THE AEROSPACE CORPORATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan THE AEROSPACE RETIREE MEDICAL PLAN
| Measure | Date | Value |
|---|
| 2022 : THE AEROSPACE RETIREE MEDICAL PLAN 2022 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-09-30 | $8,343 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-09-30 | $11,674 |
| Total income from all sources (including contributions) | 2022-09-30 | $-29,547,521 |
| Total of all expenses incurred | 2022-09-30 | $12,735,382 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-09-30 | $12,690,509 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-09-30 | $6,273,167 |
| Value of total assets at end of year | 2022-09-30 | $170,814,438 |
| Value of total assets at beginning of year | 2022-09-30 | $213,100,672 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-09-30 | $44,873 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-09-30 | No |
| Was this plan covered by a fidelity bond | 2022-09-30 | Yes |
| Value of fidelity bond cover | 2022-09-30 | $10,000,000 |
| If this is an individual account plan, was there a blackout period | 2022-09-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2022-09-30 | No |
| Contributions received from participants | 2022-09-30 | $6,273,167 |
| Participant contributions at end of year | 2022-09-30 | $210,234 |
| Participant contributions at beginning of year | 2022-09-30 | $157,535 |
| Liabilities. Value of operating payables at end of year | 2022-09-30 | $8,343 |
| Liabilities. Value of operating payables at beginning of year | 2022-09-30 | $11,674 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-09-30 | No |
| Value of net income/loss | 2022-09-30 | $-42,282,903 |
| Value of net assets at end of year (total assets less liabilities) | 2022-09-30 | $170,806,095 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-09-30 | $213,088,998 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-09-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-09-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-09-30 | No |
| Investment advisory and management fees | 2022-09-30 | $44,873 |
| Value of interest in pooled separate accounts at end of year | 2022-09-30 | $0 |
| Value of interest in common/collective trusts at end of year | 2022-09-30 | $170,604,204 |
| Value of interest in common/collective trusts at beginning of year | 2022-09-30 | $212,943,137 |
| Net investment gain or loss from common/collective trusts | 2022-09-30 | $-35,820,688 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-09-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2022-09-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-09-30 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-09-30 | $12,690,509 |
| 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 | 2022-09-30 | No |
| Did the plan have assets held for investment | 2022-09-30 | 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 | 2022-09-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-09-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2022-09-30 | Unqualified |
| Accountancy firm name | 2022-09-30 | CROWE LLP |
| Accountancy firm EIN | 2022-09-30 | 350921680 |
| 2021 : THE AEROSPACE RETIREE MEDICAL PLAN 2021 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2021-09-30 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-09-30 | $11,674 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-09-30 | $10,881 |
| Total income from all sources (including contributions) | 2021-09-30 | $38,707,735 |
| Total loss/gain on sale of assets | 2021-09-30 | $0 |
| Total of all expenses incurred | 2021-09-30 | $13,054,366 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-09-30 | $13,006,752 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-09-30 | $6,380,875 |
| Value of total assets at end of year | 2021-09-30 | $213,100,672 |
| Value of total assets at beginning of year | 2021-09-30 | $187,446,510 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-09-30 | $47,614 |
| Total interest from all sources | 2021-09-30 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2021-09-30 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-09-30 | No |
| Was this plan covered by a fidelity bond | 2021-09-30 | Yes |
| Value of fidelity bond cover | 2021-09-30 | $10,000,000 |
| If this is an individual account plan, was there a blackout period | 2021-09-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2021-09-30 | No |
| Contributions received from participants | 2021-09-30 | $6,380,875 |
| Participant contributions at end of year | 2021-09-30 | $157,535 |
| Participant contributions at beginning of year | 2021-09-30 | $115,852 |
| Liabilities. Value of operating payables at end of year | 2021-09-30 | $11,674 |
| Liabilities. Value of operating payables at beginning of year | 2021-09-30 | $10,881 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-09-30 | No |
| Value of net income/loss | 2021-09-30 | $25,653,369 |
| Value of net assets at end of year (total assets less liabilities) | 2021-09-30 | $213,088,998 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-09-30 | $187,435,629 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-09-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-09-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-09-30 | No |
| Investment advisory and management fees | 2021-09-30 | $47,614 |
| Value of interest in common/collective trusts at end of year | 2021-09-30 | $212,943,137 |
| Value of interest in common/collective trusts at beginning of year | 2021-09-30 | $187,330,658 |
