401k Plan data: TONY'S EXPRESS INC BENEFIT PLAN plan

TONY'S EXPRESS INC BENEFIT PLAN 401k Plan overview

Plan Name	TONY'S EXPRESS INC BENEFIT PLAN
Plan identification number	501

TONY'S EXPRESS INC BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Other welfare benefit cover

401k Sponsoring company profile

TONY'S EXPRESS INC has sponsored the creation of one or more 401k plans.

Company Name: TONY'S EXPRESS INC

Employer identification number (EIN): 952392469

NAIC Classification: 484110
NAIC Description: General Freight Trucking, Local

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TONY'S EXPRESS INC BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2021-01-01
501 2020-01-01
501 2019-01-01
501 2018-01-01
501 2017-01-01 GEORGE RALUY
501 2016-01-01 GEORGE RALUY
501 2015-01-01 GEORGE RALUY
501 2014-01-01 GEORGE RALUY
501 2013-01-01 GEORGE RALUY
501 2012-01-01 GEORGE RALUY
501 2011-01-01 GEORGE RALUY
501 2010-01-01 GEORGE RALUY
501 2009-01-01 GEORGE RALUY

Plan Statistics for TONY'S EXPRESS INC BENEFIT PLAN

401k plan membership statisitcs for TONY'S EXPRESS INC BENEFIT PLAN

Measure Date Value
2021: TONY'S EXPRESS INC BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 214
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 201
Total of all active and inactive participants 2021-01-01 201
Total participants 2021-01-01 201
2020: TONY'S EXPRESS INC BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 210
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 214
Total of all active and inactive participants 2020-01-01 214
Total participants 2020-01-01 214
2019: TONY'S EXPRESS INC BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 202
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 210
Total of all active and inactive participants 2019-01-01 210
Total participants 2019-01-01 210
Number of participants with account balances 2019-01-01 0
2018: TONY'S EXPRESS INC BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 202
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 202
Total of all active and inactive participants 2018-01-01 202
Total participants 2018-01-01 202
2017: TONY'S EXPRESS INC BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 206
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 202
Total of all active and inactive participants 2017-01-01 202
Total participants 2017-01-01 202
2016: TONY'S EXPRESS INC BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 188
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 206
Total of all active and inactive participants 2016-01-01 206
Total participants 2016-01-01 206
2015: TONY'S EXPRESS INC BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 171
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 188
Total of all active and inactive participants 2015-01-01 188
Total participants 2015-01-01 0
2014: TONY'S EXPRESS INC BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 165
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 171
Total of all active and inactive participants 2014-01-01 171
Total participants 2014-01-01 0
2013: TONY'S EXPRESS INC BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 159
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 165
Total of all active and inactive participants 2013-01-01 165
Total participants 2013-01-01 0
2012: TONY'S EXPRESS INC BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 156
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 159
Total of all active and inactive participants 2012-01-01 159
Total participants 2012-01-01 0
2011: TONY'S EXPRESS INC BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 151
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 156
Total of all active and inactive participants 2011-01-01 156
Total participants 2011-01-01 156
2010: TONY'S EXPRESS INC BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 154
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 151
Total of all active and inactive participants 2010-01-01 151
Total participants 2010-01-01 151
2009: TONY'S EXPRESS INC BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 156
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 154
Total of all active and inactive participants 2009-01-01 154
Total participants 2009-01-01 154

