170,868,412 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
| Investment advisory and management fees | 2017-12-31 | $446,001 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2017-12-31 | $28,779,452 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2017-12-31 | $23,540,221 |
| Income. Interest from US Government securities | 2017-12-31 | $799,858 |
| Income. Interest from corporate debt instruments | 2017-12-31 | $1,766,186 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-12-31 | $2,690,678 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-12-31 | $2,147,046 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-12-31 | $2,147,046 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-12-31 | $31,592 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $35,313,368 |
| Asset value of US Government securities at end of year | 2017-12-31 | $34,886,245 |
| Asset value of US Government securities at beginning of year | 2017-12-31 | $29,151,512 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2017-12-31 | $2,828,214 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2017-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
| Contributions received in cash from employer | 2017-12-31 | $107,579,736 |
| Employer contributions (assets) at end of year | 2017-12-31 | $10,921,388 |
| Employer contributions (assets) at beginning of year | 2017-12-31 | $8,724,512 |
| Income. Dividends from common stock | 2017-12-31 | $1,839,475 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-12-31 | $61,374,769 |
| Asset. Corporate debt instrument preferred debt at end of year | 2017-12-31 | $24,020,387 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2017-12-31 | $25,294,415 |
| Asset. Corporate debt instrument debt (other) at end of year | 2017-12-31 | $17,630,845 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2017-12-31 | $16,470,668 |
| Contract administrator fees | 2017-12-31 | $1,777,106 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2017-12-31 | $98,567,682 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2017-12-31 | $82,332,866 |
| Liabilities. Value of benefit claims payable at end of year | 2017-12-31 | $20,082,702 |
| Liabilities. Value of benefit claims payable at beginning of year | 2017-12-31 | $22,918,174 |
| Did the plan have assets held for investment | 2017-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-12-31 | No |
| Aggregate proceeds on sale of assets | 2017-12-31 | $61,189,125 |
| Aggregate carrying amount (costs) on sale of assets | 2017-12-31 | $55,872,269 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Unqualified |
| Accountancy firm name | 2017-12-31 | BJORKLUND & MONTPLAISIR, CPA'S |
| Accountancy firm EIN | 2017-12-31 | 931015766 |
| 2016 : HARRISON ELECTRICAL WORKERS TRUST FUND 2016 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2016-12-31 | $2,324,761 |
| Total unrealized appreciation/depreciation of assets | 2016-12-31 | $2,324,761 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $23,683,490 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $19,259,165 |
| Total income from all sources (including contributions) | 2016-12-31 | $111,433,907 |
| Total loss/gain on sale of assets | 2016-12-31 | $1,312,131 |
| Total of all expenses incurred | 2016-12-31 | $98,290,476 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $94,794,299 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $100,889,075 |
| Value of total assets at end of year | 2016-12-31 | $194,551,902 |
| Value of total assets at beginning of year | 2016-12-31 | $176,984,146 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $3,496,177 |
| Total interest from all sources | 2016-12-31 | $2,400,546 |
| Total dividends received (eg from common stock, registered investment company shares) | 2016-12-31 | $2,333,611 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2016-12-31 | $450,628 |
| Administrative expenses professional fees incurred | 2016-12-31 | $215,639 |
| Was this plan covered by a fidelity bond | 2016-12-31 | Yes |
| Value of fidelity bond cover | 2016-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2016-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
| Contributions received from participants | 2016-12-31 | $4,449,813 |
| Assets. Other investments not covered elsewhere at end of year | 2016-12-31 | $887,051 |
| Assets. Other investments not covered elsewhere at beginning of year | 2016-12-31 | $899,759 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-12-31 | $1,899,786 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-12-31 | $952,888 |
| Other income not declared elsewhere | 2016-12-31 | $1,219 |
| Administrative expenses (other) incurred | 2016-12-31 | $1,213,451 |
| Liabilities. Value of operating payables at end of year | 2016-12-31 | $765,316 |
| Liabilities. Value of operating payables at beginning of year | 2016-12-31 | $771,773 |
| Total non interest bearing cash at end of year | 2016-12-31 | $4,103,825 |
| Total non interest bearing cash at beginning of year | 2016-12-31 | $1,201,600 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Value of net income/loss | 2016-12-31 | $13,143,431 |
| Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $170,868,412 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $157,724,981 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
| Investment advisory and management fees | 2016-12-31 | $414,026 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2016-12-31 | $23,540,221 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2016-12-31 | $18,348,898 |
| Income. Interest from US Government securities | 2016-12-31 | $507,081 |
| Income. Interest from corporate debt instruments | 2016-12-31 | $1,886,471 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-12-31 | $2,147,046 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-12-31 | $2,318,417 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-12-31 | $2,318,417 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-12-31 | $6,994 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $33,275,488 |
| Asset value of US Government securities at end of year | 2016-12-31 | $29,151,512 |
| Asset value of US Government securities at beginning of year | 2016-12-31 | $18,232,539 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2016-12-31 | $2,172,564 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
| Contributions received in cash from employer | 2016-12-31 | $96,439,262 |
| Employer contributions (assets) at end of year | 2016-12-31 | $8,724,512 |
| Employer contributions (assets) at beginning of year | 2016-12-31 | $7,373,076 |
| Income. Dividends from common stock | 2016-12-31 | $1,882,983 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-12-31 | $61,518,811 |
| Asset. Corporate debt instrument preferred debt at end of year | 2016-12-31 | $25,294,415 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2016-12-31 | $28,027,760 |
| Asset. Corporate debt instrument debt (other) at end of year | 2016-12-31 | $16,470,668 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2016-12-31 | $15,850,383 |
| Contract administrator fees | 2016-12-31 | $1,653,061 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2016-12-31 | $82,332,866 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2016-12-31 | $83,778,826 |
| Liabilities. Value of benefit claims payable at end of year | 2016-12-31 | $22,918,174 |
| Liabilities. Value of benefit claims payable at beginning of year | 2016-12-31 | $18,487,392 |
| Did the plan have assets held for investment | 2016-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | No |
| Aggregate proceeds on sale of assets | 2016-12-31 | $106,182,092 |
| Aggregate carrying amount (costs) on sale of assets | 2016-12-31 | $104,869,961 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Unqualified |
| Accountancy firm name | 2016-12-31 | BJORKLUND & MONTPLAISIR, CPA'S |
| Accountancy firm EIN | 2016-12-31 | 931015766 |
| 2015 : HARRISON ELECTRICAL WORKERS TRUST FUND 2015 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2015-12-31 | $-10,480,018 |
| Total unrealized appreciation/depreciation of assets | 2015-12-31 | $-10,480,018 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $19,259,165 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $22,551,202 |
| Total income from all sources (including contributions) | 2015-12-31 | $81,996,749 |
| Total loss/gain on sale of assets | 2015-12-31 | $5,904,197 |
| Total of all expenses incurred | 2015-12-31 | $92,703,249 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $89,186,398 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-12-31 | $83,465,987 |
| Value of total assets at end of year | 2015-12-31 | $176,984,146 |
| Value of total assets at beginning of year | 2015-12-31 | $190,982,683 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $3,516,851 |
| Total interest from all sources | 2015-12-31 | $2,434,464 |
| Total dividends received (eg from common stock, registered investment company shares) | 2015-12-31 | $1,945,160 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2015-12-31 | $307,610 |
| Administrative expenses professional fees incurred | 2015-12-31 | $232,983 |
| Was this plan covered by a fidelity bond | 2015-12-31 | Yes |
| Value of fidelity bond cover | 2015-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2015-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
| Contributions received from participants | 2015-12-31 | $3,941,392 |
| Assets. Other investments not covered elsewhere at end of year | 2015-12-31 | $899,759 |
| Assets. Other investments not covered elsewhere at beginning of year | 2015-12-31 | $899,941 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-12-31 | $952,888 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-12-31 | $825,153 |
| Other income not declared elsewhere | 2015-12-31 | $244 |
| Administrative expenses (other) incurred | 2015-12-31 | $1,235,837 |
| Liabilities. Value of operating payables at end of year | 2015-12-31 | $771,773 |
| Liabilities. Value of operating payables at beginning of year | 2015-12-31 | $1,212,008 |
| Total non interest bearing cash at end of year | 2015-12-31 | $1,201,600 |
| Total non interest bearing cash at beginning of year | 2015-12-31 | $4,073,821 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Value of net income/loss | 2015-12-31 | $-10,706,500 |
| Value of net assets at end of year (total assets less liabilities) | 2015-12-31 | $157,724,981 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-12-31 | $168,431,481 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
| Investment advisory and management fees | 2015-12-31 | $418,625 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2015-12-31 | $18,348,898 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2015-12-31 | $18,505,607 |
| Income. Interest from US Government securities | 2015-12-31 | $513,757 |
| Income. Interest from corporate debt instruments | 2015-12-31 | $1,918,534 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-12-31 | $2,318,417 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-12-31 | $2,916,175 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-12-31 | $2,916,175 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-12-31 | $2,173 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-12-31 | $29,321,602 |
| Asset value of US Government securities at end of year | 2015-12-31 | $18,232,539 |
| Asset value of US Government securities at beginning of year | 2015-12-31 | $19,855,813 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2015-12-31 | $-1,273,285 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2015-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
| Contributions received in cash from employer | 2015-12-31 | $79,524,595 |
| Employer contributions (assets) at end of year | 2015-12-31 | $7,373,076 |