| Net investment gain or loss from common/collective trusts | 2021-09-30 | $32,326,860 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-09-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2021-09-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-09-30 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-09-30 | $13,006,752 |
| Did the plan have assets held for investment | 2021-09-30 | 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 | 2021-09-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-09-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2021-09-30 | Unqualified |
| Accountancy firm name | 2021-09-30 | CROWE LLP |
| Accountancy firm EIN | 2021-09-30 | 350921680 |
| 2020 : THE AEROSPACE RETIREE MEDICAL PLAN 2020 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-09-30 | $10,881 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-09-30 | $8,593 |
| Total income from all sources (including contributions) | 2020-09-30 | $26,617,923 |
| Total of all expenses incurred | 2020-09-30 | $14,051,592 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-09-30 | $14,007,764 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-09-30 | $6,156,782 |
| Value of total assets at end of year | 2020-09-30 | $187,446,511 |
| Value of total assets at beginning of year | 2020-09-30 | $174,877,892 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-09-30 | $43,828 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-09-30 | No |
| Was this plan covered by a fidelity bond | 2020-09-30 | Yes |
| Value of fidelity bond cover | 2020-09-30 | $10,000,000 |
| If this is an individual account plan, was there a blackout period | 2020-09-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-09-30 | No |
| Contributions received from participants | 2020-09-30 | $6,156,782 |
| Participant contributions at end of year | 2020-09-30 | $115,853 |
| Participant contributions at beginning of year | 2020-09-30 | $69,121 |
| Liabilities. Value of operating payables at end of year | 2020-09-30 | $10,881 |
| Liabilities. Value of operating payables at beginning of year | 2020-09-30 | $8,593 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-09-30 | No |
| Value of net income/loss | 2020-09-30 | $12,566,331 |
| Value of net assets at end of year (total assets less liabilities) | 2020-09-30 | $187,435,630 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-09-30 | $174,869,299 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-09-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-09-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-09-30 | No |
| Investment advisory and management fees | 2020-09-30 | $43,828 |
| Value of interest in pooled separate accounts at end of year | 2020-09-30 | $0 |
| Value of interest in common/collective trusts at end of year | 2020-09-30 | $187,330,658 |
| Value of interest in common/collective trusts at beginning of year | 2020-09-30 | $174,808,771 |
| Net investment gain or loss from common/collective trusts | 2020-09-30 | $20,461,141 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-09-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2020-09-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-09-30 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-09-30 | $14,007,764 |
| 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 | 2020-09-30 | No |
| Did the plan have assets held for investment | 2020-09-30 | 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 | 2020-09-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-09-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2020-09-30 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2020-09-30 | Disclaimer |
| Accountancy firm name | 2020-09-30 | CROWE LLP |
| Accountancy firm EIN | 2020-09-30 | 350921680 |
| 2019 : THE AEROSPACE RETIREE MEDICAL PLAN 2019 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-09-30 | $8,593 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-09-30 | $7,837 |
| Total income from all sources (including contributions) | 2019-09-30 | $15,149,042 |
| Total of all expenses incurred | 2019-09-30 | $13,234,752 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-09-30 | $13,192,334 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-09-30 | $5,842,675 |
| Value of total assets at end of year | 2019-09-30 | $174,877,892 |
| Value of total assets at beginning of year | 2019-09-30 | $172,962,846 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-09-30 | $42,418 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-09-30 | No |
| Was this plan covered by a fidelity bond | 2019-09-30 | Yes |
| Value of fidelity bond cover | 2019-09-30 | $10,000,000 |
| If this is an individual account plan, was there a blackout period | 2019-09-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-09-30 | No |
| Contributions received from participants | 2019-09-30 | $5,842,675 |
| Participant contributions at end of year | 2019-09-30 | $69,121 |
| Participant contributions at beginning of year | 2019-09-30 | $61,740 |
| Liabilities. Value of operating payables at end of year | 2019-09-30 | $8,593 |
| Liabilities. Value of operating payables at beginning of year | 2019-09-30 | $7,837 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-09-30 | No |
| Value of net income/loss | 2019-09-30 | $1,914,290 |
| Value of net assets at end of year (total assets less liabilities) | 2019-09-30 | $174,869,299 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-09-30 | $172,955,009 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-09-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-09-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-09-30 | No |