Measure	Date	Value
2021: TONY'S EXPRESS INC BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	214
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	201
Total of all active and inactive participants	2021-01-01	201
Total participants	2021-01-01	201
2020: TONY'S EXPRESS INC BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	210
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	214
Total of all active and inactive participants	2020-01-01	214
Total participants	2020-01-01	214
2019: TONY'S EXPRESS INC BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	202
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	210
Total of all active and inactive participants	2019-01-01	210
Total participants	2019-01-01	210
Number of participants with account balances	2019-01-01	0
2018: TONY'S EXPRESS INC BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	202
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	202
Total of all active and inactive participants	2018-01-01	202
Total participants	2018-01-01	202
2017: TONY'S EXPRESS INC BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	206
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	202
Total of all active and inactive participants	2017-01-01	202
Total participants	2017-01-01	202
2016: TONY'S EXPRESS INC BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	188
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	206
Total of all active and inactive participants	2016-01-01	206
Total participants	2016-01-01	206
2015: TONY'S EXPRESS INC BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	171
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	188
Total of all active and inactive participants	2015-01-01	188
Total participants	2015-01-01	0
2014: TONY'S EXPRESS INC BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	165
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	171
Total of all active and inactive participants	2014-01-01	171
Total participants	2014-01-01	0
2013: TONY'S EXPRESS INC BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	159
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	165
Total of all active and inactive participants	2013-01-01	165
Total participants	2013-01-01	0
2012: TONY'S EXPRESS INC BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	156
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	159
Total of all active and inactive participants	2012-01-01	159
Total participants	2012-01-01	0
2011: TONY'S EXPRESS INC BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	151
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	156
Total of all active and inactive participants	2011-01-01	156
Total participants	2011-01-01	156
2010: TONY'S EXPRESS INC BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	154
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	151
Total of all active and inactive participants	2010-01-01	151
Total participants	2010-01-01	151
2009: TONY'S EXPRESS INC BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	156
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	154
Total of all active and inactive participants	2009-01-01	154
Total participants	2009-01-01	154

Form 5500 Responses for TONY'S EXPRESS INC BENEFIT PLAN

2021: TONY'S EXPRESS INC BENEFIT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: TONY'S EXPRESS INC BENEFIT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: TONY'S EXPRESS INC BENEFIT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: TONY'S EXPRESS INC BENEFIT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: TONY'S EXPRESS INC BENEFIT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: TONY'S EXPRESS INC BENEFIT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: TONY'S EXPRESS INC BENEFIT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: TONY'S EXPRESS INC BENEFIT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: TONY'S EXPRESS INC BENEFIT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: TONY'S EXPRESS INC BENEFIT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: TONY'S EXPRESS INC BENEFIT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: TONY'S EXPRESS INC BENEFIT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: TONY'S EXPRESS INC BENEFIT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12003222

Policy instance

Insurance contract or identification number	12003222
Number of Individuals Covered	148
Insurance policy start date	2020-08-01
Insurance policy end date	2021-07-31
Total amount of commissions paid to insurance broker	USD $1,842
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $50,159
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,842
Insurance broker organization code?	3

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000AQAP

Policy instance

Insurance contract or identification number	G000AQAP
Number of Individuals Covered	201
Insurance policy start date	2020-08-01
Insurance policy end date	2021-07-31
Total amount of commissions paid to insurance broker	USD $21,281
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $304,577
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $21,281
Insurance broker organization code?	3

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

228953&602576

Policy instance

Insurance contract or identification number	228953&602576
Number of Individuals Covered	188
Insurance policy start date	2020-08-01
Insurance policy end date	2021-07-31
Total amount of commissions paid to insurance broker	USD $49,585
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,653,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $49,585
Insurance broker organization code?	3

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

228953&602576

Policy instance

Insurance contract or identification number	228953&602576
Number of Individuals Covered	199
Insurance policy start date	2019-08-01
Insurance policy end date	2020-07-31
Total amount of commissions paid to insurance broker	USD $48,706
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,475,562
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $48,706
Insurance broker organization code?	3

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000AQAP

Policy instance

Insurance contract or identification number	G000AQAP
Number of Individuals Covered	214
Insurance policy start date	2019-08-01
Insurance policy end date	2020-07-31
Total amount of commissions paid to insurance broker	USD $22,363
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $319,032
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,363
Insurance broker organization code?	3

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12003222

Policy instance

Insurance contract or identification number	12003222
Number of Individuals Covered	161
Insurance policy start date	2019-08-01
Insurance policy end date	2020-07-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $50,653
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

