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EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 401k Plan overview

Plan NameEMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO
Plan identification number 515

EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental

401k Sponsoring company profile

UNIVERSITY OF SAN FRANCISCO has sponsored the creation of one or more 401k plans.

Company Name:UNIVERSITY OF SAN FRANCISCO
Employer identification number (EIN):941156628
NAIC Classification:611000

Additional information about UNIVERSITY OF SAN FRANCISCO

Jurisdiction of Incorporation: California Department of State
Incorporation Date:
Company Identification Number: C0141614

More information about UNIVERSITY OF SAN FRANCISCO

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5152022-01-01
5152021-01-01
5152020-01-01
5152019-01-01
5152018-01-01
5152017-01-01MARTHA PEUGH-WADE
5152016-01-01MARTHA PEUGH-WADE
5152015-01-01MARTHA PEUGH-WADE
5152014-01-01MARTHA PEUGH-WADE
5152013-01-01MARTHA PEUGH-WADE
5152012-01-01MARTHA PEUGH-WADE
5152011-01-01MARTHA PEUGH-WADE
5152009-01-01MARTHA PEUGH-WADE

Plan Statistics for EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO

401k plan membership statisitcs for EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO

Measure Date Value
2022: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2022 401k membership
Total participants, beginning-of-year2022-01-011,169
Total number of active participants reported on line 7a of the Form 55002022-01-01928
Number of retired or separated participants receiving benefits2022-01-01281
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-011,209
2021: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2021 401k membership
Total participants, beginning-of-year2021-01-011,152
Total number of active participants reported on line 7a of the Form 55002021-01-01910
Number of retired or separated participants receiving benefits2021-01-01259
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-011,169
2020: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2020 401k membership
Total participants, beginning-of-year2020-01-011,163
Total number of active participants reported on line 7a of the Form 55002020-01-01912
Number of retired or separated participants receiving benefits2020-01-01240
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-011,152
2019: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2019 401k membership
Total participants, beginning-of-year2019-01-011,189
Total number of active participants reported on line 7a of the Form 55002019-01-01934
Number of retired or separated participants receiving benefits2019-01-01229
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-011,163
2018: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2018 401k membership
Total participants, beginning-of-year2018-01-011,167
Total number of active participants reported on line 7a of the Form 55002018-01-01984
Number of retired or separated participants receiving benefits2018-01-01205
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-011,189
2017: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2017 401k membership
Total participants, beginning-of-year2017-01-011,179
Total number of active participants reported on line 7a of the Form 55002017-01-01995
Number of retired or separated participants receiving benefits2017-01-01172
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-011,167
2016: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2016 401k membership
Total participants, beginning-of-year2016-01-011,148
Total number of active participants reported on line 7a of the Form 55002016-01-011,004
Number of retired or separated participants receiving benefits2016-01-01175
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-011,179
2015: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2015 401k membership
Total participants, beginning-of-year2015-01-011,141
Total number of active participants reported on line 7a of the Form 55002015-01-01987
Number of retired or separated participants receiving benefits2015-01-01161
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-011,148
2014: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2014 401k membership
Total participants, beginning-of-year2014-01-011,125
Total number of active participants reported on line 7a of the Form 55002014-01-01980
Number of retired or separated participants receiving benefits2014-01-01161
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-011,141
2013: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2013 401k membership
Total participants, beginning-of-year2013-01-011,127
Total number of active participants reported on line 7a of the Form 55002013-01-01986
Number of retired or separated participants receiving benefits2013-01-01139
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-011,125
2012: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2012 401k membership
Total participants, beginning-of-year2012-01-011,084
Total number of active participants reported on line 7a of the Form 55002012-01-01995
Number of retired or separated participants receiving benefits2012-01-01132
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-011,127
2011: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2011 401k membership
Total participants, beginning-of-year2011-01-01801
Total number of active participants reported on line 7a of the Form 55002011-01-01680
Number of retired or separated participants receiving benefits2011-01-01196
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01876
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01876
Number of participants with account balances2011-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2009 401k membership
Total participants, beginning-of-year2009-01-01707
Total number of active participants reported on line 7a of the Form 55002009-01-01632
Number of retired or separated participants receiving benefits2009-01-01113
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01745
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01745
Number of participants with account balances2009-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO

Measure Date Value
2022 : EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-609,004
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$242,486
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$184,769
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$618,076
Value of total assets at end of year2022-12-31$7,801,482
Value of total assets at beginning of year2022-12-31$8,652,972
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$57,717
Total interest from all sources2022-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$406,215
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$406,215
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$223,944
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-851,490
Value of net assets at end of year (total assets less liabilities)2022-12-31$7,801,482
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$8,652,972
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$7,365,616
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$8,251,034
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$435,866
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$401,938
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$401,938
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-1,633,295
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$394,132
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$184,769
Contract administrator fees2022-12-31$57,717
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31MOSS ADAMS, LLP
Accountancy firm EIN2022-12-31910189318
2021 : EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$1,286,638
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$253,620
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$198,167
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$540,169
Value of total assets at end of year2021-12-31$8,652,972
Value of total assets at beginning of year2021-12-31$7,619,954
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$55,453
Total interest from all sources2021-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$607,405
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$607,405
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$168,656
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$1,033,018
Value of net assets at end of year (total assets less liabilities)2021-12-31$8,652,972
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$7,619,954
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$8,251,034
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$7,234,915
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$401,938
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$385,039
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$385,039
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$39,206
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$139,064
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$371,513
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$158,961
Contract administrator fees2021-12-31$55,453
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31MOSS ADAMS, LLP
Accountancy firm EIN2021-12-31910189318
2020 : EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$1,325,227
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$233,129
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$179,697
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$457,003
Value of total assets at end of year2020-12-31$7,619,954
Value of total assets at beginning of year2020-12-31$6,527,856
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$53,432
Total interest from all sources2020-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$361,411
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$361,411
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$5,000,000
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$126,854
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$1,092,098
Value of net assets at end of year (total assets less liabilities)2020-12-31$7,619,954
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$6,527,856
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$7,234,916
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$6,226,306
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$385,038
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$301,550
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$301,550
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$506,813
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$330,149
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$179,697
Contract administrator fees2020-12-31$53,432
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31MOSS ADAMS, LLP
Accountancy firm EIN2020-12-31910189318
2019 : EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$1,425,687
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$228,695
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$177,181
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$428,620
Value of total assets at end of year2019-12-31$6,527,856
Value of total assets at beginning of year2019-12-31$5,330,864
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$51,514
Total interest from all sources2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$223,393
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$223,393
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$5,000,000
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$100,786
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$1,196,992
Value of net assets at end of year (total assets less liabilities)2019-12-31$6,527,856
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$5,330,864
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$6,226,306
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$5,186,733
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$301,550
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$144,131
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$144,131
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$46,074
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$773,674
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$327,834
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$131,107
Contract administrator fees2019-12-31$51,514
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31MOSS ADAMS, LLP
Accountancy firm EIN2019-12-31910189318
2018 : EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$107,935
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$209,818
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$163,018
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$448,682
Value of total assets at end of year2018-12-31$5,330,864
Value of total assets at beginning of year2018-12-31$5,432,747
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$46,800
Total interest from all sources2018-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$311,637
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$311,637
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$68,933
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-101,883
Value of net assets at end of year (total assets less liabilities)2018-12-31$5,330,864
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$5,432,747
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$5,186,733
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$5,286,911
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$144,131
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$145,836
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$145,836
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$47,486
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-652,384
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$379,749
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$115,532
Contract administrator fees2018-12-31$46,800
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31MOSS ADAMS, LLP
Accountancy firm EIN2018-12-31910189318
2017 : EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$1,191,271
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$172,571
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$128,713
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$467,417
Value of total assets at end of year2017-12-31$5,432,747
Value of total assets at beginning of year2017-12-31$4,414,047
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$43,858
Total interest from all sources2017-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$223,813
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$223,813
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$3,000,000
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$69,816
Administrative expenses (other) incurred2017-12-31$43,858
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$1,018,700
Value of net assets at end of year (total assets less liabilities)2017-12-31$5,432,747
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$4,414,047
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$5,286,911
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$4,264,684
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$145,836
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$149,363
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$149,363
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$47,774
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$500,041
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$397,601
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$80,939
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31MOSS ADAMS, LLP
Accountancy firm EIN2017-12-31910189318
2016 : EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$736,401
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$168,667
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$119,012
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$476,088
Value of total assets at end of year2016-12-31$4,414,047
Value of total assets at beginning of year2016-12-31$3,846,313
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$49,655
Total interest from all sources2016-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$191,522
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$191,522
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$3,000,000
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$62,551
Administrative expenses (other) incurred2016-12-31$49,655
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$567,734
Value of net assets at end of year (total assets less liabilities)2016-12-31$4,414,047