| Investment advisory and management fees | 2019-09-30 | $42,418 |
| Value of interest in pooled separate accounts at end of year | 2019-09-30 | $0 |
| Value of interest in common/collective trusts at end of year | 2019-09-30 | $174,808,771 |
| Value of interest in common/collective trusts at beginning of year | 2019-09-30 | $172,901,106 |
| Net investment gain or loss from common/collective trusts | 2019-09-30 | $9,306,367 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-09-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2019-09-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-09-30 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-09-30 | $13,192,334 |
| 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 | 2019-09-30 | No |
| Did the plan have assets held for investment | 2019-09-30 | 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 | 2019-09-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-09-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-09-30 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2019-09-30 | Disclaimer |
| Accountancy firm name | 2019-09-30 | CROWE LLP |
| Accountancy firm EIN | 2019-09-30 | 350921680 |
| 2018 : THE AEROSPACE RETIREE MEDICAL PLAN 2018 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2018-09-30 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-09-30 | $7,837 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-09-30 | $13,672 |
| Total income from all sources (including contributions) | 2018-09-30 | $19,176,455 |
| Total loss/gain on sale of assets | 2018-09-30 | $0 |
| Total of all expenses incurred | 2018-09-30 | $12,988,286 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-09-30 | $12,931,683 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-09-30 | $5,372,657 |
| Value of total assets at end of year | 2018-09-30 | $172,962,846 |
| Value of total assets at beginning of year | 2018-09-30 | $166,780,512 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-09-30 | $56,603 |
| Total interest from all sources | 2018-09-30 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2018-09-30 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-09-30 | No |
| Was this plan covered by a fidelity bond | 2018-09-30 | Yes |
| Value of fidelity bond cover | 2018-09-30 | $10,000,000 |
| If this is an individual account plan, was there a blackout period | 2018-09-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-09-30 | No |
| Contributions received from participants | 2018-09-30 | $5,372,657 |
| Participant contributions at end of year | 2018-09-30 | $61,740 |
| Liabilities. Value of operating payables at end of year | 2018-09-30 | $7,837 |
| Liabilities. Value of operating payables at beginning of year | 2018-09-30 | $13,672 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-09-30 | No |
| Value of net income/loss | 2018-09-30 | $6,188,169 |
| Value of net assets at end of year (total assets less liabilities) | 2018-09-30 | $172,955,009 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-09-30 | $166,766,840 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-09-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-09-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-09-30 | No |
| Investment advisory and management fees | 2018-09-30 | $56,603 |
| Value of interest in common/collective trusts at end of year | 2018-09-30 | $172,901,106 |
| Value of interest in common/collective trusts at beginning of year | 2018-09-30 | $166,780,512 |
| Net investment gain or loss from common/collective trusts | 2018-09-30 | $13,803,798 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-09-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2018-09-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-09-30 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-09-30 | $12,931,683 |
| Did the plan have assets held for investment | 2018-09-30 | 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 | 2018-09-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-09-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-09-30 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2018-09-30 | Disclaimer |
| Accountancy firm name | 2018-09-30 | CROWE LLP |
| Accountancy firm EIN | 2018-09-30 | 350921680 |
| 2017 : THE AEROSPACE RETIREE MEDICAL PLAN 2017 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-09-30 | $13,672 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-09-30 | $31,300 |
| Total income from all sources (including contributions) | 2017-09-30 | $23,049,895 |
| Total of all expenses incurred | 2017-09-30 | $12,791,380 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-09-30 | $12,733,600 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-09-30 | $5,586,852 |
| Value of total assets at end of year | 2017-09-30 | $166,780,512 |
| Value of total assets at beginning of year | 2017-09-30 | $156,539,625 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-09-30 | $57,780 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-09-30 | No |
| Was this plan covered by a fidelity bond | 2017-09-30 | Yes |
| Value of fidelity bond cover | 2017-09-30 | $10,000,000 |
| If this is an individual account plan, was there a blackout period | 2017-09-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-09-30 | No |
| Contributions received from participants | 2017-09-30 | $5,586,852 |
| Liabilities. Value of operating payables at end of year | 2017-09-30 | $13,672 |