| Employer contributions (assets) at beginning of year | 2015-12-31 | $6,972,149 |
| Income. Dividends from common stock | 2015-12-31 | $1,637,550 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-12-31 | $59,864,796 |
| Asset. Corporate debt instrument preferred debt at end of year | 2015-12-31 | $28,027,760 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2015-12-31 | $32,582,808 |
| Asset. Corporate debt instrument debt (other) at end of year | 2015-12-31 | $15,850,383 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2015-12-31 | $11,650,460 |
| Contract administrator fees | 2015-12-31 | $1,629,406 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2015-12-31 | $83,778,826 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2015-12-31 | $92,700,756 |
| Liabilities. Value of benefit claims payable at end of year | 2015-12-31 | $18,487,392 |
| Liabilities. Value of benefit claims payable at beginning of year | 2015-12-31 | $21,339,194 |
| Did the plan have assets held for investment | 2015-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-12-31 | No |
| Aggregate proceeds on sale of assets | 2015-12-31 | $95,181,766 |
| Aggregate carrying amount (costs) on sale of assets | 2015-12-31 | $89,277,569 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-12-31 | Unqualified |
| Accountancy firm name | 2015-12-31 | BJORKLUND & MONTPLAISIR, CPA'S |
| Accountancy firm EIN | 2015-12-31 | 931015766 |
| 2014 : HARRISON ELECTRICAL WORKERS TRUST FUND 2014 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2014-12-31 | $-3,234,419 |
| Total unrealized appreciation/depreciation of assets | 2014-12-31 | $-3,234,419 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $5,751,202 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $4,825,004 |
| Total income from all sources (including contributions) | 2014-12-31 | $104,757,355 |
| Total loss/gain on sale of assets | 2014-12-31 | $8,334,414 |
| Total of all expenses incurred | 2014-12-31 | $93,686,523 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $89,751,950 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-12-31 | $94,989,798 |
| Value of total assets at end of year | 2014-12-31 | $190,982,683 |
| Value of total assets at beginning of year | 2014-12-31 | $178,985,653 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $3,934,573 |
| Total interest from all sources | 2014-12-31 | $2,313,005 |
| Total dividends received (eg from common stock, registered investment company shares) | 2014-12-31 | $2,184,962 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2014-12-31 | $393,084 |
| Administrative expenses professional fees incurred | 2014-12-31 | $196,370 |
| Was this plan covered by a fidelity bond | 2014-12-31 | Yes |
| Value of fidelity bond cover | 2014-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2014-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
| Contributions received from participants | 2014-12-31 | $3,615,969 |
| Assets. Other investments not covered elsewhere at end of year | 2014-12-31 | $899,941 |
| Assets. Other investments not covered elsewhere at beginning of year | 2014-12-31 | $884,675 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-12-31 | $825,153 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-12-31 | $661,337 |
| Administrative expenses (other) incurred | 2014-12-31 | $1,591,935 |
| Liabilities. Value of operating payables at end of year | 2014-12-31 | $1,212,008 |
| Liabilities. Value of operating payables at beginning of year | 2014-12-31 | $510,956 |
| Total non interest bearing cash at end of year | 2014-12-31 | $4,073,821 |
| Total non interest bearing cash at beginning of year | 2014-12-31 | $3,037,946 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Value of net income/loss | 2014-12-31 | $11,070,832 |
| Value of net assets at end of year (total assets less liabilities) | 2014-12-31 | $185,231,481 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-12-31 | $174,160,649 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
| Investment advisory and management fees | 2014-12-31 | $385,741 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2014-12-31 | $18,505,607 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2014-12-31 | $18,975,049 |
| Income. Interest from US Government securities | 2014-12-31 | $517,979 |
| Income. Interest from corporate debt instruments | 2014-12-31 | $1,789,049 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-12-31 | $2,916,175 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-12-31 | $2,954,232 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-12-31 | $2,954,232 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-12-31 | $5,977 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-12-31 | $29,588,195 |
| Asset value of US Government securities at end of year | 2014-12-31 | $19,855,813 |
| Asset value of US Government securities at beginning of year | 2014-12-31 | $20,971,491 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2014-12-31 | $169,595 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2014-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
| Contributions received in cash from employer | 2014-12-31 | $91,373,829 |
| Employer contributions (assets) at end of year | 2014-12-31 | $6,972,149 |
| Employer contributions (assets) at beginning of year | 2014-12-31 | $7,203,846 |
| Income. Dividends from common stock | 2014-12-31 | $1,791,878 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-12-31 | $60,163,755 |
| Asset. Corporate debt instrument preferred debt at end of year | 2014-12-31 | $32,582,808 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2014-12-31 | $28,131,546 |
| Asset. Corporate debt instrument debt (other) at end of year | 2014-12-31 | $11,650,460 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2014-12-31 | $8,209,384 |
| Contract administrator fees | 2014-12-31 | $1,760,527 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2014-12-31 | $92,700,756 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2014-12-31 | $87,956,147 |
| Liabilities. Value of benefit claims payable at end of year | 2014-12-31 | $4,539,194 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-12-31 | $4,314,048 |
| Did the plan have assets held for investment | 2014-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-12-31 | No |
| Aggregate proceeds on sale of assets | 2014-12-31 | $58,316,190 |
| Aggregate carrying amount (costs) on sale of assets | 2014-12-31 | $49,981,776 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-12-31 | Unqualified |
| Accountancy firm name | 2014-12-31 | BJORKLUND & MONTPLAISIR, CPA'S |
| Accountancy firm EIN | 2014-12-31 | 931015766 |
| 2013 : HARRISON ELECTRICAL WORKERS TRUST FUND 2013 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2013-12-31 | $7,817,297 |
| Total unrealized appreciation/depreciation of assets | 2013-12-31 | $7,817,297 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $4,825,004 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $4,234,220 |
| Total income from all sources (including contributions) | 2013-12-31 | $106,355,738 |
| Total loss/gain on sale of assets | 2013-12-31 | $8,637,828 |
| Total of all expenses incurred | 2013-12-31 | $80,338,728 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $77,404,778 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-12-31 | $81,803,424 |
| Value of total assets at end of year | 2013-12-31 | $178,985,653 |
| Value of total assets at beginning of year | 2013-12-31 | $152,377,859 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $2,933,950 |
| Total interest from all sources | 2013-12-31 | $2,009,671 |
| Total dividends received (eg from common stock, registered investment company shares) | 2013-12-31 | $1,976,011 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2013-12-31 | $281,260 |
| Administrative expenses professional fees incurred | 2013-12-31 | $209,154 |
| Was this plan covered by a fidelity bond | 2013-12-31 | Yes |
| Value of fidelity bond cover | 2013-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2013-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
| Contributions received from participants | 2013-12-31 | $3,087,666 |
| Assets. Other investments not covered elsewhere at end of year | 2013-12-31 | $884,675 |
| Assets. Other investments not covered elsewhere at beginning of year | 2013-12-31 | $2,192,391 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-12-31 | $661,337 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-12-31 | $595,761 |
| Administrative expenses (other) incurred | 2013-12-31 | $817,239 |
| Liabilities. Value of operating payables at end of year | 2013-12-31 | $510,956 |
| Liabilities. Value of operating payables at beginning of year | 2013-12-31 | $435,995 |
| Total non interest bearing cash at end of year | 2013-12-31 | $3,037,946 |
| Total non interest bearing cash at beginning of year | 2013-12-31 | $5,107,259 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Value of net income/loss | 2013-12-31 | $26,017,010 |
| Value of net assets at end of year (total assets less liabilities) | 2013-12-31 | $174,160,649 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $148,143,639 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
| Investment advisory and management fees | 2013-12-31 | $333,159 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2013-12-31 | $18,975,049 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2013-12-31 | $8,419,437 |
| Income. Interest from US Government securities | 2013-12-31 | $594,597 |
| Income. Interest from corporate debt instruments | 2013-12-31 | $1,410,637 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-12-31 | $2,954,232 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-12-31 | $5,638,691 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-12-31 | $5,638,691 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-12-31 | $4,437 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-12-31 | $26,661,965 |
| Asset value of US Government securities at end of year | 2013-12-31 | $20,971,491 |
| Asset value of US Government securities at beginning of year | 2013-12-31 | $21,511,931 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2013-12-31 | $4,111,507 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2013-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
| Contributions received in cash from employer | 2013-12-31 | $78,715,758 |
| Employer contributions (assets) at end of year | 2013-12-31 | $7,203,846 |
| Employer contributions (assets) at beginning of year | 2013-12-31 | $5,725,207 |
| Income. Dividends from common stock | 2013-12-31 | $1,694,751 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-12-31 | $50,742,813 |
| Asset. Corporate debt instrument preferred debt at end of year | 2013-12-31 | $28,131,546 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2013-12-31 | $19,950,190 |
| Asset. Corporate debt instrument debt (other) at end of year | 2013-12-31 | $8,209,384 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2013-12-31 | $8,424,626 |
| Contract administrator fees | 2013-12-31 | $1,574,398 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2013-12-31 | $87,956,147 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2013-12-31 | $74,812,366 |
| Liabilities. Value of benefit claims payable at end of year | 2013-12-31 | $4,314,048 |
| Liabilities. Value of benefit claims payable at beginning of year | 2013-12-31 | $3,798,225 |
| Did the plan have assets held for investment | 2013-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-12-31 | No |
| Aggregate proceeds on sale of assets | 2013-12-31 | $63,114,957 |
| Aggregate carrying amount (costs) on sale of assets | 2013-12-31 | $54,477,129 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-12-31 | Unqualified |
| Accountancy firm name | 2013-12-31 | BJORKLUND & MONTPLAISIR, CPA'S |
