TOYOTA MOTOR NORTH AMERICA, INC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan TOYOTA MOTOR SALES, U.S.A., INC. POST-RETIREMENT MEDICAL PROGRAM
401k plan membership statisitcs for TOYOTA MOTOR SALES, U.S.A., INC. POST-RETIREMENT MEDICAL PROGRAM
| Measure | Date | Value |
|---|
| 2022 : TOYOTA MOTOR SALES, U.S.A., INC. POST-RETIREMENT MEDICAL PROGRAM 2022 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2022-12-31 | $-42,594,259 |
| Total unrealized appreciation/depreciation of assets | 2022-12-31 | $-42,594,259 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $12,687,476 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $12,462,635 |
| Total income from all sources (including contributions) | 2022-12-31 | $-9,760,359 |
| Total loss/gain on sale of assets | 2022-12-31 | $-6,916,897 |
| Total of all expenses incurred | 2022-12-31 | $34,961,109 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $32,719,750 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-12-31 | $34,844,704 |
| Value of total assets at end of year | 2022-12-31 | $235,752,909 |
| Value of total assets at beginning of year | 2022-12-31 | $280,249,536 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $2,241,359 |
| Total interest from all sources | 2022-12-31 | $1,995,621 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-12-31 | $2,774,992 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2022-12-31 | $36,504 |
| Administrative expenses professional fees incurred | 2022-12-31 | $53,980 |
| Was this plan covered by a fidelity bond | 2022-12-31 | Yes |
| Value of fidelity bond cover | 2022-12-31 | $5,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
| Assets. Other investments not covered elsewhere at end of year | 2022-12-31 | $66,880,168 |
| Assets. Other investments not covered elsewhere at beginning of year | 2022-12-31 | $73,154,245 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2022-12-31 | $5,138,792 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2022-12-31 | $726,000 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-12-31 | $1,062,066 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-12-31 | $902,814 |
| Other income not declared elsewhere | 2022-12-31 | $135,480 |
| Administrative expenses (other) incurred | 2022-12-31 | $2,187,379 |
| Liabilities. Value of operating payables at end of year | 2022-12-31 | $38,430 |
| Liabilities. Value of operating payables at beginning of year | 2022-12-31 | $273,229 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Value of net income/loss | 2022-12-31 | $-44,721,468 |
| Value of net assets at end of year (total assets less liabilities) | 2022-12-31 | $223,065,433 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-12-31 | $267,786,901 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-12-31 | $3,314,767 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-12-31 | $3,627,616 |
| Interest earned on other investments | 2022-12-31 | $1,995,621 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-12-31 | $518,101 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2022-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
| Contributions received in cash from employer | 2022-12-31 | $29,705,912 |
| Income. Dividends from common stock | 2022-12-31 | $2,738,488 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-12-31 | $31,475,649 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2022-12-31 | $164,495,908 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2022-12-31 | $202,564,861 |
| Liabilities. Value of benefit claims payable at end of year | 2022-12-31 | $12,649,046 |
| Liabilities. Value of benefit claims payable at beginning of year | 2022-12-31 | $12,189,406 |
| Did the plan have assets held for investment | 2022-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-12-31 | No |
| Aggregate proceeds on sale of assets | 2022-12-31 | $43,834,099 |
| Aggregate carrying amount (costs) on sale of assets | 2022-12-31 | $50,750,996 |
| Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
| Accountancy firm name | 2022-12-31 | MOSS ADAMS, LLP |
| Accountancy firm EIN | 2022-12-31 | 910189318 |
| 2021 : TOYOTA MOTOR SALES, U.S.A., INC. POST-RETIREMENT MEDICAL PROGRAM 2021 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2021-12-31 | $42,914,277 |
| Total unrealized appreciation/depreciation of assets | 2021-12-31 | $42,914,277 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $12,462,635 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $9,980,014 |
| Total income from all sources (including contributions) | 2021-12-31 | $86,592,922 |
| Total loss/gain on sale of assets | 2021-12-31 | $601,428 |
| Total of all expenses incurred | 2021-12-31 | $29,432,390 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $26,357,654 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-12-31 | $37,799,248 |
| Value of total assets at end of year | 2021-12-31 | $280,249,536 |
| Value of total assets at beginning of year | 2021-12-31 | $220,606,383 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $3,074,736 |
| Total interest from all sources | 2021-12-31 | $2,482,520 |
| Total dividends received (eg from common stock, registered investment company shares) | 2021-12-31 | $2,514,341 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2021-12-31 | $522 |
| Administrative expenses professional fees incurred | 2021-12-31 | $468,593 |