| Liabilities. Value of operating payables at beginning of year | 2017-09-30 | $31,300 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-09-30 | No |
| Value of net income/loss | 2017-09-30 | $10,258,515 |
| Value of net assets at end of year (total assets less liabilities) | 2017-09-30 | $166,766,840 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-09-30 | $156,508,325 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-09-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-09-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-09-30 | No |
| Investment advisory and management fees | 2017-09-30 | $57,780 |
| Value of interest in common/collective trusts at end of year | 2017-09-30 | $166,780,512 |
| Value of interest in common/collective trusts at beginning of year | 2017-09-30 | $156,539,625 |
| Net investment gain or loss from common/collective trusts | 2017-09-30 | $17,463,043 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-09-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2017-09-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-09-30 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-09-30 | $12,733,600 |
| 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 | 2017-09-30 | No |
| Did the plan have assets held for investment | 2017-09-30 | 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 | 2017-09-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-09-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-09-30 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2017-09-30 | Disclaimer |
| Accountancy firm name | 2017-09-30 | CROWE HORWATH LLP |
| Accountancy firm EIN | 2017-09-30 | 350921680 |
| 2016 : THE AEROSPACE RETIREE MEDICAL PLAN 2016 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-09-30 | $31,300 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-09-30 | $40,121 |
| Total income from all sources (including contributions) | 2016-09-30 | $20,640,917 |
| Total of all expenses incurred | 2016-09-30 | $13,845,965 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-09-30 | $13,693,489 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-09-30 | $6,303,768 |
| Value of total assets at end of year | 2016-09-30 | $156,539,625 |
| Value of total assets at beginning of year | 2016-09-30 | $149,753,494 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-09-30 | $152,476 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-09-30 | No |
| Was this plan covered by a fidelity bond | 2016-09-30 | Yes |
| Value of fidelity bond cover | 2016-09-30 | $10,000,000 |
| If this is an individual account plan, was there a blackout period | 2016-09-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-09-30 | No |
| Contributions received from participants | 2016-09-30 | $6,303,768 |
| Participant contributions at beginning of year | 2016-09-30 | $168,104 |
| Liabilities. Value of operating payables at end of year | 2016-09-30 | $31,300 |
| Liabilities. Value of operating payables at beginning of year | 2016-09-30 | $40,121 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-09-30 | No |
| Value of net income/loss | 2016-09-30 | $6,794,952 |
| Value of net assets at end of year (total assets less liabilities) | 2016-09-30 | $156,508,325 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-09-30 | $149,713,373 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-09-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-09-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-09-30 | No |
| Investment advisory and management fees | 2016-09-30 | $152,476 |
| Value of interest in common/collective trusts at end of year | 2016-09-30 | $156,539,625 |
| Value of interest in common/collective trusts at beginning of year | 2016-09-30 | $149,585,390 |
| Net investment gain or loss from common/collective trusts | 2016-09-30 | $14,337,149 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-09-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2016-09-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-09-30 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-09-30 | $13,693,489 |
| Did the plan have assets held for investment | 2016-09-30 | 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 | 2016-09-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-09-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-09-30 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2016-09-30 | Disclaimer |
| Accountancy firm name | 2016-09-30 | CROWE HORWATH LLP |
| Accountancy firm EIN | 2016-09-30 | 350921680 |
| 2015 : THE AEROSPACE RETIREE MEDICAL PLAN 2015 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-09-30 | $40,121 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-09-30 | $39,951 |
| Total income from all sources (including contributions) | 2015-09-30 | $7,009,137 |
| Total of all expenses incurred | 2015-09-30 | $13,852,831 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-09-30 | $13,688,713 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-09-30 | $6,764,402 |
| Value of total assets at end of year | 2015-09-30 | $149,753,494 |
| Value of total assets at beginning of year | 2015-09-30 | $156,597,018 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-09-30 | $164,118 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-09-30 | No |
| Was this plan covered by a fidelity bond | 2015-09-30 | Yes |
| Value of fidelity bond cover | 2015-09-30 | $10,000,000 |
| If this is an individual account plan, was there a blackout period | 2015-09-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-09-30 | No |
