BOARD OF TRUSTEES OF MFOW WELFARE FUND has sponsored the creation of one or more 401k plans.
Measure | Date | Value |
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2023 : MFOW WELFARE FUND 2023 401k financial data |
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Unrealized appreciation/depreciation of other (non real estate) assets | 2023-01-31 | $-398,475 |
Total unrealized appreciation/depreciation of assets | 2023-01-31 | $-398,475 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-01-31 | $347,898 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-01-31 | $299,250 |
Total income from all sources (including contributions) | 2023-01-31 | $5,258,507 |
Total loss/gain on sale of assets | 2023-01-31 | $-114,144 |
Total of all expenses incurred | 2023-01-31 | $6,003,353 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2023-01-31 | $5,203,838 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2023-01-31 | $5,426,209 |
Value of total assets at end of year | 2023-01-31 | $13,846,808 |
Value of total assets at beginning of year | 2023-01-31 | $14,543,006 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2023-01-31 | $799,515 |
Total interest from all sources | 2023-01-31 | $288,290 |
Total dividends received (eg from common stock, registered investment company shares) | 2023-01-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2023-01-31 | No |
Administrative expenses professional fees incurred | 2023-01-31 | $162,233 |
Was this plan covered by a fidelity bond | 2023-01-31 | Yes |
Value of fidelity bond cover | 2023-01-31 | $500,000 |
Were there any nonexempt tranactions with any party-in-interest | 2023-01-31 | No |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2023-01-31 | $78,174 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2023-01-31 | $66,323 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2023-01-31 | $197,648 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2023-01-31 | $0 |
Other income not declared elsewhere | 2023-01-31 | $56,627 |
Administrative expenses (other) incurred | 2023-01-31 | $552,230 |
Liabilities. Value of operating payables at end of year | 2023-01-31 | $3,250 |
Liabilities. Value of operating payables at beginning of year | 2023-01-31 | $3,250 |
Total non interest bearing cash at end of year | 2023-01-31 | $260,943 |
Total non interest bearing cash at beginning of year | 2023-01-31 | $262,226 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-01-31 | No |
Value of net income/loss | 2023-01-31 | $-744,846 |
Value of net assets at end of year (total assets less liabilities) | 2023-01-31 | $13,498,910 |
Value of net assets at beginning of year (total assets less liabilities) | 2023-01-31 | $14,243,756 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2023-01-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2023-01-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2023-01-31 | No |
Investment advisory and management fees | 2023-01-31 | $52,876 |
Income. Interest from US Government securities | 2023-01-31 | $109,627 |
Income. Interest from corporate debt instruments | 2023-01-31 | $172,271 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2023-01-31 | $630,381 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2023-01-31 | $987,565 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2023-01-31 | $987,565 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2023-01-31 | $6,392 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2023-01-31 | $3,535,007 |
Asset value of US Government securities at end of year | 2023-01-31 | $5,756,776 |
Asset value of US Government securities at beginning of year | 2023-01-31 | $8,274,886 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2023-01-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2023-01-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2023-01-31 | No |
Contributions received in cash from employer | 2023-01-31 | $5,426,209 |
Employer contributions (assets) at end of year | 2023-01-31 | $438,000 |
Employer contributions (assets) at beginning of year | 2023-01-31 | $453,000 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2023-01-31 | $1,668,831 |
Asset. Corporate debt instrument debt (other) at end of year | 2023-01-31 | $6,682,534 |
Asset. Corporate debt instrument debt (other) at beginning of year | 2023-01-31 | $4,499,006 |
Contract administrator fees | 2023-01-31 | $32,176 |
Liabilities. Value of benefit claims payable at end of year | 2023-01-31 | $147,000 |
Liabilities. Value of benefit claims payable at beginning of year | 2023-01-31 | $296,000 |
Did the plan have assets held for investment | 2023-01-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-01-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2023-01-31 | No |
Aggregate proceeds on sale of assets | 2023-01-31 | $7,082,110 |
Aggregate carrying amount (costs) on sale of assets | 2023-01-31 | $7,196,254 |
Opinion of an independent qualified public accountant for this plan | 2023-01-31 | Unqualified |
Accountancy firm name | 2023-01-31 | WITHUMSMITH+BROWN, PC |
Accountancy firm EIN | 2023-01-31 | 222027092 |
2022 : MFOW WELFARE FUND 2022 401k financial data |
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Unrealized appreciation/depreciation of other (non real estate) assets | 2022-01-31 | $-315,808 |
Total unrealized appreciation/depreciation of assets | 2022-01-31 | $-315,808 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-01-31 | $299,250 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-01-31 | $193,250 |
Total income from all sources (including contributions) | 2022-01-31 | $5,441,686 |
Total loss/gain on sale of assets | 2022-01-31 | $-95,728 |
Total of all expenses incurred | 2022-01-31 | $5,694,319 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-01-31 | $4,903,574 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-01-31 | $5,457,059 |
Value of total assets at end of year | 2022-01-31 | $14,543,006 |
Value of total assets at beginning of year | 2022-01-31 | $14,689,639 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-01-31 | $790,745 |
Total interest from all sources | 2022-01-31 | $243,916 |
Total dividends received (eg from common stock, registered investment company shares) | 2022-01-31 | $0 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-01-31 | No |
Administrative expenses professional fees incurred | 2022-01-31 | $178,293 |
Was this plan covered by a fidelity bond | 2022-01-31 | Yes |
Value of fidelity bond cover | 2022-01-31 | $500,000 |
Were there any nonexempt tranactions with any party-in-interest | 2022-01-31 | No |
Contributions received from participants | 2022-01-31 | $0 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-01-31 | $66,323 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-01-31 | $68,514 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2022-01-31 | $3,250 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2022-01-31 | $3,250 |
Other income not declared elsewhere | 2022-01-31 | $152,247 |
Administrative expenses (other) incurred | 2022-01-31 | $518,673 |
Total non interest bearing cash at end of year | 2022-01-31 | $262,226 |
Total non interest bearing cash at beginning of year | 2022-01-31 | $94,081 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-01-31 | No |
Value of net income/loss | 2022-01-31 | $-252,633 |
Value of net assets at end of year (total assets less liabilities) | 2022-01-31 | $14,243,756 |
Value of net assets at beginning of year (total assets less liabilities) | 2022-01-31 | $14,496,389 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-01-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2022-01-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2022-01-31 | No |
Investment advisory and management fees | 2022-01-31 | $58,565 |
Income. Interest from US Government securities | 2022-01-31 | $128,019 |
Income. Interest from corporate debt instruments | 2022-01-31 | $115,690 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-01-31 | $987,565 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-01-31 | $1,208,533 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-01-31 | $1,208,533 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-01-31 | $207 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2022-01-31 | $3,214,356 |
Asset value of US Government securities at end of year | 2022-01-31 | $8,274,886 |
Asset value of US Government securities at beginning of year | 2022-01-31 | $7,995,026 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-01-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2022-01-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2022-01-31 | No |
Contributions received in cash from employer | 2022-01-31 | $5,457,059 |
Employer contributions (assets) at end of year | 2022-01-31 | $453,000 |
Employer contributions (assets) at beginning of year | 2022-01-31 | $426,000 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-01-31 | $1,689,218 |
Asset. Corporate debt instrument debt (other) at end of year | 2022-01-31 | $4,499,006 |
Asset. Corporate debt instrument debt (other) at beginning of year | 2022-01-31 | $4,897,485 |
Contract administrator fees | 2022-01-31 | $35,214 |
Liabilities. Value of benefit claims payable at end of year | 2022-01-31 | $296,000 |
Liabilities. Value of benefit claims payable at beginning of year | 2022-01-31 | $190,000 |
Did the plan have assets held for investment | 2022-01-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-01-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-01-31 | No |
Aggregate proceeds on sale of assets | 2022-01-31 | $10,229,637 |
Aggregate carrying amount (costs) on sale of assets | 2022-01-31 | $10,325,365 |
Opinion of an independent qualified public accountant for this plan | 2022-01-31 | Unqualified |
Accountancy firm name | 2022-01-31 | WITHUMSMITH+BROWN, PC |
Accountancy firm EIN | 2022-01-31 | 222027092 |
2021 : MFOW WELFARE FUND 2021 401k financial data |
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Unrealized appreciation/depreciation of other (non real estate) assets | 2021-01-31 | $148,702 |
Total unrealized appreciation/depreciation of assets | 2021-01-31 | $148,702 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-01-31 | $193,250 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-01-31 | $464,054 |
Total income from all sources (including contributions) | 2021-01-31 | $5,557,794 |
Total loss/gain on sale of assets | 2021-01-31 | $5,878 |
Total of all expenses incurred | 2021-01-31 | $4,997,548 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-01-31 | $4,232,797 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-01-31 | $5,037,731 |
Value of total assets at end of year | 2021-01-31 | $14,689,639 |
Value of total assets at beginning of year | 2021-01-31 | $14,400,197 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-01-31 | $764,751 |
Total interest from all sources | 2021-01-31 | $321,431 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-01-31 | No |
Administrative expenses professional fees incurred | 2021-01-31 | $123,152 |
Was this plan covered by a fidelity bond | 2021-01-31 | Yes |
Value of fidelity bond cover | 2021-01-31 | $500,000 |
Were there any nonexempt tranactions with any party-in-interest | 2021-01-31 | No |
Contributions received from participants | 2021-01-31 | $4,564 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-01-31 | $68,514 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-01-31 | $103,727 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2021-01-31 | $3,250 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2021-01-31 | $50,054 |
Other income not declared elsewhere | 2021-01-31 | $44,052 |
Administrative expenses (other) incurred | 2021-01-31 | $538,104 |
Total non interest bearing cash at end of year | 2021-01-31 | $94,081 |
Total non interest bearing cash at beginning of year | 2021-01-31 | $621,794 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-01-31 | No |
Value of net income/loss | 2021-01-31 | $560,246 |
Value of net assets at end of year (total assets less liabilities) | 2021-01-31 | $14,496,389 |
Value of net assets at beginning of year (total assets less liabilities) | 2021-01-31 | $13,936,143 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-01-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2021-01-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2021-01-31 | No |
Investment advisory and management fees | 2021-01-31 | $61,263 |
Income. Interest from US Government securities | 2021-01-31 | $171,509 |
Income. Interest from corporate debt instruments | 2021-01-31 | $148,605 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-01-31 | $1,208,533 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-01-31 | $669,878 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-01-31 | $669,878 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-01-31 | $1,317 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2021-01-31 | $2,946,019 |