| Was this plan covered by a fidelity bond | 2021-12-31 | Yes |
| Value of fidelity bond cover | 2021-12-31 | $5,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
| Assets. Other investments not covered elsewhere at end of year | 2021-12-31 | $73,154,245 |
| Assets. Other investments not covered elsewhere at beginning of year | 2021-12-31 | $56,402,374 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2021-12-31 | $5,243,537 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2021-12-31 | $143,000 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-12-31 | $902,814 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-12-31 | $742,098 |
| Other income not declared elsewhere | 2021-12-31 | $281,108 |
| Administrative expenses (other) incurred | 2021-12-31 | $2,606,143 |
| Liabilities. Value of operating payables at end of year | 2021-12-31 | $273,229 |
| Liabilities. Value of operating payables at beginning of year | 2021-12-31 | $245,519 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Value of net income/loss | 2021-12-31 | $57,160,532 |
| Value of net assets at end of year (total assets less liabilities) | 2021-12-31 | $267,786,901 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-12-31 | $210,626,369 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-12-31 | $3,627,616 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-12-31 | $811,049 |
| Interest earned on other investments | 2021-12-31 | $2,482,520 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-12-31 | $401,954 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2021-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
| Contributions received in cash from employer | 2021-12-31 | $32,555,711 |
| Income. Dividends from common stock | 2021-12-31 | $2,513,819 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-12-31 | $25,812,700 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2021-12-31 | $202,564,861 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2021-12-31 | $162,650,862 |
| Liabilities. Value of benefit claims payable at end of year | 2021-12-31 | $12,189,406 |
| Liabilities. Value of benefit claims payable at beginning of year | 2021-12-31 | $9,734,495 |
| Did the plan have assets held for investment | 2021-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-12-31 | No |
| Aggregate proceeds on sale of assets | 2021-12-31 | $33,683,875 |
| Aggregate carrying amount (costs) on sale of assets | 2021-12-31 | $33,082,447 |
| Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
| Accountancy firm name | 2021-12-31 | MOSS ADAMS LLP |
| Accountancy firm EIN | 2021-12-31 | 910189318 |
| 2020 : TOYOTA MOTOR SALES, U.S.A., INC. POST-RETIREMENT MEDICAL PROGRAM 2020 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2020-12-31 | $30,488,785 |
| Total unrealized appreciation/depreciation of assets | 2020-12-31 | $30,488,785 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $9,980,014 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $9,650,498 |
| Total income from all sources (including contributions) | 2020-12-31 | $42,613,963 |
| Total loss/gain on sale of assets | 2020-12-31 | $-7,381,676 |
| Total of all expenses incurred | 2020-12-31 | $25,874,306 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $23,095,996 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-12-31 | $14,704,501 |
| Value of total assets at end of year | 2020-12-31 | $220,606,383 |
| Value of total assets at beginning of year | 2020-12-31 | $203,537,210 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $2,778,310 |
| Total interest from all sources | 2020-12-31 | $2,094,185 |
| Total dividends received (eg from common stock, registered investment company shares) | 2020-12-31 | $2,550,052 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2020-12-31 | $10,115 |
| Administrative expenses professional fees incurred | 2020-12-31 | $416,905 |
| Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
| Value of fidelity bond cover | 2020-12-31 | $5,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
| Assets. Other investments not covered elsewhere at end of year | 2020-12-31 | $56,402,374 |
| Assets. Other investments not covered elsewhere at beginning of year | 2020-12-31 | $54,565,294 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2020-12-31 | $4,662,487 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2020-12-31 | $288,000 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-12-31 | $742,098 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-12-31 | $813,324 |
| Other income not declared elsewhere | 2020-12-31 | $158,116 |
| Administrative expenses (other) incurred | 2020-12-31 | $2,361,405 |
| Liabilities. Value of operating payables at end of year | 2020-12-31 | $245,519 |
| Liabilities. Value of operating payables at beginning of year | 2020-12-31 | $230,888 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Value of net income/loss | 2020-12-31 | $16,739,657 |
| Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $210,626,369 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $193,886,712 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-12-31 | $811,049 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-12-31 | $2,429,496 |
| Interest earned on other investments | 2020-12-31 | $2,094,185 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-12-31 | $1,412,748 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