| Contributions received from participants | 2015-09-30 | $6,764,402 |
| Participant contributions at end of year | 2015-09-30 | $168,104 |
| Participant contributions at beginning of year | 2015-09-30 | $134,369 |
| Liabilities. Value of operating payables at end of year | 2015-09-30 | $40,121 |
| Liabilities. Value of operating payables at beginning of year | 2015-09-30 | $39,951 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-09-30 | No |
| Value of net income/loss | 2015-09-30 | $-6,843,694 |
| Value of net assets at end of year (total assets less liabilities) | 2015-09-30 | $149,713,373 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-09-30 | $156,557,067 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-09-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-09-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-09-30 | No |
| Investment advisory and management fees | 2015-09-30 | $164,118 |
| Value of interest in master investment trust accounts at beginning of year | 2015-09-30 | $156,462,649 |
| Value of interest in common/collective trusts at end of year | 2015-09-30 | $149,585,390 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-09-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2015-09-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-09-30 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-09-30 | $13,688,713 |
| Did the plan have assets held for investment | 2015-09-30 | 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 | 2015-09-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-09-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-09-30 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2015-09-30 | Disclaimer |
| Accountancy firm name | 2015-09-30 | DELOITTE & TOUCHE LLP |
| Accountancy firm EIN | 2015-09-30 | 133891517 |
| 2014 : THE AEROSPACE RETIREE MEDICAL PLAN 2014 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-09-30 | $39,951 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-09-30 | $37,529 |
| Total income from all sources (including contributions) | 2014-09-30 | $23,324,118 |
| Total of all expenses incurred | 2014-09-30 | $14,360,969 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-09-30 | $14,202,940 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-09-30 | $7,443,332 |
| Value of total assets at end of year | 2014-09-30 | $156,597,018 |
| Value of total assets at beginning of year | 2014-09-30 | $147,631,447 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-09-30 | $158,029 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-09-30 | No |
| Was this plan covered by a fidelity bond | 2014-09-30 | Yes |
| Value of fidelity bond cover | 2014-09-30 | $10,000,000 |
| If this is an individual account plan, was there a blackout period | 2014-09-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-09-30 | No |
| Contributions received from participants | 2014-09-30 | $7,443,332 |
| Participant contributions at end of year | 2014-09-30 | $134,369 |
| Participant contributions at beginning of year | 2014-09-30 | $147,964 |
| Liabilities. Value of operating payables at end of year | 2014-09-30 | $39,951 |
| Liabilities. Value of operating payables at beginning of year | 2014-09-30 | $37,529 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-09-30 | No |
| Value of net income/loss | 2014-09-30 | $8,963,149 |
| Value of net assets at end of year (total assets less liabilities) | 2014-09-30 | $156,557,067 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-09-30 | $147,593,918 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-09-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-09-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-09-30 | No |
| Investment advisory and management fees | 2014-09-30 | $158,029 |
| Value of interest in master investment trust accounts at end of year | 2014-09-30 | $156,462,649 |
| Value of interest in master investment trust accounts at beginning of year | 2014-09-30 | $147,483,483 |
| Value of interest in common/collective trusts at end of year | 2014-09-30 | $0 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-09-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2014-09-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-09-30 | No |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-09-30 | $14,202,940 |
| Did the plan have assets held for investment | 2014-09-30 | 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 | 2014-09-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-09-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-09-30 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2014-09-30 | Disclaimer |
| Accountancy firm name | 2014-09-30 | DELOITTE & TOUCHE LLP |
| Accountancy firm EIN | 2014-09-30 | 133891517 |
| 2013 : THE AEROSPACE RETIREE MEDICAL PLAN 2013 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-09-30 | $37,529 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-09-30 | $34,266 |
| Total income from all sources (including contributions) | 2013-09-30 | $23,091,743 |
| Total of all expenses incurred | 2013-09-30 | $13,310,958 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-09-30 | $13,161,479 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-09-30 | $6,802,125 |
| Value of total assets at end of year | 2013-09-30 | $147,631,447 |
| Value of total assets at beginning of year | 2013-09-30 | $137,847,399 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-09-30 | $149,479 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-09-30 | No |