Asset value of US Government securities at end of year | 2021-01-31 | $7,995,026 |
Asset value of US Government securities at beginning of year | 2021-01-31 | $7,841,840 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-01-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2021-01-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2021-01-31 | No |
Contributions received in cash from employer | 2021-01-31 | $5,033,167 |
Employer contributions (assets) at end of year | 2021-01-31 | $426,000 |
Employer contributions (assets) at beginning of year | 2021-01-31 | $436,000 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-01-31 | $1,286,778 |
Asset. Corporate debt instrument debt (other) at end of year | 2021-01-31 | $4,897,485 |
Asset. Corporate debt instrument debt (other) at beginning of year | 2021-01-31 | $4,726,958 |
Contract administrator fees | 2021-01-31 | $42,232 |
Liabilities. Value of benefit claims payable at end of year | 2021-01-31 | $190,000 |
Liabilities. Value of benefit claims payable at beginning of year | 2021-01-31 | $414,000 |
Did the plan have assets held for investment | 2021-01-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-01-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-01-31 | No |
Aggregate proceeds on sale of assets | 2021-01-31 | $12,530,760 |
Aggregate carrying amount (costs) on sale of assets | 2021-01-31 | $12,524,882 |
Opinion of an independent qualified public accountant for this plan | 2021-01-31 | Unqualified |
Accountancy firm name | 2021-01-31 | LINDQUIST LLP |
Accountancy firm EIN | 2021-01-31 | 522385296 |
2020 : MFOW WELFARE FUND 2020 401k financial data |
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Unrealized appreciation/depreciation of other (non real estate) assets | 2020-01-31 | $210,334 |
Unrealized appreciation/depreciation of other (non real estate) assets | 2020-01-31 | $210,334 |
Total unrealized appreciation/depreciation of assets | 2020-01-31 | $210,334 |
Total unrealized appreciation/depreciation of assets | 2020-01-31 | $210,334 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-01-31 | $464,054 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-01-31 | $464,054 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-01-31 | $105,250 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-01-31 | $105,250 |
Total income from all sources (including contributions) | 2020-01-31 | $6,002,047 |
Total income from all sources (including contributions) | 2020-01-31 | $6,002,047 |
Total loss/gain on sale of assets | 2020-01-31 | $8,252 |
Total loss/gain on sale of assets | 2020-01-31 | $8,252 |
Total of all expenses incurred | 2020-01-31 | $6,154,621 |
Total of all expenses incurred | 2020-01-31 | $6,154,621 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-01-31 | $5,289,226 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-01-31 | $5,289,226 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-01-31 | $5,357,424 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-01-31 | $5,357,424 |
Value of total assets at end of year | 2020-01-31 | $14,400,197 |
Value of total assets at end of year | 2020-01-31 | $14,400,197 |
Value of total assets at beginning of year | 2020-01-31 | $14,193,967 |
Value of total assets at beginning of year | 2020-01-31 | $14,193,967 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-01-31 | $865,395 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-01-31 | $865,395 |
Total interest from all sources | 2020-01-31 | $369,696 |
Total interest from all sources | 2020-01-31 | $369,696 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-01-31 | No |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-01-31 | No |
Administrative expenses professional fees incurred | 2020-01-31 | $158,914 |
Administrative expenses professional fees incurred | 2020-01-31 | $158,914 |
Was this plan covered by a fidelity bond | 2020-01-31 | Yes |
Was this plan covered by a fidelity bond | 2020-01-31 | Yes |
Value of fidelity bond cover | 2020-01-31 | $500,000 |
Value of fidelity bond cover | 2020-01-31 | $500,000 |
Were there any nonexempt tranactions with any party-in-interest | 2020-01-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2020-01-31 | No |
Contributions received from participants | 2020-01-31 | $1,215 |
Contributions received from participants | 2020-01-31 | $1,215 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-01-31 | $103,727 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-01-31 | $103,727 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-01-31 | $101,144 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-01-31 | $101,144 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2020-01-31 | $50,054 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2020-01-31 | $50,054 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-01-31 | $3,250 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-01-31 | $3,250 |
Other income not declared elsewhere | 2020-01-31 | $56,341 |
Other income not declared elsewhere | 2020-01-31 | $56,341 |
Administrative expenses (other) incurred | 2020-01-31 | $602,216 |
Administrative expenses (other) incurred | 2020-01-31 | $602,216 |
Total non interest bearing cash at end of year | 2020-01-31 | $621,794 |
Total non interest bearing cash at end of year | 2020-01-31 | $621,794 |
Total non interest bearing cash at beginning of year | 2020-01-31 | $375,194 |
Total non interest bearing cash at beginning of year | 2020-01-31 | $375,194 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-01-31 | No |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-01-31 | No |
Value of net income/loss | 2020-01-31 | $-152,574 |
Value of net income/loss | 2020-01-31 | $-152,574 |
Value of net assets at end of year (total assets less liabilities) | 2020-01-31 | $13,936,143 |
Value of net assets at end of year (total assets less liabilities) | 2020-01-31 | $13,936,143 |
Value of net assets at beginning of year (total assets less liabilities) | 2020-01-31 | $14,088,717 |
Value of net assets at beginning of year (total assets less liabilities) | 2020-01-31 | $14,088,717 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-01-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2020-01-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2020-01-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2020-01-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2020-01-31 | No |
Investment advisory and management fees | 2020-01-31 | $55,881 |
Investment advisory and management fees | 2020-01-31 | $55,881 |
Income. Interest from US Government securities | 2020-01-31 | $205,122 |
Income. Interest from US Government securities | 2020-01-31 | $205,122 |
Income. Interest from corporate debt instruments | 2020-01-31 | $157,652 |
Income. Interest from corporate debt instruments | 2020-01-31 | $157,652 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-01-31 | $669,878 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-01-31 | $669,878 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-01-31 | $1,354,086 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-01-31 | $1,354,086 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-01-31 | $1,354,086 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-01-31 | $1,354,086 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-01-31 | $6,922 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-01-31 | $6,922 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2020-01-31 | $3,215,039 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2020-01-31 | $3,215,039 |
Asset value of US Government securities at end of year | 2020-01-31 | $7,841,840 |
Asset value of US Government securities at end of year | 2020-01-31 | $7,841,840 |
Asset value of US Government securities at beginning of year | 2020-01-31 | $6,278,882 |
Asset value of US Government securities at beginning of year | 2020-01-31 | $6,278,882 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-01-31 | Yes |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-01-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2020-01-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2020-01-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2020-01-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2020-01-31 | No |
Contributions received in cash from employer | 2020-01-31 | $5,356,209 |
Contributions received in cash from employer | 2020-01-31 | $5,356,209 |
Employer contributions (assets) at end of year | 2020-01-31 | $436,000 |
Employer contributions (assets) at end of year | 2020-01-31 | $436,000 |
Employer contributions (assets) at beginning of year | 2020-01-31 | $436,000 |
Employer contributions (assets) at beginning of year | 2020-01-31 | $436,000 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-01-31 | $2,074,187 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-01-31 | $2,074,187 |
Asset. Corporate debt instrument debt (other) at end of year | 2020-01-31 | $4,726,958 |
Asset. Corporate debt instrument debt (other) at end of year | 2020-01-31 | $4,726,958 |
Asset. Corporate debt instrument debt (other) at beginning of year | 2020-01-31 | $5,648,661 |
Asset. Corporate debt instrument debt (other) at beginning of year | 2020-01-31 | $5,648,661 |
Contract administrator fees | 2020-01-31 | $48,384 |
Contract administrator fees | 2020-01-31 | $48,384 |
Liabilities. Value of benefit claims payable at end of year | 2020-01-31 | $414,000 |
Liabilities. Value of benefit claims payable at end of year | 2020-01-31 | $414,000 |
Liabilities. Value of benefit claims payable at beginning of year | 2020-01-31 | $102,000 |
Liabilities. Value of benefit claims payable at beginning of year | 2020-01-31 | $102,000 |
Did the plan have assets held for investment | 2020-01-31 | Yes |
Did the plan have assets held for investment | 2020-01-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-01-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-01-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-01-31 | No |
Aggregate proceeds on sale of assets | 2020-01-31 | $8,962,907 |
Aggregate proceeds on sale of assets | 2020-01-31 | $8,962,907 |
Aggregate carrying amount (costs) on sale of assets | 2020-01-31 | $8,954,655 |
Aggregate carrying amount (costs) on sale of assets | 2020-01-31 | $8,954,655 |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2020-01-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2020-01-31 | No |
Opinion of an independent qualified public accountant for this plan | 2020-01-31 | Unqualified |
Opinion of an independent qualified public accountant for this plan | 2020-01-31 | Unqualified |
Accountancy firm name | 2020-01-31 | LINDQUIST LLP |
Accountancy firm name | 2020-01-31 | LINDQUIST LLP |
Accountancy firm EIN | 2020-01-31 | 522385296 |
Accountancy firm EIN | 2020-01-31 | 522385296 |
2019 : MFOW WELFARE FUND 2019 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2019-01-31 | $-17,773 |
Total unrealized appreciation/depreciation of assets | 2019-01-31 | $-17,773 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-01-31 | $105,250 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-01-31 | $191,250 |
Total income from all sources (including contributions) | 2019-01-31 | $5,577,054 |
Total loss/gain on sale of assets | 2019-01-31 | $-29,352 |
Total of all expenses incurred | 2019-01-31 | $5,382,103 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-01-31 | $4,585,334 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-01-31 | $5,216,962 |
Value of total assets at end of year | 2019-01-31 | $14,193,967 |
Value of total assets at beginning of year | 2019-01-31 | $14,085,016 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-01-31 | $796,769 |
Total interest from all sources | 2019-01-31 | $340,010 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-01-31 | No |
Administrative expenses professional fees incurred | 2019-01-31 | $144,098 |
Was this plan covered by a fidelity bond | 2019-01-31 | Yes |
Value of fidelity bond cover | 2019-01-31 | $500,000 |
Were there any nonexempt tranactions with any party-in-interest | 2019-01-31 | No |
Contributions received from participants | 2019-01-31 | $15,755 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-01-31 | $101,144 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-01-31 | $104,775 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2019-01-31 | $3,250 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2019-01-31 | $3,250 |
Other income not declared elsewhere | 2019-01-31 | $67,207 |
Administrative expenses (other) incurred | 2019-01-31 | $543,295 |
Total non interest bearing cash at end of year | 2019-01-31 | $375,194 |