| Contributions received in cash from employer | 2020-12-31 | $10,042,014 |
| Income. Dividends from common stock | 2020-12-31 | $2,539,937 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-12-31 | $21,395,248 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2020-12-31 | $162,650,862 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2020-12-31 | $145,729,096 |
| Liabilities. Value of benefit claims payable at end of year | 2020-12-31 | $9,734,495 |
| Liabilities. Value of benefit claims payable at beginning of year | 2020-12-31 | $9,419,610 |
| Did the plan have assets held for investment | 2020-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
| Aggregate proceeds on sale of assets | 2020-12-31 | $39,176,835 |
| Aggregate carrying amount (costs) on sale of assets | 2020-12-31 | $46,558,511 |
| Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Unqualified |
| Accountancy firm name | 2020-12-31 | MOSS ADAMS LLP |
| Accountancy firm EIN | 2020-12-31 | 910189318 |
| 2019 : TOYOTA MOTOR SALES, U.S.A., INC. POST-RETIREMENT MEDICAL PROGRAM 2019 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-12-31 | $35,171,715 |
| Total unrealized appreciation/depreciation of assets | 2019-12-31 | $35,171,715 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $9,650,498 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $9,668,264 |
| Total income from all sources (including contributions) | 2019-12-31 | $54,334,772 |
| Total loss/gain on sale of assets | 2019-12-31 | $1,706,229 |
| Total of all expenses incurred | 2019-12-31 | $23,790,928 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $20,790,696 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $12,611,086 |
| Value of total assets at end of year | 2019-12-31 | $203,537,210 |
| Value of total assets at beginning of year | 2019-12-31 | $173,011,132 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $3,000,232 |
| Total interest from all sources | 2019-12-31 | $2,082,159 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-12-31 | $2,589,501 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2019-12-31 | $74,591 |
| Administrative expenses professional fees incurred | 2019-12-31 | $391,264 |
| Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
| Value of fidelity bond cover | 2019-12-31 | $50,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Assets. Other investments not covered elsewhere at end of year | 2019-12-31 | $54,565,294 |
| Assets. Other investments not covered elsewhere at beginning of year | 2019-12-31 | $51,156,394 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2019-12-31 | $3,837,689 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2019-12-31 | $103,000 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-12-31 | $813,324 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $786,569 |
| Other income not declared elsewhere | 2019-12-31 | $174,082 |
| Administrative expenses (other) incurred | 2019-12-31 | $2,608,968 |
| Liabilities. Value of operating payables at end of year | 2019-12-31 | $230,888 |
| Liabilities. Value of operating payables at beginning of year | 2019-12-31 | $118,852 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Value of net income/loss | 2019-12-31 | $30,543,844 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $193,886,712 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $163,342,868 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-12-31 | $2,429,496 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-12-31 | $2,344,946 |
| Interest earned on other investments | 2019-12-31 | $2,082,159 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $1,016,999 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Contributions received in cash from employer | 2019-12-31 | $8,773,397 |
| Income. Dividends from common stock | 2019-12-31 | $2,514,910 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $19,670,697 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2019-12-31 | $145,729,096 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2019-12-31 | $118,723,223 |
| Liabilities. Value of benefit claims payable at end of year | 2019-12-31 | $9,419,610 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-12-31 | $9,549,412 |
| Did the plan have assets held for investment | 2019-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
| Aggregate proceeds on sale of assets | 2019-12-31 | $35,981,697 |
| Aggregate carrying amount (costs) on sale of assets | 2019-12-31 | $34,275,468 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Disclaimer |
| Accountancy firm name | 2019-12-31 | MOSS ADAMS LLP |
| Accountancy firm EIN | 2019-12-31 | 910189318 |
| 2018 : TOYOTA MOTOR SALES, U.S.A., INC. POST-RETIREMENT MEDICAL PROGRAM 2018 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2018-12-31 | $-6,049,767 |
| Total unrealized appreciation/depreciation of assets | 2018-12-31 | $-6,049,767 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $9,668,264 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $8,505,220 |
| Total income from all sources (including contributions) | 2018-12-31 | $5,918,675 |
| Total loss/gain on sale of assets | 2018-12-31 | $-2,329,845 |
| Total of all expenses incurred | 2018-12-31 | $20,682,643 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $17,792,242 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $9,370,830 |