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$3,846,313
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$4,264,684
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$3,695,877
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$149,363
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$150,436
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$150,436
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$33,984
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$68,791
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$413,537
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$85,028
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31MOSS ADAMS, LLP
Accountancy firm EIN2016-12-31910189318
2015 : EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$430,563
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$128,612
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$75,648
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$426,072
Value of total assets at end of year2015-12-31$3,846,313
Value of total assets at beginning of year2015-12-31$3,544,362
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$52,964
Total interest from all sources2015-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$216,681
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$216,681
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$5,000,000
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$46,417
Administrative expenses (other) incurred2015-12-31$52,964
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$301,951
Value of net assets at end of year (total assets less liabilities)2015-12-31$3,846,313
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$3,544,362
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$3,695,877
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$3,544,362
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$150,436
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$26,330
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-212,190
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$379,655
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$49,318
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31MOSS ADAMS, LLP
Accountancy firm EIN2015-12-31910189318
2014 : EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$561,865
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$159,666
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$109,952
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$416,331
Value of total assets at end of year2014-12-31$3,544,362
Value of total assets at beginning of year2014-12-31$3,142,163
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$49,714
Total interest from all sources2014-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$189,799
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$189,799
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$5,000,000
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$37,885
Administrative expenses (other) incurred2014-12-31$49,714
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$402,199
Value of net assets at end of year (total assets less liabilities)2014-12-31$3,544,362
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$3,142,163
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$3,544,362
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$3,142,163
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$24,522
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$-44,265
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$378,446
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$85,430
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31MOSS ADAMS, LLP
Accountancy firm EIN2014-12-31910189318
2013 : EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$793,812
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$92,425
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$45,661
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$377,104
Value of total assets at end of year2013-12-31$3,142,163
Value of total assets at beginning of year2013-12-31$2,440,776
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$46,764
Total interest from all sources2013-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$150,376
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$150,376
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$3,000,000
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$35,409
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$701,387
Value of net assets at end of year (total assets less liabilities)2013-12-31$3,142,163
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$2,440,776
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$3,142,163
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$2,440,776
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$10,697
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$266,332
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$341,695
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$34,964
Contract administrator fees2013-12-31$46,764
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31MOSS ADAMS, LLP
Accountancy firm EIN2013-12-31910189318
2012 : EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$635,676
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$105,305
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$56,904
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$362,745
Value of total assets at end of year2012-12-31$2,440,776
Value of total assets at beginning of year2012-12-31$1,910,405
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$48,401
Total interest from all sources2012-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$84,297
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$84,297
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$3,000,000
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$44,216
Administrative expenses (other) incurred2012-12-31$48,401
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$530,371
Value of net assets at end of year (total assets less liabilities)2012-12-31$2,440,776
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$1,910,405
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$2,440,776
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$1,874,060
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$36,345
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$36,345
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$11,037
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$188,634
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$318,529
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$45,867
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31MOSS ADAMS, LLP
Accountancy firm EIN2012-12-31910189318
2011 : EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2011 401k financial data
Total income from all sources (including contributions)2011-12-31$352,001
Total of all expenses incurred2011-12-31$84,238
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$35,725
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$378,544
Value of total assets at end of year2011-12-31$1,910,405
Value of total assets at beginning of year2011-12-31$1,642,642
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$48,513
Total interest from all sources2011-12-31$3
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$62,254
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$62,254
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$3,000,000
If this is an individual account plan, was there a blackout period2011-12-31Yes
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$55,247
Administrative expenses (other) incurred2011-12-31$48,513
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$267,763
Value of net assets at end of year (total assets less liabilities)2011-12-31$1,910,405
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$1,642,642
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$1,874,060
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$1,631,339
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$36,345
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$11,303
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$11,303
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$3
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$10,714
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-88,800
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$323,297
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$25,011
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31Yes
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31INSERO & COMPANY CPAS, P.C.
Accountancy firm EIN2011-12-31161016457
2010 : EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2010 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$545,959
Total of all expenses incurred2010-12-31$52,096
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$17,645
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$379,188
Value of total assets at end of year2010-12-31$1,642,642
Value of total assets at beginning of year2010-12-31$1,148,779
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$34,451
Total interest from all sources2010-12-31$5
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$40,127
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$40,127
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$3,000,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$46,940
Administrative expenses (other) incurred2010-12-31$34,451
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$493,863
Value of net assets at end of year (total assets less liabilities)2010-12-31$1,642,642
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$1,148,779
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$1,631,339
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$1,141,561
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$11,303
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$7,218
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$7,218
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$5
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$10,318
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$126,639
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$332,248
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$7,327
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31INSERO & COMPANY CPAS, P.C.
Accountancy firm EIN2010-12-31161016457