| Accountancy firm EIN | 2013-12-31 | 931015766 |
| 2012 : HARRISON ELECTRICAL WORKERS TRUST FUND 2012 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2012-12-31 | $4,799,445 |
| Total unrealized appreciation/depreciation of assets | 2012-12-31 | $4,799,445 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $4,234,220 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $3,977,783 |
| Total income from all sources (including contributions) | 2012-12-31 | $91,754,912 |
| Total loss/gain on sale of assets | 2012-12-31 | $3,134,420 |
| Total of all expenses incurred | 2012-12-31 | $73,213,504 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $70,406,551 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $79,031,140 |
| Value of total assets at end of year | 2012-12-31 | $152,377,859 |
| Value of total assets at beginning of year | 2012-12-31 | $133,580,014 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $2,806,953 |
| Total interest from all sources | 2012-12-31 | $2,075,325 |
| Total dividends received (eg from common stock, registered investment company shares) | 2012-12-31 | $1,718,626 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2012-12-31 | $168,824 |
| Administrative expenses professional fees incurred | 2012-12-31 | $144,219 |
| Was this plan covered by a fidelity bond | 2012-12-31 | Yes |
| Value of fidelity bond cover | 2012-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2012-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
| Contributions received from participants | 2012-12-31 | $3,214,179 |
| Assets. Other investments not covered elsewhere at end of year | 2012-12-31 | $2,227,525 |
| Assets. Other investments not covered elsewhere at beginning of year | 2012-12-31 | $6,523,956 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2012-12-31 | $7,774 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-12-31 | $560,627 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-12-31 | $663,032 |
| Other income not declared elsewhere | 2012-12-31 | $7,379 |
| Administrative expenses (other) incurred | 2012-12-31 | $798,935 |
| Liabilities. Value of operating payables at end of year | 2012-12-31 | $435,995 |
| Liabilities. Value of operating payables at beginning of year | 2012-12-31 | $403,363 |
| Total non interest bearing cash at end of year | 2012-12-31 | $5,107,259 |
| Total non interest bearing cash at beginning of year | 2012-12-31 | $4,743,014 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Value of net income/loss | 2012-12-31 | $18,541,408 |
| Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $148,143,639 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $129,602,231 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
| Investment advisory and management fees | 2012-12-31 | $291,023 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2012-12-31 | $8,419,437 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2012-12-31 | $6,333,946 |
| Income. Interest from US Government securities | 2012-12-31 | $752,018 |
| Income. Interest from corporate debt instruments | 2012-12-31 | $1,313,684 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-12-31 | $5,638,691 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-12-31 | $7,698,286 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-12-31 | $7,698,286 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-12-31 | $9,623 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-12-31 | $24,981,231 |
| Asset value of US Government securities at end of year | 2012-12-31 | $21,511,931 |
| Asset value of US Government securities at beginning of year | 2012-12-31 | $20,814,422 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2012-12-31 | $988,577 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
| Contributions received in cash from employer | 2012-12-31 | $75,809,187 |
| Employer contributions (assets) at end of year | 2012-12-31 | $5,725,207 |
| Employer contributions (assets) at beginning of year | 2012-12-31 | $6,804,143 |
| Income. Dividends from common stock | 2012-12-31 | $1,549,802 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $45,425,320 |
| Asset. Corporate debt instrument preferred debt at end of year | 2012-12-31 | $19,950,190 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2012-12-31 | $22,645,278 |
| Asset. Corporate debt instrument debt (other) at end of year | 2012-12-31 | $8,424,626 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2012-12-31 | $4,987,380 |
| Contract administrator fees | 2012-12-31 | $1,572,776 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2012-12-31 | $74,812,366 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2012-12-31 | $52,366,557 |
| Liabilities. Value of benefit claims payable at end of year | 2012-12-31 | $3,798,225 |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-12-31 | $3,574,420 |
| Did the plan have assets held for investment | 2012-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
| Aggregate proceeds on sale of assets | 2012-12-31 | $41,341,385 |
| Aggregate carrying amount (costs) on sale of assets | 2012-12-31 | $38,206,965 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Unqualified |
| Accountancy firm name | 2012-12-31 | BJORKLUND & MONTPLAISIR, CPA'S |
| Accountancy firm EIN | 2012-12-31 | 931015766 |
| 2011 : HARRISON ELECTRICAL WORKERS TRUST FUND 2011 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2011-12-31 | $-7,250,428 |
| Total unrealized appreciation/depreciation of assets | 2011-12-31 | $-7,250,428 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $3,977,783 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $3,303,991 |
| Total income from all sources (including contributions) | 2011-12-31 | $68,333,555 |
| Total loss/gain on sale of assets | 2011-12-31 | $5,047,697 |
| Total of all expenses incurred | 2011-12-31 | $65,017,231 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $62,429,223 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $68,237,662 |
| Value of total assets at end of year | 2011-12-31 | $133,580,014 |
| Value of total assets at beginning of year | 2011-12-31 | $129,589,898 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $2,588,008 |
| Total interest from all sources | 2011-12-31 | $1,701,426 |
| Total dividends received (eg from common stock, registered investment company shares) | 2011-12-31 | $1,054,093 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2011-12-31 | $96,949 |
| Administrative expenses professional fees incurred | 2011-12-31 | $148,824 |
| Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
| Value of fidelity bond cover | 2011-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2011-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
| Contributions received from participants | 2011-12-31 | $3,889,476 |
| Assets. Other investments not covered elsewhere at end of year | 2011-12-31 | $6,523,956 |
| Assets. Other investments not covered elsewhere at beginning of year | 2011-12-31 | $879,807 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2011-12-31 | $993,467 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-12-31 | $663,032 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-12-31 | $758,425 |
| Other income not declared elsewhere | 2011-12-31 | $6,242 |
| Administrative expenses (other) incurred | 2011-12-31 | $782,614 |
| Liabilities. Value of operating payables at end of year | 2011-12-31 | $403,363 |
| Liabilities. Value of operating payables at beginning of year | 2011-12-31 | $336,854 |
| Total non interest bearing cash at end of year | 2011-12-31 | $4,743,014 |
| Total non interest bearing cash at beginning of year | 2011-12-31 | $1,589,634 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Value of net income/loss | 2011-12-31 | $3,316,324 |
| Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $129,602,231 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $126,285,907 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
| Investment advisory and management fees | 2011-12-31 | $248,582 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2011-12-31 | $6,333,946 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2011-12-31 | $7,426,604 |
| Income. Interest from US Government securities | 2011-12-31 | $663,734 |
| Income. Interest from corporate debt instruments | 2011-12-31 | $1,024,172 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-12-31 | $7,698,286 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-12-31 | $19,322,936 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-12-31 | $19,322,936 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-12-31 | $13,520 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-12-31 | $21,125,192 |
| Asset value of US Government securities at end of year | 2011-12-31 | $20,814,422 |
| Asset value of US Government securities at beginning of year | 2011-12-31 | $15,522,929 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2011-12-31 | $-463,137 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
| Contributions received in cash from employer | 2011-12-31 | $63,354,719 |
| Employer contributions (assets) at end of year | 2011-12-31 | $6,804,143 |
| Employer contributions (assets) at beginning of year | 2011-12-31 | $5,122,858 |
| Income. Dividends from common stock | 2011-12-31 | $957,144 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $41,304,031 |
| Asset. Corporate debt instrument preferred debt at end of year | 2011-12-31 | $22,645,278 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2011-12-31 | $16,757,098 |
| Asset. Corporate debt instrument debt (other) at end of year | 2011-12-31 | $4,987,380 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2011-12-31 | $2,516,891 |
| Contract administrator fees | 2011-12-31 | $1,407,988 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2011-12-31 | $52,366,557 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2011-12-31 | $59,692,716 |
| Liabilities. Value of benefit claims payable at end of year | 2011-12-31 | $3,574,420 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-12-31 | $2,967,137 |
| Did the plan have assets held for investment | 2011-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
| Aggregate proceeds on sale of assets | 2011-12-31 | $51,421,950 |
| Aggregate carrying amount (costs) on sale of assets | 2011-12-31 | $46,374,253 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Unqualified |
| Accountancy firm name | 2011-12-31 | BJORKLUND & MONTPLAISIR, CPA'S |
| Accountancy firm EIN | 2011-12-31 | 931015766 |
| 2010 : HARRISON ELECTRICAL WORKERS TRUST FUND 2010 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2010-12-31 | $7,037,811 |
| Total unrealized appreciation/depreciation of assets | 2010-12-31 | $7,037,811 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $3,303,991 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $3,322,541 |
| Total income from all sources (including contributions) | 2010-12-31 | $72,965,813 |
| Total loss/gain on sale of assets | 2010-12-31 | $1,927,391 |
| Total of all expenses incurred | 2010-12-31 | $63,664,943 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $61,154,255 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $60,162,347 |
| Value of total assets at end of year | 2010-12-31 | $129,589,898 |
| Value of total assets at beginning of year | 2010-12-31 | $120,307,578 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $2,510,688 |
| Total interest from all sources | 2010-12-31 | $1,552,923 |
| Total dividends received (eg from common stock, registered investment company shares) | 2010-12-31 | $988,929 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2010-12-31 | $112,355 |
| Administrative expenses professional fees incurred | 2010-12-31 | $180,360 |
| Was this plan covered by a fidelity bond | 2010-12-31 | Yes |