| Value of total assets at end of year | 2018-12-31 | $173,011,132 |
| Value of total assets at beginning of year | 2018-12-31 | $186,612,056 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $2,890,401 |
| Total interest from all sources | 2018-12-31 | $1,970,005 |
| Total dividends received (eg from common stock, registered investment company shares) | 2018-12-31 | $2,651,985 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2018-12-31 | $66,603 |
| Administrative expenses professional fees incurred | 2018-12-31 | $431,111 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2018-12-31 | $133,521,103 |
| Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
| Value of fidelity bond cover | 2018-12-31 | $50,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
| Assets. Other investments not covered elsewhere at end of year | 2018-12-31 | $51,156,394 |
| Assets. Other investments not covered elsewhere at beginning of year | 2018-12-31 | $50,967,282 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2018-12-31 | $3,028,380 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2018-12-31 | $112,000 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-12-31 | $786,569 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-12-31 | $685,118 |
| Other income not declared elsewhere | 2018-12-31 | $305,467 |
| Administrative expenses (other) incurred | 2018-12-31 | $2,459,290 |
| Liabilities. Value of operating payables at end of year | 2018-12-31 | $118,852 |
| Liabilities. Value of operating payables at beginning of year | 2018-12-31 | $153,427 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Value of net income/loss | 2018-12-31 | $-14,763,968 |
| Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $163,342,868 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $178,106,836 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2018-12-31 | $2,344,946 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2018-12-31 | $1,438,553 |
| Interest earned on other investments | 2018-12-31 | $1,970,005 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $1,037,497 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2018-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
| Contributions received in cash from employer | 2018-12-31 | $6,342,450 |
| Income. Dividends from common stock | 2018-12-31 | $2,585,382 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-12-31 | $16,642,745 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2018-12-31 | $118,723,223 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2018-12-31 | $133,521,103 |
| Liabilities. Value of benefit claims payable at end of year | 2018-12-31 | $9,549,412 |
| Liabilities. Value of benefit claims payable at beginning of year | 2018-12-31 | $8,351,793 |
| Did the plan have assets held for investment | 2018-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-12-31 | No |
| Aggregate proceeds on sale of assets | 2018-12-31 | $46,040,959 |
| Aggregate carrying amount (costs) on sale of assets | 2018-12-31 | $48,370,804 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Disclaimer |
| Accountancy firm name | 2018-12-31 | MOSS ADAMS LLP |
| Accountancy firm EIN | 2018-12-31 | 910189318 |
| 2017 : TOYOTA MOTOR SALES, U.S.A., INC. POST-RETIREMENT MEDICAL PROGRAM 2017 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2017-12-31 | $23,808,681 |
| Total unrealized appreciation/depreciation of assets | 2017-12-31 | $23,808,681 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $8,505,220 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $9,769,951 |
| Total income from all sources (including contributions) | 2017-12-31 | $55,325,402 |
| Total loss/gain on sale of assets | 2017-12-31 | $-879,231 |
| Total of all expenses incurred | 2017-12-31 | $15,641,176 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $13,564,306 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $28,606,513 |
| Value of total assets at end of year | 2017-12-31 | $186,612,056 |
| Value of total assets at beginning of year | 2017-12-31 | $148,192,561 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $2,076,870 |
| Total interest from all sources | 2017-12-31 | $1,257,937 |
| Total dividends received (eg from common stock, registered investment company shares) | 2017-12-31 | $2,405,162 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2017-12-31 | $27,027 |
| Administrative expenses professional fees incurred | 2017-12-31 | $341,041 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2017-12-31 | $133,521,103 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2017-12-31 | $105,653,547 |
| Was this plan covered by a fidelity bond | 2017-12-31 | Yes |
| Value of fidelity bond cover | 2017-12-31 | $50,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
| Contributions received from participants | 2017-12-31 | $2,229,468 |
| Assets. Other investments not covered elsewhere at end of year | 2017-12-31 | $50,967,282 |
| Assets. Other investments not covered elsewhere at beginning of year | 2017-12-31 | $37,587,643 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2017-12-31 | $-266,000 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-12-31 | $685,118 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-12-31 | $596,822 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2017-12-31 | $2,339,027 |