228953&602576

Policy instance

Insurance contract or identification number	228953&602576
Number of Individuals Covered	199
Insurance policy start date	2018-08-01
Insurance policy end date	2019-07-31
Total amount of commissions paid to insurance broker	USD $52,895
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,524,187
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $52,895
Insurance broker organization code?	3

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12003222

Policy instance

Insurance contract or identification number	12003222
Number of Individuals Covered	152
Insurance policy start date	2018-08-01
Insurance policy end date	2019-07-31
Total amount of commissions paid to insurance broker	USD $1,821
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $47,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,821
Insurance broker organization code?	3

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000AQAP

Policy instance

Insurance contract or identification number	G000AQAP
Number of Individuals Covered	210
Insurance policy start date	2018-08-01
Insurance policy end date	2019-07-31
Total amount of commissions paid to insurance broker	USD $21,906
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $312,938
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $21,906
Insurance broker organization code?	3

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

228953&602576

Policy instance

Insurance contract or identification number	228953&602576
Number of Individuals Covered	189
Insurance policy start date	2017-08-01
Insurance policy end date	2018-07-31
Total amount of commissions paid to insurance broker	USD $48,826
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,380,367
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $48,826
Insurance broker organization code?	3

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000AQAP

Policy instance

Insurance contract or identification number	G000AQAP
Number of Individuals Covered	202
Insurance policy start date	2017-08-01
Insurance policy end date	2018-07-31
Total amount of commissions paid to insurance broker	USD $21,977
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $315,969
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $21,977
Insurance broker organization code?	3

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12003222

Policy instance

Insurance contract or identification number	12003222
Number of Individuals Covered	144
Insurance policy start date	2017-08-01
Insurance policy end date	2018-07-31
Total amount of commissions paid to insurance broker	USD $1,805
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $47,763
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,805
Insurance broker organization code?	3

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

228953&602576

Policy instance

Insurance contract or identification number	228953&602576
Number of Individuals Covered	191
Insurance policy start date	2016-08-01
Insurance policy end date	2017-07-31
Total amount of commissions paid to insurance broker	USD $47,712
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,383,961
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $47,712
Insurance broker organization code?	3
Insurance broker name	ARK INSURANCE SVC INC

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000AQAP

Policy instance

Insurance contract or identification number	G000AQAP
Number of Individuals Covered	202
Insurance policy start date	2016-08-01
Insurance policy end date	2017-07-31
Total amount of commissions paid to insurance broker	USD $22,667
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $327,405
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,667
Additional information about fees paid to insurance broker	SERVICE FEE
Insurance broker organization code?	3
Insurance broker name	ARK INSURANCE SVC INC

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12003222

Policy instance

Insurance contract or identification number	12003222
Number of Individuals Covered	147
Insurance policy start date	2016-08-01
Insurance policy end date	2017-07-31
Total amount of commissions paid to insurance broker	USD $1,812
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $47,990
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,812
Insurance broker organization code?	3
Insurance broker name	ARK INSURANCE SERVICES, INC

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12003222

Policy instance

Insurance contract or identification number	12003222
Number of Individuals Covered	132
Insurance policy start date	2014-08-01
Insurance policy end date	2015-07-31
Total amount of commissions paid to insurance broker	USD $1,658
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $40,857
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,658
Insurance broker organization code?	3
Insurance broker name	ARK INSURANCE SERVICES, INC

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000AQAP

Policy instance

Insurance contract or identification number	G000AQAP
Number of Individuals Covered	188
Insurance policy start date	2014-08-01
Insurance policy end date	2015-07-31
Total amount of commissions paid to insurance broker	USD $11,215
Total amount of fees paid to insurance company	USD $1,539
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $204,414
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,215
Amount paid for insurance broker fees	1539
Additional information about fees paid to insurance broker	SERVICE FEE
Insurance broker organization code?	3
Insurance broker name	ARK INSURANCE SVC INC

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

228953&602576

Policy instance

Insurance contract or identification number	228953&602576
Number of Individuals Covered	170
Insurance policy start date	2014-08-01
Insurance policy end date	2015-07-31
Total amount of commissions paid to insurance broker	USD $38,119
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,110,884
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $38,119
Insurance broker organization code?	3
Insurance broker name	ARK INSURANCE SVC INC

AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 )

Policy contract number

36042

Policy instance

Insurance contract or identification number	36042
Number of Individuals Covered	2
Insurance policy start date	2014-08-01
Insurance policy end date	2015-07-31
Total amount of commissions paid to insurance broker	USD $206
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $6,513
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $206
Insurance broker organization code?	3
Insurance broker name	CA TRUCKING ASSN

AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 )

Policy contract number

36042

Policy instance

Insurance contract or identification number	36042
Number of Individuals Covered	94
Insurance policy start date	2013-08-01
Insurance policy end date	2014-07-31
Total amount of commissions paid to insurance broker	USD $2,216
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $72,235
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,216
Insurance broker organization code?	3
Insurance broker name	CA TRUCKING ASSN

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12003222

Policy instance

Insurance contract or identification number	12003222
Number of Individuals Covered	127
Insurance policy start date	2013-08-01
Insurance policy end date	2014-07-31
Total amount of commissions paid to insurance broker	USD $1,610
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $37,831
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,610
Insurance broker organization code?	3
Insurance broker name	ARK INSURANCE SERVICES, INC

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

228953&602576

Policy instance

Insurance contract or identification number	228953&602576
Number of Individuals Covered	166
Insurance policy start date	2013-08-01
Insurance policy end date	2014-07-31
Total amount of commissions paid to insurance broker	USD $31,011
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $881,798
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $31,011
Insurance broker organization code?	3
Insurance broker name	ARK INSURANCE SVC INC

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000AQAP

Policy instance

Insurance contract or identification number	G000AQAP
Number of Individuals Covered	171
Insurance policy start date	2013-08-01
Insurance policy end date	2014-07-31
Total amount of commissions paid to insurance broker	USD $7,926
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $150,851
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,926
Insurance broker organization code?	3
Insurance broker name	ARK INSURANCE SVC INC

AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 )

Policy contract number

36042

Policy instance

Insurance contract or identification number	36042
Number of Individuals Covered	86
Insurance policy start date	2012-08-01
Insurance policy end date	2013-07-31
Total amount of commissions paid to insurance broker	USD $3,062
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $70,774
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,035
Insurance broker organization code?	3
Insurance broker name	ARK INSURANCE SVC INC

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12003222

Policy instance

Insurance contract or identification number	12003222
Number of Individuals Covered	115
Insurance policy start date	2012-08-01
Insurance policy end date	2013-07-31
Total amount of commissions paid to insurance broker	USD $1,549
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $35,992
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,246
Insurance broker organization code?	3
Insurance broker name	ARK INSURANCE SERVICES, INC

SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )

Policy contract number

049-4082-00

Policy instance

Insurance contract or identification number	049-4082-00
Number of Individuals Covered	165
Insurance policy start date	2012-08-01
Insurance policy end date	2013-07-31
Total amount of commissions paid to insurance broker	USD $5,062
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $152,241
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,062
Insurance broker organization code?	3
Insurance broker name	ALLEN LAWRENCE & ASSOCIATES, INC

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

228953&602576

Policy instance

Insurance contract or identification number	228953&602576
Number of Individuals Covered	186
Insurance policy start date	2012-08-01
Insurance policy end date	2013-07-31
Total amount of commissions paid to insurance broker	USD $39,486
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $799,951
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $39,486
Insurance broker organization code?	3
Insurance broker name	ALLEN LAWRENCE & ASSOCIATES INC

AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 )

Policy contract number

36042

Policy instance

Insurance contract or identification number	36042
Number of Individuals Covered	92
Insurance policy start date	2011-08-01
Insurance policy end date	2012-07-31
Total amount of commissions paid to insurance broker	USD $2,589
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $59,726
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,589
Insurance broker organization code?	3
Insurance broker name	ALLEN LAWRENCE & ASSOCIATES, INC