Total non interest bearing cash at beginning of year | 2019-01-31 | $501,720 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-01-31 | No |
Value of net income/loss | 2019-01-31 | $194,951 |
Value of net assets at end of year (total assets less liabilities) | 2019-01-31 | $14,088,717 |
Value of net assets at beginning of year (total assets less liabilities) | 2019-01-31 | $13,893,766 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-01-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2019-01-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2019-01-31 | No |
Investment advisory and management fees | 2019-01-31 | $53,448 |
Income. Interest from US Government securities | 2019-01-31 | $150,534 |
Income. Interest from corporate debt instruments | 2019-01-31 | $183,175 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-01-31 | $1,354,086 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-01-31 | $1,302,804 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-01-31 | $1,302,804 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-01-31 | $6,301 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2019-01-31 | $3,093,439 |
Asset value of US Government securities at end of year | 2019-01-31 | $6,278,882 |
Asset value of US Government securities at beginning of year | 2019-01-31 | $6,113,275 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-01-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2019-01-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2019-01-31 | No |
Contributions received in cash from employer | 2019-01-31 | $5,201,207 |
Employer contributions (assets) at end of year | 2019-01-31 | $436,000 |
Employer contributions (assets) at beginning of year | 2019-01-31 | $401,000 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-01-31 | $1,491,895 |
Asset. Corporate debt instrument debt (other) at end of year | 2019-01-31 | $5,648,661 |
Asset. Corporate debt instrument debt (other) at beginning of year | 2019-01-31 | $5,661,442 |
Contract administrator fees | 2019-01-31 | $55,928 |
Liabilities. Value of benefit claims payable at end of year | 2019-01-31 | $102,000 |
Liabilities. Value of benefit claims payable at beginning of year | 2019-01-31 | $188,000 |
Did the plan have assets held for investment | 2019-01-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-01-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-01-31 | No |
Aggregate proceeds on sale of assets | 2019-01-31 | $9,828,670 |
Aggregate carrying amount (costs) on sale of assets | 2019-01-31 | $9,858,022 |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-01-31 | No |
Opinion of an independent qualified public accountant for this plan | 2019-01-31 | Unqualified |
Accountancy firm name | 2019-01-31 | LINDQUIST LLP |
Accountancy firm EIN | 2019-01-31 | 522385296 |
2018 : MFOW WELFARE FUND 2018 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2018-01-31 | $-113,422 |
Total unrealized appreciation/depreciation of assets | 2018-01-31 | $-113,422 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-01-31 | $191,250 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-01-31 | $408,674 |
Total income from all sources (including contributions) | 2018-01-31 | $5,353,144 |
Total loss/gain on sale of assets | 2018-01-31 | $-77,463 |
Total of all expenses incurred | 2018-01-31 | $5,281,952 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-01-31 | $4,607,349 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-01-31 | $5,148,212 |
Value of total assets at end of year | 2018-01-31 | $14,085,016 |
Value of total assets at beginning of year | 2018-01-31 | $14,231,248 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-01-31 | $674,603 |
Total interest from all sources | 2018-01-31 | $318,791 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-01-31 | No |
Administrative expenses professional fees incurred | 2018-01-31 | $121,000 |
Was this plan covered by a fidelity bond | 2018-01-31 | Yes |
Value of fidelity bond cover | 2018-01-31 | $500,000 |
If this is an individual account plan, was there a blackout period | 2018-01-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2018-01-31 | No |
Contributions received from participants | 2018-01-31 | $5,460 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-01-31 | $104,775 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-01-31 | $110,032 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2018-01-31 | $3,250 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2018-01-31 | $3,674 |
Other income not declared elsewhere | 2018-01-31 | $77,026 |
Administrative expenses (other) incurred | 2018-01-31 | $459,528 |
Total non interest bearing cash at end of year | 2018-01-31 | $501,720 |
Total non interest bearing cash at beginning of year | 2018-01-31 | $169,648 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-01-31 | No |
Value of net income/loss | 2018-01-31 | $71,192 |
Value of net assets at end of year (total assets less liabilities) | 2018-01-31 | $13,893,766 |
Value of net assets at beginning of year (total assets less liabilities) | 2018-01-31 | $13,822,574 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-01-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2018-01-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2018-01-31 | No |
Investment advisory and management fees | 2018-01-31 | $54,008 |
Income. Interest from US Government securities | 2018-01-31 | $151,879 |
Income. Interest from corporate debt instruments | 2018-01-31 | $163,607 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-01-31 | $1,302,804 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-01-31 | $2,056,734 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-01-31 | $2,056,734 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-01-31 | $3,305 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2018-01-31 | $2,890,258 |
Asset value of US Government securities at end of year | 2018-01-31 | $6,113,275 |
Asset value of US Government securities at beginning of year | 2018-01-31 | $6,665,703 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-01-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2018-01-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2018-01-31 | No |
Contributions received in cash from employer | 2018-01-31 | $5,142,752 |
Employer contributions (assets) at end of year | 2018-01-31 | $401,000 |
Employer contributions (assets) at beginning of year | 2018-01-31 | $409,000 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-01-31 | $1,717,091 |
Asset. Corporate debt instrument debt (other) at end of year | 2018-01-31 | $5,661,442 |
Asset. Corporate debt instrument debt (other) at beginning of year | 2018-01-31 | $4,820,131 |
Contract administrator fees | 2018-01-31 | $40,067 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2018-01-31 | No |
Liabilities. Value of benefit claims payable at end of year | 2018-01-31 | $188,000 |
Liabilities. Value of benefit claims payable at beginning of year | 2018-01-31 | $405,000 |
Did the plan have assets held for investment | 2018-01-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-01-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-01-31 | No |
Aggregate proceeds on sale of assets | 2018-01-31 | $10,706,686 |
Aggregate carrying amount (costs) on sale of assets | 2018-01-31 | $10,784,149 |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-01-31 | No |
Opinion of an independent qualified public accountant for this plan | 2018-01-31 | Unqualified |
Accountancy firm name | 2018-01-31 | LINDQUIST LLP |
Accountancy firm EIN | 2018-01-31 | 522385296 |
2017 : MFOW WELFARE FUND 2017 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2017-01-31 | $-92,736 |
Total unrealized appreciation/depreciation of assets | 2017-01-31 | $-92,736 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-01-31 | $408,674 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-01-31 | $97,674 |
Total income from all sources (including contributions) | 2017-01-31 | $5,425,337 |
Total loss/gain on sale of assets | 2017-01-31 | $-21,661 |
Total of all expenses incurred | 2017-01-31 | $5,740,024 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-01-31 | $4,939,879 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-01-31 | $5,123,607 |
Value of total assets at end of year | 2017-01-31 | $14,231,248 |
Value of total assets at beginning of year | 2017-01-31 | $14,234,935 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-01-31 | $800,145 |
Total interest from all sources | 2017-01-31 | $320,460 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-01-31 | No |
Administrative expenses professional fees incurred | 2017-01-31 | $142,721 |
Was this plan covered by a fidelity bond | 2017-01-31 | Yes |
Value of fidelity bond cover | 2017-01-31 | $500,000 |
If this is an individual account plan, was there a blackout period | 2017-01-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2017-01-31 | No |
Contributions received from participants | 2017-01-31 | $16,264 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-01-31 | $110,032 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-01-31 | $120,877 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2017-01-31 | $3,674 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2017-01-31 | $3,674 |
Other income not declared elsewhere | 2017-01-31 | $95,667 |
Administrative expenses (other) incurred | 2017-01-31 | $546,385 |
Total non interest bearing cash at end of year | 2017-01-31 | $169,648 |
Total non interest bearing cash at beginning of year | 2017-01-31 | $316,327 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-01-31 | No |
Value of net income/loss | 2017-01-31 | $-314,687 |
Value of net assets at end of year (total assets less liabilities) | 2017-01-31 | $13,822,574 |
Value of net assets at beginning of year (total assets less liabilities) | 2017-01-31 | $14,137,261 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-01-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2017-01-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2017-01-31 | No |
Investment advisory and management fees | 2017-01-31 | $70,306 |
Income. Interest from US Government securities | 2017-01-31 | $143,111 |
Income. Interest from corporate debt instruments | 2017-01-31 | $175,812 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-01-31 | $2,056,734 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-01-31 | $2,000,741 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-01-31 | $2,000,741 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-01-31 | $1,537 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2017-01-31 | $2,756,266 |
Asset value of US Government securities at end of year | 2017-01-31 | $6,665,703 |
Asset value of US Government securities at beginning of year | 2017-01-31 | $5,156,280 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-01-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2017-01-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2017-01-31 | No |
Contributions received in cash from employer | 2017-01-31 | $5,107,343 |
Employer contributions (assets) at end of year | 2017-01-31 | $409,000 |
Employer contributions (assets) at beginning of year | 2017-01-31 | $365,000 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-01-31 | $2,183,613 |
Asset. Corporate debt instrument debt (other) at end of year | 2017-01-31 | $4,820,131 |
Asset. Corporate debt instrument debt (other) at beginning of year | 2017-01-31 | $6,275,710 |
Contract administrator fees | 2017-01-31 | $40,733 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2017-01-31 | No |
Liabilities. Value of benefit claims payable at end of year | 2017-01-31 | $405,000 |
Liabilities. Value of benefit claims payable at beginning of year | 2017-01-31 | $94,000 |
Did the plan have assets held for investment | 2017-01-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-01-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-01-31 | No |
Aggregate proceeds on sale of assets | 2017-01-31 | $9,657,786 |
Aggregate carrying amount (costs) on sale of assets | 2017-01-31 | $9,679,447 |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-01-31 | No |
Opinion of an independent qualified public accountant for this plan | 2017-01-31 | Unqualified |
Accountancy firm name | 2017-01-31 | LINDQUIST LLP |
Accountancy firm EIN | 2017-01-31 | 522385296 |
2016 : MFOW WELFARE FUND 2016 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2016-01-31 | $-160,770 |
Total unrealized appreciation/depreciation of assets | 2016-01-31 | $-160,770 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-01-31 | $97,674 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-01-31 | $171,102 |
Total income from all sources (including contributions) | 2016-01-31 | $5,062,920 |