| Value of fidelity bond cover | 2010-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2010-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
| Contributions received from participants | 2010-12-31 | $4,552,618 |
| Assets. Other investments not covered elsewhere at end of year | 2010-12-31 | $879,807 |
| Assets. Other investments not covered elsewhere at beginning of year | 2010-12-31 | $33,088 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2010-12-31 | $1,662,600 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2010-12-31 | $758,425 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2010-12-31 | $711,387 |
| Other income not declared elsewhere | 2010-12-31 | $394 |
| Administrative expenses (other) incurred | 2010-12-31 | $780,782 |
| Liabilities. Value of operating payables at end of year | 2010-12-31 | $336,854 |
| Liabilities. Value of operating payables at beginning of year | 2010-12-31 | $457,551 |
| Total non interest bearing cash at end of year | 2010-12-31 | $1,589,634 |
| Total non interest bearing cash at beginning of year | 2010-12-31 | $1,310,476 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Value of net income/loss | 2010-12-31 | $9,300,870 |
| Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $126,285,907 |
| Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $116,985,037 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2010-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | Yes |
| Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year | 2010-12-31 | $265,938 |
| Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
| Investment advisory and management fees | 2010-12-31 | $172,745 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2010-12-31 | $7,426,604 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2010-12-31 | $8,118,445 |
| Income. Interest from US Government securities | 2010-12-31 | $581,543 |
| Income. Interest from corporate debt instruments | 2010-12-31 | $964,195 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2010-12-31 | $19,322,936 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2010-12-31 | $18,632,533 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2010-12-31 | $18,632,533 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2010-12-31 | $7,185 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2010-12-31 | $19,289,108 |
| Asset value of US Government securities at end of year | 2010-12-31 | $15,522,929 |
| Asset value of US Government securities at beginning of year | 2010-12-31 | $15,494,178 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2010-12-31 | $1,296,018 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
| Contributions received in cash from employer | 2010-12-31 | $53,947,129 |
| Employer contributions (assets) at end of year | 2010-12-31 | $5,122,858 |
| Employer contributions (assets) at beginning of year | 2010-12-31 | $4,760,131 |
| Income. Dividends from common stock | 2010-12-31 | $876,574 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2010-12-31 | $41,865,147 |
| Asset. Corporate debt instrument preferred debt at end of year | 2010-12-31 | $16,757,098 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2010-12-31 | $18,551,958 |
| Asset. Corporate debt instrument debt (other) at end of year | 2010-12-31 | $2,516,891 |
| Contract administrator fees | 2010-12-31 | $1,376,801 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2010-12-31 | $59,692,716 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2010-12-31 | $52,695,382 |
| Liabilities. Value of benefit claims payable at end of year | 2010-12-31 | $2,967,137 |
| Liabilities. Value of benefit claims payable at beginning of year | 2010-12-31 | $2,864,990 |
| Did the plan have assets held for investment | 2010-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-12-31 | No |
| Aggregate proceeds on sale of assets | 2010-12-31 | $47,804,384 |
| Aggregate carrying amount (costs) on sale of assets | 2010-12-31 | $45,876,993 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Unqualified |
| Accountancy firm name | 2010-12-31 | BJORKLUND & MONTPLAISIR, CPAS |
| Accountancy firm EIN | 2010-12-31 | 931015766 |
| KAISER PERMANENTE NW REGION (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 2454 |
| Policy instance | 1 |
| Insurance contract or identification number | 2454 | | Number of Individuals Covered | 2684 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $132,546 | | Welfare Benefit Premiums Paid to Carrier | USD $15,132,080 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $66,273 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 615939 |
| Policy instance | 2 |
| Insurance contract or identification number | 615939 | | Number of Individuals Covered | 6915 | | Insurance policy start date | 2021-11-01 | | Insurance policy end date | 2022-11-01 | | Total amount of commissions paid to insurance broker | USD $3,090 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | OTHER (SPECIFY) | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,545 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 03325888 |
| Policy instance | 3 |
| Insurance contract or identification number | 03325888 | | Number of Individuals Covered | 15136 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $752,063 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 16-007337 |
| Policy instance | 4 |
| Insurance contract or identification number | 16-007337 | | Number of Individuals Covered | 5908 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $2,455,184 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 95893 ) |
| Policy contract number | 005477 |
| Policy instance | 5 |
| Insurance contract or identification number | 005477 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $48,151 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 48038 ) |
| Policy contract number | 006084 |
| Policy instance | 6 |
| Insurance contract or identification number | 006084 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $23,940 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 100576 |
| Policy instance | 7 |
| Insurance contract or identification number | 100576 | | Number of Individuals Covered | 381 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,419,630 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 105122 |
| Policy instance | 8 |
| Insurance contract or identification number | 105122 | | Number of Individuals Covered | 4454 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $151,754 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $25,721,002 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $75,877 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 4000007,407,907 |
| Policy instance | 9 |
| Insurance contract or identification number | 4000007,407,907 | | Number of Individuals Covered | 963 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $221,112 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | MEDICARE SUPPLEMENT PLAN | | Welfare Benefit Premiums Paid to Carrier | USD $2,962,115 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $110,556 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 |
|
| PACIFIC SOURCE COMMUNITY HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 12595 ) |
| Policy contract number | GA000003 |
| Policy instance | 10 |
| Insurance contract or identification number | GA000003 | | Number of Individuals Covered | 28 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $32,928 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 57069 ) |
| Policy contract number | Z1334-Z1335 |
| Policy instance | 11 |
| Insurance contract or identification number | Z1334-Z1335 | | Number of Individuals Covered | 4488 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,976,997 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ASURIS NORTHWEST HEALTH (National Association of Insurance Commissioners NAIC id number: 47350 ) |
| Policy contract number | 40000507 |
| Policy instance | 12 |
| Insurance contract or identification number | 40000507 | | Number of Individuals Covered | 214 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $496 | | Welfare Benefit Premiums Paid to Carrier | USD $233,568 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $248 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 100576 |
| Policy instance | 7 |
| Insurance contract or identification number | 100576 | | Number of Individuals Covered | 356 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,418,923 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 95893 ) |
| Policy contract number | 005477 |
| Policy instance | 5 |
| Insurance contract or identification number | 005477 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $51,225 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 16-007337 |
| Policy instance | 4 |
| Insurance contract or identification number | 16-007337 | | Number of Individuals Covered | 5313 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $2,769,198 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 03325888 |
| Policy instance | 3 |
| Insurance contract or identification number | 03325888 | | Number of Individuals Covered | 6694 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $657,599 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 615939 |
| Policy instance | 2 |
| Insurance contract or identification number | 615939 | | Number of Individuals Covered | 6915 | | Insurance policy start date | 2020-11-01 | | Insurance policy end date | 2021-10-31 | | Total amount of commissions paid to insurance broker | USD $2,956 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | OTHER (SPECIFY) | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,478 |
|
| UNITEDHEALTHCARE OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 48038 ) |
| Policy contract number | 006084 |
| Policy instance | 6 |
| Insurance contract or identification number | 006084 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $29,365 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 105122 |
| Policy instance | 8 |
| Insurance contract or identification number | 105122 | | Number of Individuals Covered | 4170 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $141,516 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,860,406 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $70,758 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 |
|
| KAISER PERMANENTE NW REGION (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 2454 |
| Policy instance | 1 |
| Insurance contract or identification number | 2454 | | Number of Individuals Covered | 2736 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $145,082 | | Welfare Benefit Premiums Paid to Carrier | USD $15,150,702 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $72,541 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 |
|
| ASURIS NORTHWEST HEALTH (National Association of Insurance Commissioners NAIC id number: 47350 ) |
| Policy contract number | 40000507 |
| Policy instance | 12 |
| Insurance contract or identification number | 40000507 | | Number of Individuals Covered | 211 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $236,827 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 |
|
| WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 57069 ) |
| Policy contract number | Z1334-Z1335 |
| Policy instance | 11 |
| Insurance contract or identification number | Z1334-Z1335 | | Number of Individuals Covered | 4091 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,800,303 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PACIFIC SOURCE COMMUNITY HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 12595 ) |
| Policy contract number | GA000003 |
| Policy instance | 10 |
| Insurance contract or identification number | GA000003 | | Number of Individuals Covered | 29 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $33,264 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 4000007,407,907 |