| Other income not declared elsewhere | 2017-12-31 | $126,340 |
| Administrative expenses (other) incurred | 2017-12-31 | $1,735,829 |
| Liabilities. Value of operating payables at end of year | 2017-12-31 | $153,427 |
| Liabilities. Value of operating payables at beginning of year | 2017-12-31 | $159,613 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Value of net income/loss | 2017-12-31 | $39,684,226 |
| Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $178,106,836 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $138,422,610 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2017-12-31 | $1,438,553 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2017-12-31 | $4,354,549 |
| Interest earned on other investments | 2017-12-31 | $1,257,937 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $794,430 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2017-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
| Contributions received in cash from employer | 2017-12-31 | $26,377,045 |
| Income. Dividends from common stock | 2017-12-31 | $2,378,135 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-12-31 | $13,035,876 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2017-12-31 | $133,521,103 |
| Liabilities. Value of benefit claims payable at end of year | 2017-12-31 | $8,351,793 |
| Liabilities. Value of benefit claims payable at beginning of year | 2017-12-31 | $7,271,311 |
| Did the plan have assets held for investment | 2017-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-12-31 | No |
| Aggregate proceeds on sale of assets | 2017-12-31 | $42,878,602 |
| Aggregate carrying amount (costs) on sale of assets | 2017-12-31 | $43,757,833 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Disclaimer |
| Accountancy firm name | 2017-12-31 | MOSS ADAMS LLP |
| Accountancy firm EIN | 2017-12-31 | 910189318 |
| 2016 : TOYOTA MOTOR SALES, U.S.A., INC. POST-RETIREMENT MEDICAL PROGRAM 2016 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2016-12-31 | $9,855,231 |
| Total unrealized appreciation/depreciation of assets | 2016-12-31 | $9,855,231 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $9,769,951 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $4,296,195 |
| Total income from all sources (including contributions) | 2016-12-31 | $40,110,696 |
| Total loss/gain on sale of assets | 2016-12-31 | $-1,949,022 |
| Total of all expenses incurred | 2016-12-31 | $14,097,899 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $12,298,352 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $28,494,041 |
| Value of total assets at end of year | 2016-12-31 | $148,192,561 |
| Value of total assets at beginning of year | 2016-12-31 | $116,706,008 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $1,799,547 |
| Total interest from all sources | 2016-12-31 | $1,518,967 |
| Total dividends received (eg from common stock, registered investment company shares) | 2016-12-31 | $2,066,713 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2016-12-31 | $7,744 |
| Administrative expenses professional fees incurred | 2016-12-31 | $359,296 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2016-12-31 | $105,653,547 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2016-12-31 | $80,478,835 |
| Was this plan covered by a fidelity bond | 2016-12-31 | Yes |
| Value of fidelity bond cover | 2016-12-31 | $50,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
| Contributions received from participants | 2016-12-31 | $1,725,662 |
| Assets. Other investments not covered elsewhere at end of year | 2016-12-31 | $37,587,643 |
| Assets. Other investments not covered elsewhere at beginning of year | 2016-12-31 | $34,236,533 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2016-12-31 | $927,000 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-12-31 | $596,822 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-12-31 | $443,868 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2016-12-31 | $2,339,027 |
| Other income not declared elsewhere | 2016-12-31 | $124,766 |
| Administrative expenses (other) incurred | 2016-12-31 | $1,440,251 |
| Liabilities. Value of operating payables at end of year | 2016-12-31 | $159,613 |
| Liabilities. Value of operating payables at beginning of year | 2016-12-31 | $68,592 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Value of net income/loss | 2016-12-31 | $26,012,797 |
| Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $138,422,610 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $112,409,813 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2016-12-31 | $4,354,549 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2016-12-31 | $1,546,772 |
| Interest earned on other investments | 2016-12-31 | $1,518,967 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $750,941 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
| Contributions received in cash from employer | 2016-12-31 | $26,768,379 |
| Income. Dividends from common stock | 2016-12-31 | $2,058,969 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-12-31 | $10,620,411 |
| Liabilities. Value of benefit claims payable at end of year | 2016-12-31 | $7,271,311 |
| Liabilities. Value of benefit claims payable at beginning of year | 2016-12-31 | $4,227,603 |
| Did the plan have assets held for investment | 2016-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | No |