Total loss/gain on sale of assets | 2016-01-31 | $-50,957 |
Total of all expenses incurred | 2016-01-31 | $4,984,349 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-01-31 | $4,300,747 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-01-31 | $4,869,593 |
Value of total assets at end of year | 2016-01-31 | $14,234,935 |
Value of total assets at beginning of year | 2016-01-31 | $14,229,792 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-01-31 | $683,602 |
Total interest from all sources | 2016-01-31 | $315,602 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-01-31 | No |
Administrative expenses professional fees incurred | 2016-01-31 | $95,189 |
Was this plan covered by a fidelity bond | 2016-01-31 | Yes |
Value of fidelity bond cover | 2016-01-31 | $500,000 |
If this is an individual account plan, was there a blackout period | 2016-01-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2016-01-31 | No |
Contributions received from participants | 2016-01-31 | $16,205 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-01-31 | $120,877 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-01-31 | $126,667 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2016-01-31 | $3,674 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2016-01-31 | $4,102 |
Other income not declared elsewhere | 2016-01-31 | $89,452 |
Administrative expenses (other) incurred | 2016-01-31 | $502,811 |
Total non interest bearing cash at end of year | 2016-01-31 | $316,327 |
Total non interest bearing cash at beginning of year | 2016-01-31 | $401,335 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-01-31 | No |
Value of net income/loss | 2016-01-31 | $78,571 |
Value of net assets at end of year (total assets less liabilities) | 2016-01-31 | $14,137,261 |
Value of net assets at beginning of year (total assets less liabilities) | 2016-01-31 | $14,058,690 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-01-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2016-01-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2016-01-31 | No |
Investment advisory and management fees | 2016-01-31 | $31,261 |
Income. Interest from US Government securities | 2016-01-31 | $119,905 |
Income. Interest from corporate debt instruments | 2016-01-31 | $195,080 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-01-31 | $2,000,741 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-01-31 | $1,853,501 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-01-31 | $1,853,501 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-01-31 | $617 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2016-01-31 | $2,601,987 |
Asset value of US Government securities at end of year | 2016-01-31 | $5,156,280 |
Asset value of US Government securities at beginning of year | 2016-01-31 | $4,846,151 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-01-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2016-01-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2016-01-31 | No |
Contributions received in cash from employer | 2016-01-31 | $4,853,388 |
Employer contributions (assets) at end of year | 2016-01-31 | $365,000 |
Employer contributions (assets) at beginning of year | 2016-01-31 | $404,000 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-01-31 | $1,698,760 |
Asset. Corporate debt instrument debt (other) at end of year | 2016-01-31 | $6,275,710 |
Asset. Corporate debt instrument debt (other) at beginning of year | 2016-01-31 | $6,598,138 |
Contract administrator fees | 2016-01-31 | $54,341 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2016-01-31 | No |
Liabilities. Value of benefit claims payable at end of year | 2016-01-31 | $94,000 |
Liabilities. Value of benefit claims payable at beginning of year | 2016-01-31 | $167,000 |
Did the plan have assets held for investment | 2016-01-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-01-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-01-31 | No |
Aggregate proceeds on sale of assets | 2016-01-31 | $9,030,383 |
Aggregate carrying amount (costs) on sale of assets | 2016-01-31 | $9,081,340 |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-01-31 | No |
Opinion of an independent qualified public accountant for this plan | 2016-01-31 | Unqualified |
Accountancy firm name | 2016-01-31 | LINDQUIST LLP |
Accountancy firm EIN | 2016-01-31 | 522385296 |
2015 : MFOW WELFARE FUND 2015 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2015-01-31 | $-66,662 |
Total unrealized appreciation/depreciation of assets | 2015-01-31 | $-66,662 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-01-31 | $171,102 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-01-31 | $573,177 |
Total income from all sources (including contributions) | 2015-01-31 | $4,798,205 |
Total loss/gain on sale of assets | 2015-01-31 | $-58,708 |
Total of all expenses incurred | 2015-01-31 | $4,476,989 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-01-31 | $3,785,447 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-01-31 | $4,491,496 |
Value of total assets at end of year | 2015-01-31 | $14,229,792 |
Value of total assets at beginning of year | 2015-01-31 | $14,310,651 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-01-31 | $691,542 |
Total interest from all sources | 2015-01-31 | $336,009 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-01-31 | No |
Administrative expenses professional fees incurred | 2015-01-31 | $90,454 |
Was this plan covered by a fidelity bond | 2015-01-31 | Yes |
Value of fidelity bond cover | 2015-01-31 | $500,000 |
If this is an individual account plan, was there a blackout period | 2015-01-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2015-01-31 | No |
Contributions received from participants | 2015-01-31 | $12,367 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-01-31 | $126,667 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-01-31 | $176,878 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2015-01-31 | $4,102 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2015-01-31 | $493,177 |
Other income not declared elsewhere | 2015-01-31 | $96,070 |
Administrative expenses (other) incurred | 2015-01-31 | $498,581 |
Total non interest bearing cash at end of year | 2015-01-31 | $401,335 |
Total non interest bearing cash at beginning of year | 2015-01-31 | $349,461 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-01-31 | No |
Value of net income/loss | 2015-01-31 | $321,216 |
Value of net assets at end of year (total assets less liabilities) | 2015-01-31 | $14,058,690 |
Value of net assets at beginning of year (total assets less liabilities) | 2015-01-31 | $13,737,474 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-01-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2015-01-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2015-01-31 | No |
Investment advisory and management fees | 2015-01-31 | $47,357 |
Income. Interest from US Government securities | 2015-01-31 | $129,150 |
Income. Interest from corporate debt instruments | 2015-01-31 | $206,413 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-01-31 | $1,853,501 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-01-31 | $2,281,202 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-01-31 | $2,281,202 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-01-31 | $446 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2015-01-31 | $2,319,770 |
Asset value of US Government securities at end of year | 2015-01-31 | $4,846,151 |
Asset value of US Government securities at beginning of year | 2015-01-31 | $5,145,756 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-01-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2015-01-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2015-01-31 | No |
Contributions received in cash from employer | 2015-01-31 | $4,479,129 |
Employer contributions (assets) at end of year | 2015-01-31 | $404,000 |
Employer contributions (assets) at beginning of year | 2015-01-31 | $290,000 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-01-31 | $1,465,677 |
Asset. Corporate debt instrument debt (other) at end of year | 2015-01-31 | $6,598,138 |
Asset. Corporate debt instrument debt (other) at beginning of year | 2015-01-31 | $6,067,354 |
Contract administrator fees | 2015-01-31 | $55,150 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2015-01-31 | No |
Liabilities. Value of benefit claims payable at end of year | 2015-01-31 | $167,000 |
Liabilities. Value of benefit claims payable at beginning of year | 2015-01-31 | $80,000 |
Did the plan have assets held for investment | 2015-01-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-01-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-01-31 | No |
Aggregate proceeds on sale of assets | 2015-01-31 | $7,846,441 |
Aggregate carrying amount (costs) on sale of assets | 2015-01-31 | $7,905,149 |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-01-31 | No |
Opinion of an independent qualified public accountant for this plan | 2015-01-31 | Unqualified |
Accountancy firm name | 2015-01-31 | LINDQUIST LLP |
Accountancy firm EIN | 2015-01-31 | 522385296 |
2014 : MFOW WELFARE FUND 2014 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2014-01-31 | $-98,431 |
Total unrealized appreciation/depreciation of assets | 2014-01-31 | $-98,431 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-01-31 | $573,177 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-01-31 | $290,987 |
Total income from all sources (including contributions) | 2014-01-31 | $4,231,146 |
Total loss/gain on sale of assets | 2014-01-31 | $-131,944 |
Total of all expenses incurred | 2014-01-31 | $4,667,038 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-01-31 | $3,988,461 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-01-31 | $3,915,925 |
Value of total assets at end of year | 2014-01-31 | $14,310,651 |
Value of total assets at beginning of year | 2014-01-31 | $14,464,353 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-01-31 | $678,577 |
Total interest from all sources | 2014-01-31 | $400,315 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-01-31 | No |
Administrative expenses professional fees incurred | 2014-01-31 | $96,056 |
Was this plan covered by a fidelity bond | 2014-01-31 | Yes |
Value of fidelity bond cover | 2014-01-31 | $500,000 |
If this is an individual account plan, was there a blackout period | 2014-01-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2014-01-31 | No |
Contributions received from participants | 2014-01-31 | $13,798 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-01-31 | $176,878 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-01-31 | $225,478 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2014-01-31 | $493,177 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2014-01-31 | $137,987 |
Other income not declared elsewhere | 2014-01-31 | $145,281 |
Administrative expenses (other) incurred | 2014-01-31 | $488,988 |
Total non interest bearing cash at end of year | 2014-01-31 | $349,461 |
Total non interest bearing cash at beginning of year | 2014-01-31 | $233,118 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-01-31 | No |
Value of net income/loss | 2014-01-31 | $-435,892 |
Value of net assets at end of year (total assets less liabilities) | 2014-01-31 | $13,737,474 |
Value of net assets at beginning of year (total assets less liabilities) | 2014-01-31 | $14,173,366 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-01-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2014-01-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2014-01-31 | No |
Investment advisory and management fees | 2014-01-31 | $58,347 |
Income. Interest from US Government securities | 2014-01-31 | $160,804 |
Income. Interest from corporate debt instruments | 2014-01-31 | $238,644 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-01-31 | $2,281,202 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-01-31 | $2,298,326 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-01-31 | $2,298,326 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-01-31 | $867 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2014-01-31 | $2,257,514 |
Asset value of US Government securities at end of year | 2014-01-31 | $5,145,756 |
Asset value of US Government securities at beginning of year | 2014-01-31 | $5,783,541 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-01-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2014-01-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2014-01-31 | No |
Contributions received in cash from employer | 2014-01-31 | $3,902,127 |
Employer contributions (assets) at end of year | 2014-01-31 | $290,000 |
Employer contributions (assets) at beginning of year | 2014-01-31 | $347,000 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-01-31 | $1,730,947 |