| Policy instance | 9 |
| Insurance contract or identification number | 4000007,407,907 | | Number of Individuals Covered | 968 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $221,340 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | MEDICARE SUPPLEMENT PLAN | | Welfare Benefit Premiums Paid to Carrier | USD $2,917,665 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $110,670 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 615939 |
| Policy instance | 2 |
| Insurance contract or identification number | 615939 | | Number of Individuals Covered | 6696 | | Insurance policy start date | 2019-11-01 | | Insurance policy end date | 2020-10-31 | | Total amount of commissions paid to insurance broker | USD $2,944 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | OTHER (SPECIFY) | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,472 |
|
| PACIFIC SOURCE COMMUNITY HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 12595 ) |
| Policy contract number | GA000003 |
| Policy instance | 10 |
| Insurance contract or identification number | GA000003 | | Number of Individuals Covered | 24 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $28,611 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 4000007,407,907 |
| Policy instance | 9 |
| Insurance contract or identification number | 4000007,407,907 | | Number of Individuals Covered | 937 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $209,902 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | MEDICARE SUPPLEMENT PLAN | | Welfare Benefit Premiums Paid to Carrier | USD $2,869,183 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $104,951 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 105122 |
| Policy instance | 8 |
| Insurance contract or identification number | 105122 | | Number of Individuals Covered | 4644 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $126,495 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,397,060 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $63,469 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 100576 |
| Policy instance | 7 |
| Insurance contract or identification number | 100576 | | Number of Individuals Covered | 322 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,308,685 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 48038 ) |
| Policy contract number | 006084 |
| Policy instance | 6 |
| Insurance contract or identification number | 006084 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $35,583 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 95893 ) |
| Policy contract number | 005477 |
| Policy instance | 5 |
| Insurance contract or identification number | 005477 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $65,603 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 16-007337 |
| Policy instance | 4 |
| Insurance contract or identification number | 16-007337 | | Number of Individuals Covered | 4933 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $2,831,160 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 03325888 |
| Policy instance | 3 |
| Insurance contract or identification number | 03325888 | | Number of Individuals Covered | 6348 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $586,637 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER PERMANENTE NW REGION (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 2454 |
| Policy instance | 1 |
| Insurance contract or identification number | 2454 | | Number of Individuals Covered | 2790 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $138,712 | | Welfare Benefit Premiums Paid to Carrier | USD $14,778,100 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $69,356 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 |
|
| WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 57069 ) |
| Policy contract number | Z1334-Z1335 |
| Policy instance | 11 |
| Insurance contract or identification number | Z1334-Z1335 | | Number of Individuals Covered | 3817 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,804,268 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ASURIS NORTHWEST HEALTH (National Association of Insurance Commissioners NAIC id number: 47350 ) |
| Policy contract number | 40000507 |
| Policy instance | 12 |
| Insurance contract or identification number | 40000507 | | Number of Individuals Covered | 215 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $5,814 | | Welfare Benefit Premiums Paid to Carrier | USD $235,820 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,907 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 03325888 |
| Policy instance | 3 |
| Insurance contract or identification number | 03325888 | | Number of Individuals Covered | 6348 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $621,263 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 95893 ) |
| Policy contract number | 005477 |
| Policy instance | 5 |
| Insurance contract or identification number | 005477 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $79,563 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PACIFIC SOURCE COMMUNITY HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 12595 ) |
| Policy contract number | GA000003 |
| Policy instance | 10 |
| Insurance contract or identification number | GA000003 | | Number of Individuals Covered | 24 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $32,480 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER PERMANENTE NW REGION (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 2454 |
| Policy instance | 1 |
| Insurance contract or identification number | 2454 | | Number of Individuals Covered | 2681 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $107,190 | | Welfare Benefit Premiums Paid to Carrier | USD $13,654,893 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $64,407 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 615939 |
| Policy instance | 2 |
| Insurance contract or identification number | 615939 | | Number of Individuals Covered | 6696 | | Insurance policy start date | 2008-11-01 | | Insurance policy end date | 2019-10-31 | | Total amount of commissions paid to insurance broker | USD $2,694 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | OTHER (SPECIFY) | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,347 |
|
| ASURIS NORTHWEST HEALTH (National Association of Insurance Commissioners NAIC id number: 47350 ) |
| Policy contract number | 40000507 |
| Policy instance | 12 |
| Insurance contract or identification number | 40000507 | | Number of Individuals Covered | 228 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $6,092 | | Welfare Benefit Premiums Paid to Carrier | USD $233,276 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,046 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 |
|
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 16-007337 |
| Policy instance | 4 |
| Insurance contract or identification number | 16-007337 | | Number of Individuals Covered | 4849 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $2,337,060 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 4000007,407,907 |
| Policy instance | 9 |
| Insurance contract or identification number | 4000007,407,907 | | Number of Individuals Covered | 950 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $195,584 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | MEDICARE SUPPLEMENT PLAN | | Welfare Benefit Premiums Paid to Carrier | USD $2,891,690 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $97,792 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 105122 |
| Policy instance | 8 |
| Insurance contract or identification number | 105122 | | Number of Individuals Covered | 4250 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $125,250 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,270,665 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $62,625 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 100576 |
| Policy instance | 7 |
| Insurance contract or identification number | 100576 | | Number of Individuals Covered | 303 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,118,463 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 48038 ) |
| Policy contract number | 006084 |
| Policy instance | 6 |
| Insurance contract or identification number | 006084 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $51,969 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 57069 ) |
| Policy contract number | Z1334-Z1335 |
| Policy instance | 11 |
| Insurance contract or identification number | Z1334-Z1335 | | Number of Individuals Covered | 3530 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,633,220 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER PERMANENTE NW REGION (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 2454 |
| Policy instance | 1 |
| Insurance contract or identification number | 2454 | | Number of Individuals Covered | 2508 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $110,692 | | Welfare Benefit Premiums Paid to Carrier | USD $11,916,056 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $55,346 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 |
|
| ASURIS NORTHWEST HEALTH (National Association of Insurance Commissioners NAIC id number: 47350 ) |
| Policy contract number | 40000507 |
| Policy instance | 12 |
| Insurance contract or identification number | 40000507 | | Number of Individuals Covered | 224 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $5,528 | | Welfare Benefit Premiums Paid to Carrier | USD $255,328 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,764 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 |
|
| WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 57069 ) |
| Policy contract number | Z1334-Z1335 |
| Policy instance | 11 |
| Insurance contract or identification number | Z1334-Z1335 | | Number of Individuals Covered | 3063 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,389,276 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PACIFIC SOURCE COMMUNITY HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 12595 ) |
| Policy contract number | GA000003 |
| Policy instance | 10 |
| Insurance contract or identification number | GA000003 | | Number of Individuals Covered | 24 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $38,860 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 4000007,407,907 |
| Policy instance | 9 |
| Insurance contract or identification number | 4000007,407,907 | | Number of Individuals Covered | 961 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $165,634 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | MEDICARE SUPPLEMENT PLAN | | Welfare Benefit Premiums Paid to Carrier | USD $2,838,363 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $82,817 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 03325888 |
| Policy instance | 3 |
| Insurance contract or identification number | 03325888 | | Number of Individuals Covered | 5766 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $753,212 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 100576 |
| Policy instance | 7 |
| Insurance contract or identification number | 100576 | | Number of Individuals Covered | 310 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,273,844 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 615939 |
| Policy instance | 2 |
| Insurance contract or identification number | 615939 | | Number of Individuals Covered | 6303 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $2,702 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D INSURANCE | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,351 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 48038 ) |
| Policy contract number | 006084 |
| Policy instance | 6 |
| Insurance contract or identification number | 006084 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $46,187 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 95893 ) |