| Was this plan covered by a fidelity bond | 2013-09-30 | Yes |
| Value of fidelity bond cover | 2013-09-30 | $10,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2013-09-30 | No |
| Contributions received from participants | 2013-09-30 | $6,311,202 |
| Participant contributions at end of year | 2013-09-30 | $147,964 |
| Participant contributions at beginning of year | 2013-09-30 | $155,529 |
| Liabilities. Value of operating payables at end of year | 2013-09-30 | $37,529 |
| Liabilities. Value of operating payables at beginning of year | 2013-09-30 | $34,266 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-09-30 | No |
| Value of net income/loss | 2013-09-30 | $9,780,785 |
| Value of net assets at end of year (total assets less liabilities) | 2013-09-30 | $147,593,918 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-09-30 | $137,813,133 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-09-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-09-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-09-30 | No |
| Investment advisory and management fees | 2013-09-30 | $149,479 |
| Value of interest in master investment trust accounts at end of year | 2013-09-30 | $147,483,483 |
| Value of interest in master investment trust accounts at beginning of year | 2013-09-30 | $137,691,870 |
| Value of interest in common/collective trusts at end of year | 2013-09-30 | $0 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-09-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2013-09-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-09-30 | No |
| Contributions received in cash from employer | 2013-09-30 | $490,923 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-09-30 | $13,161,479 |
| Did the plan have assets held for investment | 2013-09-30 | 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 | 2013-09-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-09-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-09-30 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2013-09-30 | Disclaimer |
| Accountancy firm name | 2013-09-30 | DELOITTE & TOUCHE LLP |
| Accountancy firm EIN | 2013-09-30 | 133891517 |
| 2012 : THE AEROSPACE RETIREE MEDICAL PLAN 2012 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-09-30 | $34,266 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-09-30 | $56,010 |
| Total income from all sources (including contributions) | 2012-09-30 | $30,287,244 |
| Total of all expenses incurred | 2012-09-30 | $14,681,666 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-09-30 | $14,566,099 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-09-30 | $8,663,947 |
| Value of total assets at end of year | 2012-09-30 | $137,847,399 |
| Value of total assets at beginning of year | 2012-09-30 | $122,263,565 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-09-30 | $115,567 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-09-30 | No |
| Was this plan covered by a fidelity bond | 2012-09-30 | Yes |
| Value of fidelity bond cover | 2012-09-30 | $10,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2012-09-30 | No |
| Contributions received from participants | 2012-09-30 | $6,774,226 |
| Participant contributions at end of year | 2012-09-30 | $155,529 |
| Participant contributions at beginning of year | 2012-09-30 | $132,700 |
| Liabilities. Value of operating payables at end of year | 2012-09-30 | $34,266 |
| Liabilities. Value of operating payables at beginning of year | 2012-09-30 | $56,010 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-09-30 | No |
| Value of net income/loss | 2012-09-30 | $15,605,578 |
| Value of net assets at end of year (total assets less liabilities) | 2012-09-30 | $137,813,133 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-09-30 | $122,207,555 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-09-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-09-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-09-30 | No |
| Investment advisory and management fees | 2012-09-30 | $115,567 |
| Value of interest in master investment trust accounts at end of year | 2012-09-30 | $137,691,870 |
| Value of interest in master investment trust accounts at beginning of year | 2012-09-30 | $122,130,865 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-09-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2012-09-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-09-30 | No |
| Contributions received in cash from employer | 2012-09-30 | $1,889,721 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-09-30 | $14,566,099 |
| Did the plan have assets held for investment | 2012-09-30 | 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 | 2012-09-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-09-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-09-30 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2012-09-30 | Disclaimer |
| Accountancy firm name | 2012-09-30 | DELOITTE & TOUCHE LLP |
| Accountancy firm EIN | 2012-09-30 | 133891517 |
| 2011 : THE AEROSPACE RETIREE MEDICAL PLAN 2011 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-09-30 | $56,010 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-09-30 | $60,204 |
| Total income from all sources (including contributions) | 2011-09-30 | $15,735,212 |
| Total of all expenses incurred | 2011-09-30 | $12,603,901 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-09-30 | $12,603,901 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-09-30 | $13,382,346 |