Asset. Corporate debt instrument debt (other) at end of year | 2014-01-31 | $6,067,354 |
Asset. Corporate debt instrument debt (other) at beginning of year | 2014-01-31 | $5,576,890 |
Contract administrator fees | 2014-01-31 | $35,186 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2014-01-31 | No |
Liabilities. Value of benefit claims payable at end of year | 2014-01-31 | $80,000 |
Liabilities. Value of benefit claims payable at beginning of year | 2014-01-31 | $153,000 |
Did the plan have assets held for investment | 2014-01-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-01-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-01-31 | No |
Aggregate proceeds on sale of assets | 2014-01-31 | $9,680,133 |
Aggregate carrying amount (costs) on sale of assets | 2014-01-31 | $9,812,077 |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-01-31 | No |
Opinion of an independent qualified public accountant for this plan | 2014-01-31 | Unqualified |
Accountancy firm name | 2014-01-31 | LINDQUIST LLP |
Accountancy firm EIN | 2014-01-31 | 522385296 |
2013 : MFOW WELFARE FUND 2013 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2013-01-31 | $-48,428 |
Total unrealized appreciation/depreciation of assets | 2013-01-31 | $-48,428 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-01-31 | $290,987 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-01-31 | $276,090 |
Total income from all sources (including contributions) | 2013-01-31 | $4,738,853 |
Total loss/gain on sale of assets | 2013-01-31 | $-111,230 |
Total of all expenses incurred | 2013-01-31 | $4,312,543 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-01-31 | $3,664,249 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-01-31 | $4,100,768 |
Value of total assets at end of year | 2013-01-31 | $14,464,353 |
Value of total assets at beginning of year | 2013-01-31 | $14,023,146 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-01-31 | $648,294 |
Total interest from all sources | 2013-01-31 | $450,228 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-01-31 | No |
Administrative expenses professional fees incurred | 2013-01-31 | $88,897 |
Was this plan covered by a fidelity bond | 2013-01-31 | Yes |
Value of fidelity bond cover | 2013-01-31 | $500,000 |
If this is an individual account plan, was there a blackout period | 2013-01-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2013-01-31 | No |
Contributions received from participants | 2013-01-31 | $6,598 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-01-31 | $225,478 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-01-31 | $192,454 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2013-01-31 | $137,987 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2013-01-31 | $135,090 |
Other income not declared elsewhere | 2013-01-31 | $347,515 |
Administrative expenses (other) incurred | 2013-01-31 | $461,225 |
Total non interest bearing cash at end of year | 2013-01-31 | $233,118 |
Total non interest bearing cash at beginning of year | 2013-01-31 | $274,861 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-01-31 | No |
Value of net income/loss | 2013-01-31 | $426,310 |
Value of net assets at end of year (total assets less liabilities) | 2013-01-31 | $14,173,366 |
Value of net assets at beginning of year (total assets less liabilities) | 2013-01-31 | $13,747,056 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-01-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2013-01-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2013-01-31 | No |
Investment advisory and management fees | 2013-01-31 | $68,172 |
Income. Interest from US Government securities | 2013-01-31 | $217,948 |
Income. Interest from corporate debt instruments | 2013-01-31 | $229,812 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-01-31 | $2,298,326 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-01-31 | $2,208,219 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-01-31 | $2,208,219 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-01-31 | $2,468 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2013-01-31 | $1,986,303 |
Asset value of US Government securities at end of year | 2013-01-31 | $5,783,541 |
Asset value of US Government securities at beginning of year | 2013-01-31 | $6,284,183 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-01-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2013-01-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2013-01-31 | No |
Contributions received in cash from employer | 2013-01-31 | $4,094,170 |
Employer contributions (assets) at end of year | 2013-01-31 | $347,000 |
Employer contributions (assets) at beginning of year | 2013-01-31 | $362,000 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-01-31 | $1,677,946 |
Asset. Corporate debt instrument debt (other) at end of year | 2013-01-31 | $5,576,890 |
Asset. Corporate debt instrument debt (other) at beginning of year | 2013-01-31 | $4,701,429 |
Contract administrator fees | 2013-01-31 | $30,000 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2013-01-31 | No |
Liabilities. Value of benefit claims payable at end of year | 2013-01-31 | $153,000 |
Liabilities. Value of benefit claims payable at beginning of year | 2013-01-31 | $141,000 |
Did the plan have assets held for investment | 2013-01-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-01-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-01-31 | No |
Aggregate proceeds on sale of assets | 2013-01-31 | $8,717,033 |
Aggregate carrying amount (costs) on sale of assets | 2013-01-31 | $8,828,263 |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-01-31 | No |
Opinion of an independent qualified public accountant for this plan | 2013-01-31 | Unqualified |
Accountancy firm name | 2013-01-31 | LINDQUIST LLP |
Accountancy firm EIN | 2013-01-31 | 522385296 |
2012 : MFOW WELFARE FUND 2012 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2012-01-31 | $-17,521 |
Total unrealized appreciation/depreciation of assets | 2012-01-31 | $-17,521 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-01-31 | $276,090 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-01-31 | $342,513 |
Total income from all sources (including contributions) | 2012-01-31 | $4,624,271 |
Total loss/gain on sale of assets | 2012-01-31 | $-130,798 |
Total of all expenses incurred | 2012-01-31 | $3,953,386 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-01-31 | $3,331,314 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-01-31 | $4,032,069 |
Value of total assets at end of year | 2012-01-31 | $14,023,146 |
Value of total assets at beginning of year | 2012-01-31 | $13,418,684 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-01-31 | $622,072 |
Total interest from all sources | 2012-01-31 | $454,246 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-01-31 | No |
Administrative expenses professional fees incurred | 2012-01-31 | $111,050 |
Was this plan covered by a fidelity bond | 2012-01-31 | Yes |
Value of fidelity bond cover | 2012-01-31 | $500,000 |
If this is an individual account plan, was there a blackout period | 2012-01-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2012-01-31 | No |
Contributions received from participants | 2012-01-31 | $2,212 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-01-31 | $192,454 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-01-31 | $273,367 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2012-01-31 | $135,090 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2012-01-31 | $175,677 |
Other income not declared elsewhere | 2012-01-31 | $286,275 |
Administrative expenses (other) incurred | 2012-01-31 | $427,685 |
Liabilities. Value of operating payables at end of year | 2012-01-31 | $0 |
Liabilities. Value of operating payables at beginning of year | 2012-01-31 | $836 |
Total non interest bearing cash at end of year | 2012-01-31 | $274,861 |
Total non interest bearing cash at beginning of year | 2012-01-31 | $307,459 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-01-31 | No |
Value of net income/loss | 2012-01-31 | $670,885 |
Value of net assets at end of year (total assets less liabilities) | 2012-01-31 | $13,747,056 |
Value of net assets at beginning of year (total assets less liabilities) | 2012-01-31 | $13,076,171 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-01-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2012-01-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2012-01-31 | No |
Investment advisory and management fees | 2012-01-31 | $53,337 |
Income. Interest from US Government securities | 2012-01-31 | $226,710 |
Income. Interest from corporate debt instruments | 2012-01-31 | $224,720 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-01-31 | $2,208,219 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-01-31 | $1,930,915 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-01-31 | $1,930,915 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-01-31 | $2,816 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2012-01-31 | $1,804,323 |
Asset value of US Government securities at end of year | 2012-01-31 | $6,284,183 |
Asset value of US Government securities at beginning of year | 2012-01-31 | $5,827,598 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-01-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2012-01-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2012-01-31 | No |
Contributions received in cash from employer | 2012-01-31 | $4,029,857 |
Employer contributions (assets) at end of year | 2012-01-31 | $362,000 |
Employer contributions (assets) at beginning of year | 2012-01-31 | $332,000 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-01-31 | $1,526,991 |
Asset. Corporate debt instrument debt (other) at end of year | 2012-01-31 | $4,701,429 |
Asset. Corporate debt instrument debt (other) at beginning of year | 2012-01-31 | $4,747,345 |
Contract administrator fees | 2012-01-31 | $30,000 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2012-01-31 | No |
Liabilities. Value of benefit claims payable at end of year | 2012-01-31 | $141,000 |
Liabilities. Value of benefit claims payable at beginning of year | 2012-01-31 | $166,000 |
Did the plan have assets held for investment | 2012-01-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-01-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-01-31 | No |
Aggregate proceeds on sale of assets | 2012-01-31 | $14,256,130 |
Aggregate carrying amount (costs) on sale of assets | 2012-01-31 | $14,386,928 |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-01-31 | No |
Opinion of an independent qualified public accountant for this plan | 2012-01-31 | Unqualified |
Accountancy firm name | 2012-01-31 | LINDQUIST LLP |
Accountancy firm EIN | 2012-01-31 | 522385296 |
2011 : MFOW WELFARE FUND 2011 401k financial data |
---|
Unrealized appreciation/depreciation of other (non real estate) assets | 2011-01-31 | $-4,530 |
Total unrealized appreciation/depreciation of assets | 2011-01-31 | $-4,530 |
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-01-31 | $342,513 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-01-31 | $114,000 |
Total income from all sources (including contributions) | 2011-01-31 | $4,326,647 |
Total loss/gain on sale of assets | 2011-01-31 | $-113,918 |
Total of all expenses incurred | 2011-01-31 | $3,785,752 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-01-31 | $3,161,396 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-01-31 | $3,770,150 |
Value of total assets at end of year | 2011-01-31 | $13,418,684 |
Value of total assets at beginning of year | 2011-01-31 | $12,649,276 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-01-31 | $624,356 |
Total interest from all sources | 2011-01-31 | $472,919 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-01-31 | No |
Administrative expenses professional fees incurred | 2011-01-31 | $106,501 |
Was this plan covered by a fidelity bond | 2011-01-31 | Yes |
Value of fidelity bond cover | 2011-01-31 | $500,000 |
If this is an individual account plan, was there a blackout period | 2011-01-31 | No |
Were there any nonexempt tranactions with any party-in-interest | 2011-01-31 | No |
Contributions received from participants | 2011-01-31 | $12,918 |
Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-01-31 | $273,367 |
Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-01-31 | $227,337 |
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2011-01-31 | $175,677 |
Other income not declared elsewhere | 2011-01-31 | $202,026 |
Administrative expenses (other) incurred | 2011-01-31 | $422,670 |
Liabilities. Value of operating payables at end of year | 2011-01-31 | $836 |