| Policy contract number | 005477 |
| Policy instance | 5 |
| Insurance contract or identification number | 005477 | | Number of Individuals Covered | 15 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $96,668 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 105122 |
| Policy instance | 8 |
| Insurance contract or identification number | 105122 | | Number of Individuals Covered | 4238 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $115,534 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,797,944 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $57,767 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 |
|
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 16-007337 |
| Policy instance | 4 |
| Insurance contract or identification number | 16-007337 | | Number of Individuals Covered | 4456 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $2,093,718 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| KAISER PERMANENTE NW REGION (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 2454 |
| Policy instance | 1 |
| Insurance contract or identification number | 2454 | | Number of Individuals Covered | 2362 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $99,742 | | Welfare Benefit Premiums Paid to Carrier | USD $10,677,650 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $49,871 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 | | Insurance broker name | J.B. NIBLEY INS. |
|
| ASURIS NORTHWEST HEALTH (National Association of Insurance Commissioners NAIC id number: 47350 ) |
| Policy contract number | 40000507 |
| Policy instance | 12 |
| Insurance contract or identification number | 40000507 | | Number of Individuals Covered | 220 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $6,446 | | Welfare Benefit Premiums Paid to Carrier | USD $248,969 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,223 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 | | Insurance broker name | J.H. HERRLE & ASSOCIATES |
|
| WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 57069 ) |
| Policy contract number | Z1334-Z1335 |
| Policy instance | 11 |
| Insurance contract or identification number | Z1334-Z1335 | | Number of Individuals Covered | 2635 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,127,078 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 4000007,407,907 |
| Policy instance | 9 |
| Insurance contract or identification number | 4000007,407,907 | | Number of Individuals Covered | 961 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $173,506 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | MEDICARE SUPPLEMENT PLAN | | Welfare Benefit Premiums Paid to Carrier | USD $2,865,897 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $86,753 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 | | Insurance broker name | J.H. HERRLE & ASS. |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 100576 |
| Policy instance | 7 |
| Insurance contract or identification number | 100576 | | Number of Individuals Covered | 311 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,403,455 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | J.B. NIBLEY INSURANCE |
|
| UNITEDHEALTHCARE OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 48038 ) |
| Policy contract number | 006084 |
| Policy instance | 6 |
| Insurance contract or identification number | 006084 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $49,920 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 95893 ) |
| Policy contract number | 005477 |
| Policy instance | 5 |
| Insurance contract or identification number | 005477 | | Number of Individuals Covered | 17 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $111,171 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 16-007337 |
| Policy instance | 4 |
| Insurance contract or identification number | 16-007337 | | Number of Individuals Covered | 4072 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $1,474,390 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | NIBLEY & HERRLE ASS. |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 03325888 |
| Policy instance | 3 |
| Insurance contract or identification number | 03325888 | | Number of Individuals Covered | 5247 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $595,586 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 615939 |
| Policy instance | 2 |
| Insurance contract or identification number | 615939 | | Number of Individuals Covered | 5645 | | Insurance policy start date | 2016-11-01 | | Insurance policy end date | 2017-10-31 | | Total amount of commissions paid to insurance broker | USD $2,760 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D INSURANCE | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,380 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 | | Insurance broker name | J.H. HERRLE & ASSOCIATES |
|
| PACIFIC SOURCE COMMUNITY HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 12595 ) |
| Policy contract number | GA000003 |
| Policy instance | 10 |
| Insurance contract or identification number | GA000003 | | Number of Individuals Covered | 26 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $38,494 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 105122 |
| Policy instance | 8 |
| Insurance contract or identification number | 105122 | | Number of Individuals Covered | 4731 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $99,075 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,936,984 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $49,538 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 | | Insurance broker name | J.B. NIBLEY INSURANCE |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 105122 |
| Policy instance | 8 |
| Insurance contract or identification number | 105122 | | Number of Individuals Covered | 3780 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $84,968 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,935,677 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $42,484 | | Additional information about fees paid to insurance broker | 3 | | Insurance broker name | J.B. NIBLEY INSURANCE |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 100576 |
| Policy instance | 7 |
| Insurance contract or identification number | 100576 | | Number of Individuals Covered | 285 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $879,027 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | 3 | | Insurance broker name | J.B. NIBLEY INSURANCE |
|
| UNITEDHEALTHCARE OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 48038 ) |
| Policy contract number | 006084 |
| Policy instance | 6 |
| Insurance contract or identification number | 006084 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $72,185 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 95893 ) |
| Policy contract number | 005477 |
| Policy instance | 5 |
| Insurance contract or identification number | 005477 | | Number of Individuals Covered | 27 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $142,934 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 16-007337 |
| Policy instance | 4 |
| Insurance contract or identification number | 16-007337 | | Number of Individuals Covered | 237 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $383,563 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | 3 | | Insurance broker name | NIBLEY & HERRLE ASS. |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 03325888 |
| Policy instance | 3 |
| Insurance contract or identification number | 03325888 | | Number of Individuals Covered | 4534 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $581,047 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 615939 |
| Policy instance | 2 |
| Insurance contract or identification number | 615939 | | Number of Individuals Covered | 4889 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | Total amount of commissions paid to insurance broker | USD $2,410 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D INSURANCE | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,205 | | Additional information about fees paid to insurance broker | 3 | | Insurance broker name | J.H. HERRLE & ASSOCIATES |
|
| KAISER PERMANENTE NW REGION (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 2454 |
| Policy instance | 1 |
| Insurance contract or identification number | 2454 | | Number of Individuals Covered | 2345 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $96,818 | | Welfare Benefit Premiums Paid to Carrier | USD $10,270,305 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $48,409 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT 3 | | Insurance broker name | J.B. NIBLEY INS. |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 4000007,407,907 |
| Policy instance | 9 |
| Insurance contract or identification number | 4000007,407,907 | | Number of Individuals Covered | 982 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $183,576 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | MEDICARE SUPPLEMENT PLAN | | Welfare Benefit Premiums Paid to Carrier | USD $2,317,758 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $91,788 | | Insurance broker organization code? | 3 | | Insurance broker name | J.H. HERRLE & ASS. |
|
| ASURIS NORTHWEST HEALTH (National Association of Insurance Commissioners NAIC id number: 47350 ) |
| Policy contract number | 40000507 |
| Policy instance | 12 |
| Insurance contract or identification number | 40000507 | | Number of Individuals Covered | 213 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $10,436 | | Welfare Benefit Premiums Paid to Carrier | USD $207,720 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,218 | | Insurance broker organization code? | 3 | | Insurance broker name | J.H. HERRLE & ASSOCIATES |
|
| WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 57069 ) |
| Policy contract number | Z1334-Z1335 |
| Policy instance | 11 |
| Insurance contract or identification number | Z1334-Z1335 | | Number of Individuals Covered | 2218 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $869,666 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PACIFIC SOURCE COMMUNITY HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 12595 ) |
| Policy contract number | GA000003 |
| Policy instance | 10 |
| Insurance contract or identification number | GA000003 | | Number of Individuals Covered | 23 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $27,767 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 4000007,407,907 |
| Policy instance | 9 |
| Insurance contract or identification number | 4000007,407,907 | | Number of Individuals Covered | 913 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $142,412 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | MEDICARE SUPPLEMENT PLAN | | Welfare Benefit Premiums Paid to Carrier | USD $2,009,168 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $71,206 | | Insurance broker organization code? | 3 | | Insurance broker name | J.H. HERRLE & ASS. |
|
| PROVIDENCE MEDICARE SUPPLEMENT (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 105663 |
| Policy instance | 12 |
| Insurance contract or identification number | 105663 | | Number of Individuals Covered | 45 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Other welfare benefits provided | MEDICARE SUPPLEMENT | | Welfare Benefit Premiums Paid to Carrier | USD $347,582 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | 3 | | Insurance broker name | J.B. NIBLEY INSURANCE |
|
| ASURIS NORTHWEST HEALTH (National Association of Insurance Commissioners NAIC id number: 47350 ) |
| Policy contract number | 40000507 |
| Policy instance | 13 |