| Value of total assets at end of year | 2011-09-30 | $122,263,565 |
| Value of total assets at beginning of year | 2011-09-30 | $119,136,448 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-09-30 | No |
| Was this plan covered by a fidelity bond | 2011-09-30 | Yes |
| Value of fidelity bond cover | 2011-09-30 | $10,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2011-09-30 | No |
| Contributions received from participants | 2011-09-30 | $7,738,416 |
| Participant contributions at end of year | 2011-09-30 | $132,700 |
| Participant contributions at beginning of year | 2011-09-30 | $83,626 |
| Liabilities. Value of operating payables at end of year | 2011-09-30 | $56,010 |
| Liabilities. Value of operating payables at beginning of year | 2011-09-30 | $60,204 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-09-30 | No |
| Value of net income/loss | 2011-09-30 | $3,131,311 |
| Value of net assets at end of year (total assets less liabilities) | 2011-09-30 | $122,207,555 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-09-30 | $119,076,244 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-09-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-09-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-09-30 | No |
| Value of interest in master investment trust accounts at end of year | 2011-09-30 | $122,130,865 |
| Value of interest in master investment trust accounts at beginning of year | 2011-09-30 | $119,052,822 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-09-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2011-09-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-09-30 | No |
| Contributions received in cash from employer | 2011-09-30 | $5,643,930 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-09-30 | $12,603,901 |
| Did the plan have assets held for investment | 2011-09-30 | 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 | 2011-09-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-09-30 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-09-30 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2011-09-30 | Disclaimer |
| Accountancy firm name | 2011-09-30 | DELOITTE & TOUCHE LLP |
| Accountancy firm EIN | 2011-09-30 | 133891517 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | BNM00011 |
| Policy instance | 7 |
| Insurance contract or identification number | BNM00011 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $26,556 | | 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 | 174151 |
| Policy instance | 1 |
| Insurance contract or identification number | 174151 | | Number of Individuals Covered | 1253 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,526,839 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 174151 |
| Policy instance | 2 |
| Insurance contract or identification number | 174151 | | Number of Individuals Covered | 129 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $445,837 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 ) |
| Policy contract number | 3283 |
| Policy instance | 3 |
| Insurance contract or identification number | 3283 | | Number of Individuals Covered | 37 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $160,732 | | 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 | 7698 |
| Policy instance | 4 |
| Insurance contract or identification number | 7698 | | Number of Individuals Covered | 29 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $97,203 | | 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 | 100232 |
| Policy instance | 5 |
| Insurance contract or identification number | 100232 | | Number of Individuals Covered | 436 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $1,595,118 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 0001834 |
| Policy instance | 6 |
| Insurance contract or identification number | 0001834 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,790 | | 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 | 174151 |
| Policy instance | 1 |
| Insurance contract or identification number | 174151 | | Number of Individuals Covered | 1319 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $8,861,809 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 174151 |
| Policy instance | 2 |
| Insurance contract or identification number | 174151 | | Number of Individuals Covered | 129 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $482,352 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 ) |
| Policy contract number | 3283 |
| Policy instance | 3 |
| Insurance contract or identification number | 3283 | | Number of Individuals Covered | 26 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $167,139 | | 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 | 7698 |
| Policy instance | 4 |
| Insurance contract or identification number | 7698 | | Number of Individuals Covered | 31 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $122,113 | | 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 | 100232 |
| Policy instance | 5 |
| Insurance contract or identification number | 100232 | | Number of Individuals Covered | 462 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $1,849,840 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MONUMENTAL LIFE (National Association of Insurance Commissioners NAIC id number: 66281 ) |
| Policy contract number | 0001834 |
| Policy instance | 6 |
| Insurance contract or identification number | 0001834 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $20,790 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | BNM00011 |
| Policy instance | 7 |