Total non interest bearing cash at end of year | 2011-01-31 | $307,459 |
Total non interest bearing cash at beginning of year | 2011-01-31 | $182,430 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-01-31 | No |
Value of net income/loss | 2011-01-31 | $540,895 |
Value of net assets at end of year (total assets less liabilities) | 2011-01-31 | $13,076,171 |
Value of net assets at beginning of year (total assets less liabilities) | 2011-01-31 | $12,535,276 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-01-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2011-01-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2011-01-31 | No |
Investment advisory and management fees | 2011-01-31 | $67,685 |
Income. Interest from US Government securities | 2011-01-31 | $236,218 |
Income. Interest from corporate debt instruments | 2011-01-31 | $232,952 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-01-31 | $1,930,915 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-01-31 | $1,653,965 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-01-31 | $1,653,965 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-01-31 | $3,749 |
Expenses. Payments to insurance carriers foe the provision of benefits | 2011-01-31 | $1,610,351 |
Asset value of US Government securities at end of year | 2011-01-31 | $5,827,598 |
Asset value of US Government securities at beginning of year | 2011-01-31 | $5,706,853 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-01-31 | Yes |
Was there a failure to transmit to the plan any participant contributions | 2011-01-31 | No |
Has the plan failed to provide any benefit when due under the plan | 2011-01-31 | No |
Contributions received in cash from employer | 2011-01-31 | $3,757,232 |
Employer contributions (assets) at end of year | 2011-01-31 | $332,000 |
Employer contributions (assets) at beginning of year | 2011-01-31 | $285,000 |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-01-31 | $1,551,045 |
Asset. Corporate debt instrument debt (other) at end of year | 2011-01-31 | $4,747,345 |
Asset. Corporate debt instrument debt (other) at beginning of year | 2011-01-31 | $4,593,691 |
Contract administrator fees | 2011-01-31 | $27,500 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2011-01-31 | No |
Liabilities. Value of benefit claims payable at end of year | 2011-01-31 | $166,000 |
Liabilities. Value of benefit claims payable at beginning of year | 2011-01-31 | $114,000 |
Did the plan have assets held for investment | 2011-01-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-01-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-01-31 | No |
Aggregate proceeds on sale of assets | 2011-01-31 | $11,012,704 |
Aggregate carrying amount (costs) on sale of assets | 2011-01-31 | $11,126,622 |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-01-31 | No |
Opinion of an independent qualified public accountant for this plan | 2011-01-31 | Unqualified |
Accountancy firm name | 2011-01-31 | LINDQUIST LLP |
Accountancy firm EIN | 2011-01-31 | 522385296 |
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 20506 |
Policy instance | 3 |
Insurance contract or identification number | 20506 | Number of Individuals Covered | 213 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $466,508 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 282458 |
Policy instance | 1 |
Insurance contract or identification number | 282458 | Number of Individuals Covered | 361 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $145,065 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 282458 |
Policy instance | 2 |
Insurance contract or identification number | 282458 | Number of Individuals Covered | 367 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $21,659 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 711949 |
Policy instance | 10 |
Insurance contract or identification number | 711949 | Number of Individuals Covered | 194 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $70,600 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DENTAL HEALTH SERVICES OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47490 ) |
Policy contract number | W1034 |
Policy instance | 4 |
Insurance contract or identification number | W1034 | Number of Individuals Covered | 38 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $10,342 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 ) |
Policy contract number | N4367A, 57953A, |
Policy instance | 5 |
Insurance contract or identification number | N4367A, 57953A, | Number of Individuals Covered | 29 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $533,787 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 2311 |
Policy instance | 6 |
Insurance contract or identification number | 2311 | Number of Individuals Covered | 58 | Insurance policy start date | 2021-10-01 | Insurance policy end date | 2022-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $398,789 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1817 |
Policy instance | 7 |
Insurance contract or identification number | 1817 | Number of Individuals Covered | 10 | Insurance policy start date | 2021-10-01 | Insurance policy end date | 2022-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $105,864 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
Policy contract number | 0156000 |
Policy instance | 8 |
Insurance contract or identification number | 0156000 | Number of Individuals Covered | 36 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $412,963 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 102126-0000 |
Policy instance | 9 |
Insurance contract or identification number | 102126-0000 | Number of Individuals Covered | 163 | Insurance policy start date | 2021-10-01 | Insurance policy end date | 2022-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $1,297,718 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 282458 |
Policy instance | 1 |
Insurance contract or identification number | 282458 | Number of Individuals Covered | 349 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $144,534 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 282458 |
Policy instance | 2 |
Insurance contract or identification number | 282458 | Number of Individuals Covered | 198 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $414,855 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DENTAL HEALTH SERVICES OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47490 ) |
Policy contract number | W1034 |
Policy instance | 3 |
Insurance contract or identification number | W1034 | Number of Individuals Covered | 37 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $10,807 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 ) |
Policy contract number | N4367A, 57953A, |
Policy instance | 4 |
Insurance contract or identification number | N4367A, 57953A, | Number of Individuals Covered | 30 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $441,323 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 2311 |
Policy instance | 5 |
Insurance contract or identification number | 2311 | Number of Individuals Covered | 56 | Insurance policy start date | 2020-10-01 | Insurance policy end date | 2021-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $305,656 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
Policy contract number | 0156000 |
Policy instance | 7 |
Insurance contract or identification number | 0156000 | Number of Individuals Covered | 38 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $230,081 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 102126-0000 |
Policy instance | 8 |
Insurance contract or identification number | 102126-0000 | Number of Individuals Covered | 154 | Insurance policy start date | 2020-10-01 | Insurance policy end date | 2021-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $1,263,732 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 1178301 |
Policy instance | 9 |
Insurance contract or identification number | 1178301 | Number of Individuals Covered | 400 | Insurance policy start date | 2020-11-01 | Insurance policy end date | 2021-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | 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 Carrier | USD $220,571 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 711949 |
Policy instance | 10 |
Insurance contract or identification number | 711949 | Number of Individuals Covered | 184 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $67,235 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1817 |
Policy instance | 6 |
Insurance contract or identification number | 1817 | Number of Individuals Covered | 10 | Insurance policy start date | 2020-10-01 | Insurance policy end date | 2021-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $111,745 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1817 |
Policy instance | 7 |
Insurance contract or identification number | 1817 | Number of Individuals Covered | 9 | Insurance policy start date | 2019-10-01 | Insurance policy end date | 2020-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $98,174 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 2311 |
Policy instance | 3 |
Insurance contract or identification number | 2311 | Number of Individuals Covered | 50 | Insurance policy start date | 2019-10-01 | Insurance policy end date | 2020-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $338,947 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DENTAL HEALTH SERVICES OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47490 ) |
Policy contract number | W1034 |
Policy instance | 2 |
Insurance contract or identification number | W1034 | Number of Individuals Covered | 42 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,616 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 1178301 |
Policy instance | 1 |
Insurance contract or identification number | 1178301 | Number of Individuals Covered | 398 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $81,062 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
Policy contract number | 0156000 |
Policy instance | 4 |
Insurance contract or identification number | 0156000 | Number of Individuals Covered | 39 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $294,958 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 ) |
Policy contract number | N4367A,57953A, |
Policy instance | 5 |
Insurance contract or identification number | N4367A,57953A, | Number of Individuals Covered | 33 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $513,649 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 102126-0000 |
Policy instance | 6 |
Insurance contract or identification number | 102126-0000 | Number of Individuals Covered | 155 | Insurance policy start date | 2019-10-01 | Insurance policy end date | 2020-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,307,528 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 711949 |
Policy instance | 8 |
Insurance contract or identification number | 711949 | Number of Individuals Covered | 184 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $67,652 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 282458 |
Policy instance | 9 |
Insurance contract or identification number | 282458 | Number of Individuals Covered | 971 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $373,623 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 282458 |
Policy instance | 10 |
Insurance contract or identification number | 282458 | Number of Individuals Covered | 323 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $150,617 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 276595, 282458 |
Policy instance | 9 |
Insurance contract or identification number | 276595, 282458 | Number of Individuals Covered | 389 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $359,274 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 711949 |
Policy instance | 8 |
Insurance contract or identification number | 711949 | Number of Individuals Covered | 202 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $75,539 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1817 |
Policy instance | 7 |
Insurance contract or identification number | 1817 | Number of Individuals Covered | 10 | Insurance policy start date | 2018-10-01 | Insurance policy end date | 2019-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $106,387 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 ) |
Policy contract number | N4367A,57953A |
Policy instance | 5 |
Insurance contract or identification number | N4367A,57953A | Number of Individuals Covered | 33 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $525,883 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 102126-0000 |
Policy instance | 6 |