| Insurance contract or identification number | 40000507 | | Number of Individuals Covered | 188 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $4,600 | | Welfare Benefit Premiums Paid to Carrier | USD $142,097 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,300 | | Insurance broker organization code? | 3 | | Insurance broker name | J.H. HERRLE & ASSOCIATES |
|
| WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 57069 ) |
| Policy contract number | Z1334-Z1335 |
| Policy instance | 11 |
| Insurance contract or identification number | Z1334-Z1335 | | Number of Individuals Covered | 2124 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $848,861 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER PERMANENTE NW REGION (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 2454 |
| Policy instance | 1 |
| Insurance contract or identification number | 2454 | | Number of Individuals Covered | 2438 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $93,430 | | Welfare Benefit Premiums Paid to Carrier | USD $10,050,850 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $46,715 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT 3 | | Insurance broker name | J.B. NIBLEY INS. |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 615939 |
| Policy instance | 2 |
| Insurance contract or identification number | 615939 | | Number of Individuals Covered | 5495 | | Insurance policy start date | 2013-11-01 | | Insurance policy end date | 2014-10-31 | | Total amount of commissions paid to insurance broker | USD $2,486 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D INSURANCE | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,243 | | Additional information about fees paid to insurance broker | 3 | | Insurance broker name | J.H. HERRLE & ASSOCIATES |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 03325888 |
| Policy instance | 3 |
| Insurance contract or identification number | 03325888 | | Number of Individuals Covered | 4938 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $599,194 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 16-007337 |
| Policy instance | 4 |
| Insurance contract or identification number | 16-007337 | | Number of Individuals Covered | 255 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $383,701 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | 3 | | Insurance broker name | NIBLEY & HERRLE ASS. |
|
| UNITEDHEALTHCARE OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 95893 ) |
| Policy contract number | 005477 |
| Policy instance | 5 |
| Insurance contract or identification number | 005477 | | Number of Individuals Covered | 28 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $149,386 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 48038 ) |
| Policy contract number | 006084 |
| Policy instance | 6 |
| Insurance contract or identification number | 006084 | | Number of Individuals Covered | 14 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $67,429 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 100576 |
| Policy instance | 7 |
| Insurance contract or identification number | 100576 | | Number of Individuals Covered | 200 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $804,544 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | 3 | | Insurance broker name | J.B. NIBLEY INSURANCE |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 105122 |
| Policy instance | 8 |
| Insurance contract or identification number | 105122 | | Number of Individuals Covered | 3531 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $86,802 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,513,827 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $43,401 | | Additional information about fees paid to insurance broker | 3 | | Insurance broker name | J.B. NIBLEY INSURANCE |
|
| PACIFIC SOURCE COMMUNITY HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 12595 ) |
| Policy contract number | GA000003 |
| Policy instance | 10 |
| Insurance contract or identification number | GA000003 | | Number of Individuals Covered | 24 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $38,367 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROVIDENCE MEDICARE SUPPLEMENT (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 105663 |
| Policy instance | 12 |
| Insurance contract or identification number | 105663 | | Number of Individuals Covered | 46 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Other welfare benefits provided | MEDICARE SUPPLEMENT | | Welfare Benefit Premiums Paid to Carrier | USD $282,479 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | 3 | | Insurance broker name | J.B. NIBLEY INSURANCE |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 615939 |
| Policy instance | 2 |
| Insurance contract or identification number | 615939 | | Number of Individuals Covered | 5043 | | Insurance policy start date | 2012-11-01 | | Insurance policy end date | 2013-10-31 | | Total amount of commissions paid to insurance broker | USD $2,350 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D INSURANCE | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,175 | | Additional information about fees paid to insurance broker | 3 | | Insurance broker name | J.H. HERRLE & ASSOCIATES |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 03325888 |
| Policy instance | 3 |
| Insurance contract or identification number | 03325888 | | Number of Individuals Covered | 4356 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $567,346 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 16-007337 |
| Policy instance | 4 |
| Insurance contract or identification number | 16-007337 | | Number of Individuals Covered | 262 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $378,074 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | 3 | | Insurance broker name | NIBLEY & HERRLE ASS. |
|
| UNITEDHEALTHCARE OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 95893 ) |
| Policy contract number | 005477 |
| Policy instance | 5 |
| Insurance contract or identification number | 005477 | | Number of Individuals Covered | 30 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $149,010 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ASURIS NORTHWEST HEALTH (National Association of Insurance Commissioners NAIC id number: 47350 ) |
| Policy contract number | 40000507 |
| Policy instance | 13 |
| Insurance contract or identification number | 40000507 | | Number of Individuals Covered | 180 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $5,010 | | Welfare Benefit Premiums Paid to Carrier | USD $122,349 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,505 | | Insurance broker organization code? | 3 | | Insurance broker name | J.H. HERRLE & ASSOCIATES |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 100576 |
| Policy instance | 7 |
| Insurance contract or identification number | 100576 | | Number of Individuals Covered | 232 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $825,711 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | 3 | | Insurance broker name | J.B. NIBLEY INSURANCE |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 105122 |
| Policy instance | 8 |
| Insurance contract or identification number | 105122 | | Number of Individuals Covered | 3374 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $78,984 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,925,251 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $39,492 | | Additional information about fees paid to insurance broker | 3 | | Insurance broker name | J.B. NIBLEY INSURANCE |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 4000007,407,907 |
| Policy instance | 9 |
| Insurance contract or identification number | 4000007,407,907 | | Number of Individuals Covered | 860 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $86,161 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | MEDICARE SUPPLEMENT PLAN | | Welfare Benefit Premiums Paid to Carrier | USD $1,653,534 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $57,378 | | Insurance broker organization code? | 3 | | Insurance broker name | J.H. HERRLE & ASS. |
|
| PACIFIC SOURCE COMMUNITY HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 12595 ) |
| Policy contract number | GA000003 |
| Policy instance | 10 |
| Insurance contract or identification number | GA000003 | | Number of Individuals Covered | 25 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $29,079 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 48038 ) |
| Policy contract number | 006084 |
| Policy instance | 6 |
| Insurance contract or identification number | 006084 | | Number of Individuals Covered | 15 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $76,429 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 57069 ) |
| Policy contract number | Z1334-Z1335 |
| Policy instance | 11 |
| Insurance contract or identification number | Z1334-Z1335 | | Number of Individuals Covered | 1710 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $676,330 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER PERMANENTE NW REGION (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 2454 |
| Policy instance | 1 |
| Insurance contract or identification number | 2454 | | Number of Individuals Covered | 2337 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $83,520 | | Welfare Benefit Premiums Paid to Carrier | USD $8,900,309 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $41,760 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT 3 | | Insurance broker name | J.B. NIBLEY INS. |
|
| KAISER PERMANENTE NW REGION (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 2454 |
| Policy instance | 1 |
| Insurance contract or identification number | 2454 | | Number of Individuals Covered | 2242 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $81,534 | | Welfare Benefit Premiums Paid to Carrier | USD $8,759,935 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $40,767 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT 3 | | Insurance broker name | J.B. NIBLEY INS. |
|
| ASURIS NORTHWEST HEALTH (National Association of Insurance Commissioners NAIC id number: 47350 ) |
| Policy contract number | 40000507 |
| Policy instance | 13 |
| Insurance contract or identification number | 40000507 | | Number of Individuals Covered | 183 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $4,956 | | Welfare Benefit Premiums Paid to Carrier | USD $156,754 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,478 | | Insurance broker organization code? | 3 | | Insurance broker name | J.H. HERRLE & ASSOCIATES |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 03325888 |
| Policy instance | 3 |
| Insurance contract or identification number | 03325888 | | Number of Individuals Covered | 4292 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $506,969 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 16-007337 |
| Policy instance | 4 |
| Insurance contract or identification number | 16-007337 | | Number of Individuals Covered | 264 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $384,990 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | 3 | | Insurance broker name | NIBLEY & HERRLE ASS. |
|
| UNITEDHEALTHCARE OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 95893 ) |
| Policy contract number | 005477 |
| Policy instance | 5 |
| Insurance contract or identification number | 005477 | | Number of Individuals Covered | 33 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $163,887 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 48038 ) |
| Policy contract number | 006084 |
| Policy instance | 6 |
| Insurance contract or identification number | 006084 | | Number of Individuals Covered | 19 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $97,257 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 105122 |
| Policy instance | 8 |