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12003222

Policy instance

Insurance contract or identification number	12003222
Number of Individuals Covered	109
Insurance policy start date	2011-08-01
Insurance policy end date	2012-07-31
Total amount of commissions paid to insurance broker	USD $1,544
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $35,013
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,544
Insurance broker organization code?	3
Insurance broker name	ALLEN LAWRENCE & ASSOCIATES INC

SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )

Policy contract number

049-4082-00

Policy instance

Insurance contract or identification number	049-4082-00
Number of Individuals Covered	159
Insurance policy start date	2011-08-01
Insurance policy end date	2012-08-01
Total amount of commissions paid to insurance broker	USD $5,147
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $162,191
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,147
Insurance broker organization code?	3
Insurance broker name	ALLEN LAWRENCE & ASSOCIATES, INC

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

228953&602576

Policy instance

Insurance contract or identification number	228953&602576
Number of Individuals Covered	142
Insurance policy start date	2011-08-01
Insurance policy end date	2012-07-31
Total amount of commissions paid to insurance broker	USD $44,882
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $716,107
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $44,882
Insurance broker organization code?	3
Insurance broker name	ALLEN LAWRENCE & ASSOCIATES INC

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

228953&602576

Policy instance

Insurance contract or identification number	228953&602576
Number of Individuals Covered	135
Insurance policy start date	2010-08-01
Insurance policy end date	2011-07-31
Total amount of commissions paid to insurance broker	USD $27,455
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $627,843
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )

Policy contract number

049-4082-00

Policy instance

Insurance contract or identification number	049-4082-00
Number of Individuals Covered	156
Insurance policy start date	2010-08-01
Insurance policy end date	2011-08-01
Total amount of commissions paid to insurance broker	USD $5,030
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $153,211
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12003222

Policy instance

Insurance contract or identification number	12003222
Number of Individuals Covered	100
Insurance policy start date	2010-08-01
Insurance policy end date	2011-07-31
Total amount of commissions paid to insurance broker	USD $1,437
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $31,363
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 )

Policy contract number

36042

Policy instance

Insurance contract or identification number	36042
Number of Individuals Covered	91
Insurance policy start date	2010-08-01
Insurance policy end date	2011-07-31
Total amount of commissions paid to insurance broker	USD $2,052
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $54,367
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 )

Policy contract number

36042

Policy instance

Insurance contract or identification number	36042
Number of Individuals Covered	94
Insurance policy start date	2009-08-01
Insurance policy end date	2010-07-31
Total amount of commissions paid to insurance broker	USD $160
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $54,861
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $160
Insurance broker organization code?	3
Insurance broker name	ALLEN LAWRENCE & ASSOCIATES, INC

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

12003222

Policy instance

Insurance contract or identification number	12003222
Number of Individuals Covered	108
Insurance policy start date	2009-08-01
Insurance policy end date	2010-07-31
Total amount of commissions paid to insurance broker	USD $1,486
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $33,351
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,486
Insurance broker organization code?	3
Insurance broker name	ALLEN LAWRENCE & ASSOCIATES INC

SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )

Policy contract number

049-4082-00

Policy instance

Insurance contract or identification number	049-4082-00
Number of Individuals Covered	151
Insurance policy start date	2009-08-01
Insurance policy end date	2010-08-01
Total amount of commissions paid to insurance broker	USD $4,810
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $150,632
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,810
Insurance broker organization code?	3
Insurance broker name	ALLEN LAWRENCE & ASSOCIATES, INC

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

228953&602576

Policy instance

Insurance contract or identification number	228953&602576
Number of Individuals Covered	136
Insurance policy start date	2009-08-01
Insurance policy end date	2010-07-31
Total amount of commissions paid to insurance broker	USD $50,474
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $842,855
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $50,474
Insurance broker organization code?	3
Insurance broker name	ALLEN LAWRENCE & ASSOCIATES INC

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Company Name:	TONY'S EXPRESS INC
Employer identification number (EIN):	952392469
NAIC Classification:	484110
NAIC Description:	General Freight Trucking, Local