Insurance contract or identification number | 102126-0000 | Number of Individuals Covered | 178 | Insurance policy start date | 2018-10-01 | Insurance policy end date | 2019-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,210,652 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
Policy contract number | 0156000 |
Policy instance | 4 |
Insurance contract or identification number | 0156000 | Number of Individuals Covered | 42 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $286,509 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 2311 |
Policy instance | 3 |
Insurance contract or identification number | 2311 | Number of Individuals Covered | 51 | Insurance policy start date | 2018-10-01 | Insurance policy end date | 2019-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $315,936 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DENTAL HEALTH SERVICES OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47490 ) |
Policy contract number | W1034 |
Policy instance | 2 |
Insurance contract or identification number | W1034 | Number of Individuals Covered | 43 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,809 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 1178301 |
Policy instance | 1 |
Insurance contract or identification number | 1178301 | Number of Individuals Covered | 419 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $82,929 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 276595, 282458 |
Policy instance | 10 |
Insurance contract or identification number | 276595, 282458 | Number of Individuals Covered | 342 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $177,328 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 1178301 |
Policy instance | 1 |
Insurance contract or identification number | 1178301 | Number of Individuals Covered | 438 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2018-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $85,072 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 276595 |
Policy instance | 10 |
Insurance contract or identification number | 276595 | Number of Individuals Covered | 360 | Insurance policy start date | 2018-02-01 | Insurance policy end date | 2019-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $154,405 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 276595 |
Policy instance | 9 |
Insurance contract or identification number | 276595 | Number of Individuals Covered | 383 | Insurance policy start date | 2018-02-01 | Insurance policy end date | 2019-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $311,221 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 711949 |
Policy instance | 8 |
Insurance contract or identification number | 711949 | Number of Individuals Covered | 393 | Insurance policy start date | 2018-02-01 | Insurance policy end date | 2019-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $75,662 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1817 |
Policy instance | 7 |
Insurance contract or identification number | 1817 | Number of Individuals Covered | 7 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $43,686 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 102126-0000 |
Policy instance | 6 |
Insurance contract or identification number | 102126-0000 | Number of Individuals Covered | 162 | Insurance policy start date | 2017-10-01 | Insurance policy end date | 2018-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $1,146,544 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 ) |
Policy contract number | N4367A,57953A |
Policy instance | 5 |
Insurance contract or identification number | N4367A,57953A | Number of Individuals Covered | 38 | Insurance policy start date | 2018-02-01 | Insurance policy end date | 2019-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $602,135 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
Policy contract number | 0156000 |
Policy instance | 4 |
Insurance contract or identification number | 0156000 | Number of Individuals Covered | 43 | Insurance policy start date | 2018-02-01 | Insurance policy end date | 2019-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $265,283 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 2311 |
Policy instance | 3 |
Insurance contract or identification number | 2311 | Number of Individuals Covered | 51 | Insurance policy start date | 2017-10-01 | Insurance policy end date | 2018-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $322,734 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DENTAL HEALTH SERVICES OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47490 ) |
Policy contract number | W1034 |
Policy instance | 2 |
Insurance contract or identification number | W1034 | Number of Individuals Covered | 40 | Insurance policy start date | 2018-02-01 | Insurance policy end date | 2019-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,346 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DENTAL HEALTH SERVICES OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47490 ) |
Policy contract number | W1034 |
Policy instance | 2 |
Insurance contract or identification number | W1034 | Number of Individuals Covered | 39 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,195 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 2311 |
Policy instance | 3 |
Insurance contract or identification number | 2311 | Number of Individuals Covered | 44 | Insurance policy start date | 2016-10-01 | Insurance policy end date | 2017-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $238,623 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
Policy contract number | 0156000 |
Policy instance | 4 |
Insurance contract or identification number | 0156000 | Number of Individuals Covered | 43 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $66,599 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 ) |
Policy contract number | N4367A,57953A |
Policy instance | 5 |
Insurance contract or identification number | N4367A,57953A | Number of Individuals Covered | 47 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $629,961 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 102126-0000 |
Policy instance | 6 |
Insurance contract or identification number | 102126-0000 | Number of Individuals Covered | 158 | Insurance policy start date | 2016-10-01 | Insurance policy end date | 2017-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $1,071,915 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1817 |
Policy instance | 7 |
Insurance contract or identification number | 1817 | Number of Individuals Covered | 9 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $76,687 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 711949 |
Policy instance | 8 |
Insurance contract or identification number | 711949 | Number of Individuals Covered | 210 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $75,755 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 276595 |
Policy instance | 9 |
Insurance contract or identification number | 276595 | Number of Individuals Covered | 390 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $268,814 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 276595 |
Policy instance | 10 |
Insurance contract or identification number | 276595 | Number of Individuals Covered | 363 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $147,487 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 1178301 |
Policy instance | 1 |
Insurance contract or identification number | 1178301 | Number of Individuals Covered | 450 | Insurance policy start date | 2016-11-01 | Insurance policy end date | 2017-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $82,934 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1817 |
Policy instance | 7 |
Insurance contract or identification number | 1817 | Number of Individuals Covered | 6 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $56,794 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 276595 |
Policy instance | 10 |
Insurance contract or identification number | 276595 | Number of Individuals Covered | 390 | Insurance policy start date | 2015-02-01 | Insurance policy end date | 2016-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $185,275 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 276595 |
Policy instance | 9 |
Insurance contract or identification number | 276595 | Number of Individuals Covered | 442 | Insurance policy start date | 2015-02-01 | Insurance policy end date | 2016-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $220,040 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 711949 |
Policy instance | 8 |
Insurance contract or identification number | 711949 | Number of Individuals Covered | 194 | Insurance policy start date | 2015-02-01 | Insurance policy end date | 2016-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $68,005 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 102126-0000 |
Policy instance | 6 |
Insurance contract or identification number | 102126-0000 | Number of Individuals Covered | 139 | Insurance policy start date | 2014-10-01 | Insurance policy end date | 2015-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $829,952 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 1178301 |
Policy instance | 1 |
Insurance contract or identification number | 1178301 | Number of Individuals Covered | 456 | Insurance policy start date | 2015-02-01 | Insurance policy end date | 2016-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $77,899 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 ) |
Policy contract number | N4367A,57953A |
Policy instance | 5 |
Insurance contract or identification number | N4367A,57953A | Number of Individuals Covered | 51 | Insurance policy start date | 2015-02-01 | Insurance policy end date | 2016-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $553,138 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
Policy contract number | 0156000 |
Policy instance | 4 |
Insurance contract or identification number | 0156000 | Number of Individuals Covered | 48 | Insurance policy start date | 2015-02-01 | Insurance policy end date | 2016-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $257,275 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 2311 |
Policy instance | 3 |
Insurance contract or identification number | 2311 | Number of Individuals Covered | 35 | Insurance policy start date | 2014-10-01 | Insurance policy end date | 2015-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $218,373 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DENTAL HEALTH SERVICES OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47490 ) |
Policy contract number | W1034 |
Policy instance | 2 |
Insurance contract or identification number | W1034 | Number of Individuals Covered | 46 | Insurance policy start date | 2015-02-01 | Insurance policy end date | 2016-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $13,469 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 102126-0000 |
Policy instance | 6 |
Insurance contract or identification number | 102126-0000 | Number of Individuals Covered | 115 | Insurance policy start date | 2013-10-01 | Insurance policy end date | 2014-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $734,314 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1817 |
Policy instance | 7 |
Insurance contract or identification number | 1817 | Number of Individuals Covered | 8 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $61,992 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 711949 |
Policy instance | 8 |
Insurance contract or identification number | 711949 | Number of Individuals Covered | 168 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2015-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $59,256 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 276595 |
Policy instance | 9 |
Insurance contract or identification number | 276595 | Number of Individuals Covered | 381 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2015-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $187,984 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 ) |
Policy contract number | N4367A,57953A |
Policy instance | 5 |
Insurance contract or identification number | N4367A,57953A | Number of Individuals Covered | 45 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2015-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $536,072 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
Policy contract number | 0156000 |
Policy instance | 4 |
Insurance contract or identification number | 0156000 | Number of Individuals Covered | 46 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2015-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $226,368 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 2311 |
Policy instance | 3 |