| Insurance contract or identification number | 105122 | | Number of Individuals Covered | 3376 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $73,776 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,985,177 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $36,888 | | Additional information about fees paid to insurance broker | 3 | | Insurance broker name | J.B. NIBLEY INSURANCE |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 100576 |
| Policy instance | 7 |
| Insurance contract or identification number | 100576 | | Number of Individuals Covered | 231 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $733,469 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | 3 | | Insurance broker name | J.B. NIBLEY INSURANCE |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 4000007,407,907 |
| Policy instance | 9 |
| Insurance contract or identification number | 4000007,407,907 | | Number of Individuals Covered | 785 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $201,412 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | MEDICARE SUPPLEMENT PLAN | | Welfare Benefit Premiums Paid to Carrier | USD $1,402,015 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $100,706 | | Insurance broker organization code? | 3 | | Insurance broker name | J.H. HERRLE & ASS. |
|
| PACIFIC SOURCE COMMUNITY HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 12595 ) |
| Policy contract number | GA000003 |
| Policy instance | 10 |
| Insurance contract or identification number | GA000003 | | Number of Individuals Covered | 24 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $28,048 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 57069 ) |
| Policy contract number | Z1334-Z1335 |
| Policy instance | 11 |
| Insurance contract or identification number | Z1334-Z1335 | | Number of Individuals Covered | 1507 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROVIDENCE MEDICARE SUPPLEMENT (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 105663 |
| Policy instance | 12 |
| Insurance contract or identification number | 105663 | | Number of Individuals Covered | 46 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Other welfare benefits provided | MEDICARE SUPPLEMENT | | Welfare Benefit Premiums Paid to Carrier | USD $355,725 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | 3 | | Insurance broker name | J.B. NIBLEY INSURANCE |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 615939 |
| Policy instance | 2 |
| Insurance contract or identification number | 615939 | | Number of Individuals Covered | 4942 | | Insurance policy start date | 2011-11-01 | | Insurance policy end date | 2012-10-31 | | Total amount of commissions paid to insurance broker | USD $2,338 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D INSURANCE | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,169 | | Additional information about fees paid to insurance broker | 3 | | Insurance broker name | J.H. HERRLE & ASSOCIATES |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 100576 |
| Policy instance | 7 |
| Insurance contract or identification number | 100576 | | Number of Individuals Covered | 202 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $655,026 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 57069 ) |
| Policy contract number | Z1334-Z1335 |
| Policy instance | 11 |
| Insurance contract or identification number | Z1334-Z1335 | | Number of Individuals Covered | 1223 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 615939 |
| Policy instance | 2 |
| Insurance contract or identification number | 615939 | | Number of Individuals Covered | 4350 | | Insurance policy start date | 2010-11-01 | | Insurance policy end date | 2011-10-31 | | Total amount of commissions paid to insurance broker | USD $2,172 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD INSURANCE | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 03325888 |
| Policy instance | 3 |
| Insurance contract or identification number | 03325888 | | Number of Individuals Covered | 3948 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $521,031 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 16-007337 |
| Policy instance | 4 |
| Insurance contract or identification number | 16-007337 | | Number of Individuals Covered | 312 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $481,877 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 95893 ) |
| Policy contract number | 005477 |
| Policy instance | 5 |
| Insurance contract or identification number | 005477 | | Number of Individuals Covered | 37 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $161,523 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 48038 ) |
| Policy contract number | 006084 |
| Policy instance | 6 |
| Insurance contract or identification number | 006084 | | Number of Individuals Covered | 23 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $108,654 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 105122 |
| Policy instance | 8 |
| Insurance contract or identification number | 105122 | | Number of Individuals Covered | 2853 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,576,377 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 4000007407907 |
| Policy instance | 9 |
| Insurance contract or identification number | 4000007407907 | | Number of Individuals Covered | 733 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $120,354 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | MEDICARE SUPPLEMENT PLAN | | Welfare Benefit Premiums Paid to Carrier | USD $1,270,346 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PACIFIC SOURCE COMMUNITY HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 12595 ) |
| Policy contract number | GA000003 |
| Policy instance | 10 |
| Insurance contract or identification number | GA000003 | | Number of Individuals Covered | 22 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $32,766 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROVIDENCE MEDICARE SUPPLEMENT (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 105663 |
| Policy instance | 12 |
| Insurance contract or identification number | 105663 | | Number of Individuals Covered | 63 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Other welfare benefits provided | MEDICARE SUPPLEMENT | | Welfare Benefit Premiums Paid to Carrier | USD $309,736 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER PERMANENTE NW REGION (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 2454 |
| Policy instance | 1 |
| Insurance contract or identification number | 2454 | | Number of Individuals Covered | 2033 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $66,252 | | Welfare Benefit Premiums Paid to Carrier | USD $7,215,682 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WILLAMETTE DENTAL INSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 57069 ) |
| Policy contract number | Z1334-Z1335 |
| Policy instance | 11 |
| Insurance contract or identification number | Z1334-Z1335 | | Number of Individuals Covered | 528 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER PERMANENTE NW REGION (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 2454 |
| Policy instance | 1 |
| Insurance contract or identification number | 2454 | | Number of Individuals Covered | 1866 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $59,216 | | Total amount of fees paid to insurance company | USD $11,229 | | Welfare Benefit Premiums Paid to Carrier | USD $6,432,772 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $29,608 | | Amount paid for insurance broker fees | 5946 | | Additional information about fees paid to insurance broker | SERVICE OF CONTRACT | | Insurance broker organization code? | 3 | | Insurance broker name | J.B. NIBLEY INS. |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 615939 |
| Policy instance | 2 |
| Insurance contract or identification number | 615939 | | Number of Individuals Covered | 4322 | | Insurance policy start date | 2009-11-01 | | Insurance policy end date | 2010-10-31 | | Total amount of commissions paid to insurance broker | USD $2,136 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD INSURANCE | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,068 | | Insurance broker organization code? | 3 | | Insurance broker name | J.H. HERRLE & ASSOCIATES |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 03325888 |
| Policy instance | 3 |
| Insurance contract or identification number | 03325888 | | Number of Individuals Covered | 3863 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $488,454 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 48038 ) |
| Policy contract number | 006084 |
| Policy instance | 6 |
| Insurance contract or identification number | 006084 | | Number of Individuals Covered | 27 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $110,497 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | J.H. HERRLE & ASSOCIATES |
|
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
| Policy contract number | 16-007337 |
| Policy instance | 4 |
| Insurance contract or identification number | 16-007337 | | Number of Individuals Covered | 312 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $481,877 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | NIBLEY & HERRLE ASS. |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 100576 |
| Policy instance | 7 |
| Insurance contract or identification number | 100576 | | Number of Individuals Covered | 202 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $484,291 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | J.B. NIBLEY INSURANCE |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 105122 |
| Policy instance | 8 |
| Insurance contract or identification number | 105122 | | Number of Individuals Covered | 2853 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $58,260 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,761,587 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $29,130 | | Insurance broker organization code? | 3 | | Insurance broker name | J.B. NIBLEY INSURANCE |
|
| REGENCE BLUECROSS BLUESHIELD OF OREGON (National Association of Insurance Commissioners NAIC id number: 54933 ) |
| Policy contract number | 837111112113 |
| Policy instance | 9 |
| Insurance contract or identification number | 837111112113 | | Number of Individuals Covered | 674 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $98,312 | | Health Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Other welfare benefits provided | MEDICARE SUPPLEMENT PLAN | | Welfare Benefit Premiums Paid to Carrier | USD $1,791,408 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $49,156 | | Insurance broker organization code? | 3 | | Insurance broker name | J.H. HERRLE & ASS. |
|
| PACIFIC SOURCE COMMUNITY HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 12595 ) |
| Policy contract number | 100886898692 |
| Policy instance | 10 |
| Insurance contract or identification number | 100886898692 | | Number of Individuals Covered | 22 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $44,100 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 95893 ) |
| Policy contract number | 006697 |
| Policy instance | 5 |
| Insurance contract or identification number | 006697 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $166,062 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | J.H. HERRLE & ASSOCIATES |
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| PROVIDENCE MEDICARE SUPPLEMENT (National Association of Insurance Commissioners NAIC id number: 95005 ) |
| Policy contract number | 105663 |
| Policy instance | 12 |
| Insurance contract or identification number | 105663 | | Number of Individuals Covered | 63 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Other welfare benefits provided | MEDICARE SUPPLEMENT | | Welfare Benefit Premiums Paid to Carrier | USD $403,271 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | J.B. NIBLEY INSURANCE |
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