| Insurance contract or identification number | BNM00011 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $25,506 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | BNM00011 |
| Policy instance | 7 |
| Insurance contract or identification number | BNM00011 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $22,330 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MONUMENTAL LIFE (National Association of Insurance Commissioners NAIC id number: 66281 ) |
| Policy contract number | 0001834 |
| Policy instance | 6 |
| Insurance contract or identification number | 0001834 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,053 | | 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 | 100232 |
| Policy instance | 5 |
| Insurance contract or identification number | 100232 | | Number of Individuals Covered | 415 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $1,846,736 | | 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 | 7698 |
| Policy instance | 4 |
| Insurance contract or identification number | 7698 | | Number of Individuals Covered | 26 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $104,580 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 ) |
| Policy contract number | 3283 |
| Policy instance | 3 |
| Insurance contract or identification number | 3283 | | Number of Individuals Covered | 37 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $171,253 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 174151 |
| Policy instance | 2 |
| Insurance contract or identification number | 174151 | | Number of Individuals Covered | 123 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $585,334 | | 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 | 174151 |
| Policy instance | 1 |
| Insurance contract or identification number | 174151 | | Number of Individuals Covered | 1754 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,360,713 | | 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 | 174151 |
| Policy instance | 1 |
| Insurance contract or identification number | 174151 | | Number of Individuals Covered | 1235 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,291,836 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 174151 |
| Policy instance | 2 |
| Insurance contract or identification number | 174151 | | Number of Individuals Covered | 129 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $665,240 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 ) |
| Policy contract number | 3283 |
| Policy instance | 3 |
| Insurance contract or identification number | 3283 | | Number of Individuals Covered | 21 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $145,192 | | 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 | 7698 |
| Policy instance | 4 |
| Insurance contract or identification number | 7698 | | Number of Individuals Covered | 28 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $119,588 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MONUMENTAL LIFE (National Association of Insurance Commissioners NAIC id number: 66281 ) |
| Policy contract number | 0001834 |
| Policy instance | 6 |
| Insurance contract or identification number | 0001834 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,930 | | 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 | 100232 |
| Policy instance | 5 |
| Insurance contract or identification number | 100232 | | Number of Individuals Covered | 422 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $1,783,496 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | BNM00011 |
| Policy instance | 7 |
| Insurance contract or identification number | BNM00011 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $22,885 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 174151 |
| Policy instance | 2 |
| Insurance contract or identification number | 174151 | | Number of Individuals Covered | 132 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $899,442 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 ) |
| Policy contract number | 3283 |
| Policy instance | 3 |
| Insurance contract or identification number | 3283 | | Number of Individuals Covered | 19 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $134,105 | | 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 | 7698 |
| Policy instance | 4 |
| Insurance contract or identification number | 7698 | | Number of Individuals Covered | 29 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $123,318 | | 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 | 100232 |
| Policy instance | 5 |
| Insurance contract or identification number | 100232 | | Number of Individuals Covered | 395 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $1,406,625 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MONUMENTAL LIFE (National Association of Insurance Commissioners NAIC id number: 66281 ) |
| Policy contract number | 0001834 |
| Policy instance | 6 |
| Insurance contract or identification number | 0001834 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $16,240 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | BNM00011 |
| Policy instance | 7 |
| Insurance contract or identification number | BNM00011 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $19,457 | | 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 | 174151 |
| Policy instance | 1 |
| Insurance contract or identification number | 174151 | | Number of Individuals Covered | 1248 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $8,392,006 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