Insurance contract or identification number | 2311 | Number of Individuals Covered | 34 | Insurance policy start date | 2013-10-01 | Insurance policy end date | 2014-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $176,696 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 276595 |
Policy instance | 10 |
Insurance contract or identification number | 276595 | Number of Individuals Covered | 425 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2015-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $208,747 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 1178301 |
Policy instance | 1 |
Insurance contract or identification number | 1178301 | Number of Individuals Covered | 440 | Insurance policy start date | 2013-11-01 | Insurance policy end date | 2014-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $71,415 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DENTAL HEALTH SERVICES OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47490 ) |
Policy contract number | W1034 |
Policy instance | 2 |
Insurance contract or identification number | W1034 | Number of Individuals Covered | 45 | Insurance policy start date | 2014-02-01 | Insurance policy end date | 2015-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,357 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 276595 |
Policy instance | 11 |
Insurance contract or identification number | 276595 | Number of Individuals Covered | 406 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $95,912 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DENTAL HEALTH SERVICES OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47490 ) |
Policy contract number | W1034 |
Policy instance | 2 |
Insurance contract or identification number | W1034 | Number of Individuals Covered | 42 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $13,039 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 2311 |
Policy instance | 3 |
Insurance contract or identification number | 2311 | Number of Individuals Covered | 32 | Insurance policy start date | 2012-10-01 | Insurance policy end date | 2013-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $157,730 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
Policy contract number | 0156000 |
Policy instance | 4 |
Insurance contract or identification number | 0156000 | Number of Individuals Covered | 41 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-01 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $209,189 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 ) |
Policy contract number | N4367A,57953A |
Policy instance | 5 |
Insurance contract or identification number | N4367A,57953A | Number of Individuals Covered | 50 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $549,066 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 102126-0000 |
Policy instance | 7 |
Insurance contract or identification number | 102126-0000 | Number of Individuals Covered | 114 | Insurance policy start date | 2012-10-01 | Insurance policy end date | 2013-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $756,035 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1817 |
Policy instance | 8 |
Insurance contract or identification number | 1817 | Number of Individuals Covered | 9 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $66,884 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 711949 |
Policy instance | 9 |
Insurance contract or identification number | 711949 | Number of Individuals Covered | 171 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $61,586 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
Policy contract number | 276595 |
Policy instance | 10 |
Insurance contract or identification number | 276595 | Number of Individuals Covered | 373 | Insurance policy start date | 2013-02-01 | Insurance policy end date | 2014-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $169,745 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 1178301 |
Policy instance | 1 |
Insurance contract or identification number | 1178301 | Number of Individuals Covered | 439 | Insurance policy start date | 2012-11-01 | Insurance policy end date | 2013-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $75,950 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
Policy contract number | 16-010074-000 |
Policy instance | 6 |
Insurance contract or identification number | 16-010074-000 | Number of Individuals Covered | 393 | Insurance policy start date | 2012-09-01 | Insurance policy end date | 2013-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $154,579 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 1178301 |
Policy instance | 1 |
Insurance contract or identification number | 1178301 | Number of Individuals Covered | 492 | Insurance policy start date | 2011-11-01 | Insurance policy end date | 2012-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $80,620 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DENTAL HEALTH SERVICES OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47490 ) |
Policy contract number | W1034 |
Policy instance | 2 |
Insurance contract or identification number | W1034 | Number of Individuals Covered | 45 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $14,482 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 2311 |
Policy instance | 3 |
Insurance contract or identification number | 2311 | Number of Individuals Covered | 129 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $149,842 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
Policy contract number | 0156000 |
Policy instance | 4 |
Insurance contract or identification number | 0156000 | Number of Individuals Covered | 42 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $223,414 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 ) |
Policy contract number | N4367A,57953A |
Policy instance | 5 |
Insurance contract or identification number | N4367A,57953A | Number of Individuals Covered | 57 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $515,113 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) |
Policy contract number | 16-010074-000 |
Policy instance | 6 |
Insurance contract or identification number | 16-010074-000 | Number of Individuals Covered | 337 | Insurance policy start date | 2011-09-01 | Insurance policy end date | 2012-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $75,272 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 102126-0000 |
Policy instance | 7 |
Insurance contract or identification number | 102126-0000 | Number of Individuals Covered | 33 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $744,175 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 711949 |
Policy instance | 9 |
Insurance contract or identification number | 711949 | Number of Individuals Covered | 183 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $64,851 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1817 |
Policy instance | 8 |
Insurance contract or identification number | 1817 | Number of Individuals Covered | 9 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $63,950 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 ) |
Policy contract number | N4367A,57953A |
Policy instance | 5 |
Insurance contract or identification number | N4367A,57953A | Number of Individuals Covered | 53 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $414,077 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 2311/10 |
Policy instance | 3 |
Insurance contract or identification number | 2311/10 | Number of Individuals Covered | 33 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $146,665 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 711949 |
Policy instance | 10 |
Insurance contract or identification number | 711949 | Number of Individuals Covered | 176 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $61,734 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1817 |
Policy instance | 9 |
Insurance contract or identification number | 1817 | Number of Individuals Covered | 9 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $56,515 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
MHN SERVICES (National Association of Insurance Commissioners NAIC id number: 52411 ) |
Policy contract number | 4549 |
Policy instance | 8 |
Insurance contract or identification number | 4549 | Number of Individuals Covered | 0 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2011-02-28 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | EAP PREMIUMS | Welfare Benefit Premiums Paid to Carrier | USD $256 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 102126-0000 |
Policy instance | 7 |
Insurance contract or identification number | 102126-0000 | Number of Individuals Covered | 122 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $665,951 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | P80263-3 |
Policy instance | 6 |
Insurance contract or identification number | P80263-3 | Number of Individuals Covered | 203 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $111,821 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
Policy contract number | 0156000 |
Policy instance | 4 |
Insurance contract or identification number | 0156000 | Number of Individuals Covered | 41 | Insurance policy start date | 2010-10-01 | Insurance policy end date | 2011-09-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $187,943 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DENTAL HEALTH SERVICES OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47490 ) |
Policy contract number | W1034 |
Policy instance | 2 |
Insurance contract or identification number | W1034 | Number of Individuals Covered | 39 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $13,157 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 1178301 |
Policy instance | 1 |
Insurance contract or identification number | 1178301 | Number of Individuals Covered | 501 | Insurance policy start date | 2010-11-01 | Insurance policy end date | 2011-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $89,088 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MHN SERVICES (National Association of Insurance Commissioners NAIC id number: 52411 ) |
Policy contract number | 4549 |
Policy instance | 8 |
Insurance contract or identification number | 4549 | Number of Individuals Covered | 250 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | EAP PREMIUMS | Welfare Benefit Premiums Paid to Carrier | USD $2,686 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 1178301 |
Policy instance | 1 |
Insurance contract or identification number | 1178301 | Number of Individuals Covered | 641 | Insurance policy start date | 2009-11-01 | Insurance policy end date | 2010-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $84,150 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DENTAL HEALTH SERVICES OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 47490 ) |
Policy contract number | W1034 |
Policy instance | 2 |
Insurance contract or identification number | W1034 | Number of Individuals Covered | 34 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,293 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 2311/10 |
Policy instance | 3 |
Insurance contract or identification number | 2311/10 | Number of Individuals Covered | 34 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $120,365 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) |
Policy contract number | 0156000 |
Policy instance | 4 |
Insurance contract or identification number | 0156000 | Number of Individuals Covered | 36 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $182,756 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | P80263-3 |
Policy instance | 6 |
Insurance contract or identification number | P80263-3 | Number of Individuals Covered | 195 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $136,231 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 ) |
Policy contract number | N4367A,57953A |
Policy instance | 5 |
Insurance contract or identification number | N4367A,57953A | Number of Individuals Covered | 48 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $384,456 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 711949 |
Policy instance | 10 |
Insurance contract or identification number | 711949 | Number of Individuals Covered | 172 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $59,983 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 102126-0000 |
Policy instance | 7 |
Insurance contract or identification number | 102126-0000 | Number of Individuals Covered | 124 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $572,206 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
Policy contract number | 1817 |
Policy instance | 9 |
Insurance contract or identification number | 1817 | Number of Individuals Covered | 7 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $56,525 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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