Form 5500 Responses for EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO

2022: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: EMERITI RETIREMENT HEALTH PLAN FOR UNIVERSITY OF SAN FRANCISCO 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number82036382038644
Policy instance 2
Insurance contract or identification number82036382038644
Number of Individuals Covered11
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $6,932
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number820363
Policy instance 1
Insurance contract or identification number820363
Number of Individuals Covered15
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $39,078
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number820363
Policy instance 1
Insurance contract or identification number820363
Number of Individuals Covered16
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $35,840
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number82036382038644
Policy instance 2
Insurance contract or identification number82036382038644
Number of Individuals Covered8
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $6,181
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number820363
Policy instance 1
Insurance contract or identification number820363
Number of Individuals Covered15
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $44,589
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number82036382038644
Policy instance 2
Insurance contract or identification number82036382038644
Number of Individuals Covered8
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $6,181
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number820363
Policy instance 1
Insurance contract or identification number820363
Number of Individuals Covered16
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $43,977
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number82036382038644
Policy instance 2
Insurance contract or identification number82036382038644
Number of Individuals Covered10
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $6,180
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number820363
Policy instance 1
Insurance contract or identification number820363
Number of Individuals Covered16
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $44,839
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number82036382038644
Policy instance 2
Insurance contract or identification number82036382038644
Number of Individuals Covered10
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $6,181
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number82036382038644
Policy instance 2
Insurance contract or identification number82036382038644
Number of Individuals Covered10
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $6,181
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number820363
Policy instance 1
Insurance contract or identification number820363
Number of Individuals Covered15
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $41,495
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number820363
Policy instance 3
Insurance contract or identification number820363
Number of Individuals Covered12
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $11,226
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number82036382038644
Policy instance 2
Insurance contract or identification number82036382038644
Number of Individuals Covered7
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $4,289
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number820363
Policy instance 1
Insurance contract or identification number820363
Number of Individuals Covered14
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $21,991
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE426876
Policy instance 4
Insurance contract or identification numberAE426876
Number of Individuals Covered1
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $994
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number82036382038644
Policy instance 3
Insurance contract or identification number82036382038644
Number of Individuals Covered7
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,732
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number82036382036344
Policy instance 2
Insurance contract or identification number82036382036344
Number of Individuals Covered11
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $20,165
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE351468
Policy instance 1
Insurance contract or identification numberAE351468
Number of Individuals Covered14
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $17,042
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number82036382038644
Policy instance 3
Insurance contract or identification number82036382038644
Number of Individuals Covered7
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $3,091
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number82036382036344
Policy instance 2
Insurance contract or identification number82036382036344
Number of Individuals Covered11
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $24,576
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE351468
Policy instance 1
Insurance contract or identification numberAE351468
Number of Individuals Covered14
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $9,472
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number82036382036344
Policy instance 2
Insurance contract or identification number82036382036344
Number of Individuals Covered8
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $21,182
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number82036382038644
Policy instance 3
Insurance contract or identification number82036382038644
Number of Individuals Covered6
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,953
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE351468
Policy instance 1
Insurance contract or identification numberAE351468
Number of Individuals Covered9
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $8,456
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE380630
Policy instance 5
Insurance contract or identification numberAE380630
Number of Individuals Covered0
Insurance policy start date2011-01-01
Insurance policy end date2011-01-01
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE426878
Policy instance 1
Insurance contract or identification numberAE426878
Number of Individuals Covered0
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $56
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAE351468
Policy instance 2
Insurance contract or identification numberAE351468
Number of Individuals Covered5
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $3,471
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number820363-363-44
Policy instance 3
Insurance contract or identification number820363-363-44
Number of Individuals Covered4
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,529
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number820363-386-44
Policy instance 4
Insurance contract or identification number820363-386-44
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $925
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberAE351468
Policy instance 4
Insurance contract or identification numberAE351468
Number of Individuals Covered5
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $2,906
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberAE380630
Policy instance 2
Insurance contract or identification numberAE380630
Number of Individuals Covered1
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $597
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number82036336344
Policy instance 1
Insurance contract or identification number82036336344
Number of Individuals Covered4
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,221
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number82036338644
Policy instance 3
Insurance contract or identification number82036338644
Number of Individuals Covered2
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,260

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