| Aggregate proceeds on sale of assets | 2016-12-31 | $51,095,301 |
| Aggregate carrying amount (costs) on sale of assets | 2016-12-31 | $53,044,323 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Disclaimer |
| Accountancy firm name | 2016-12-31 | MOSS ADAMS LLP |
| Accountancy firm EIN | 2016-12-31 | 910189318 |
| KAISER PERMANANETE (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 102560 |
| Policy instance | 3 |
| Insurance contract or identification number | 102560 | | Number of Individuals Covered | 110 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $831,416 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMPATHIA, INC. (National Association of Insurance Commissioners NAIC id number: 62419 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 221 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $5,039 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 1913 |
| Policy instance | 1 |
| Insurance contract or identification number | 1913 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,904 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 7840 |
| Policy instance | 4 |
| Insurance contract or identification number | 7840 | | Number of Individuals Covered | 31 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $491,538 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
| Policy contract number | 70045 |
| Policy instance | 5 |
| Insurance contract or identification number | 70045 | | Number of Individuals Covered | 943 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $47 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $3,021 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 47 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | | Insurance broker organization code? | 3 |
|
| SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
| Policy contract number | 70045 |
| Policy instance | 6 |
| Insurance contract or identification number | 70045 | | Number of Individuals Covered | 2901 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $12,617 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $814,634 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 12617 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | | Insurance broker organization code? | 3 |
|
| SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
| Policy contract number | 70046 |
| Policy instance | 7 |
| Insurance contract or identification number | 70046 | | Number of Individuals Covered | 145 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $382 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $23,865 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 382 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | | Insurance broker organization code? | 3 |
|
| KAISER PERMANANETE (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 102560 |
| Policy instance | 3 |
| Insurance contract or identification number | 102560 | | Number of Individuals Covered | 114 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $151,892 | | 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 | 7840 |
| Policy instance | 4 |
| Insurance contract or identification number | 7840 | | Number of Individuals Covered | 32 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $66,499 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 1913 |
| Policy instance | 1 |
| Insurance contract or identification number | 1913 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,600 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
| Policy contract number | 70045 |
| Policy instance | 5 |
| Insurance contract or identification number | 70045 | | Number of Individuals Covered | 676 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $58 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $3,337 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 58 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | | Insurance broker organization code? | 3 |
|
| SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
| Policy contract number | 70045 |
| Policy instance | 6 |
| Insurance contract or identification number | 70045 | | Number of Individuals Covered | 2791 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $15,807 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $909,702 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 15807 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | | Insurance broker organization code? | 3 |
|
| SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
| Policy contract number | 70046 |
| Policy instance | 7 |
| Insurance contract or identification number | 70046 | | Number of Individuals Covered | 188 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $517 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $29,156 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 517 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | | Insurance broker organization code? | 3 |
|
| EMPATHIA, INC. (National Association of Insurance Commissioners NAIC id number: 62419 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 222 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $4,729 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
| Policy contract number | 70045 |
| Policy instance | 6 |
| Insurance contract or identification number | 70045 | | Number of Individuals Covered | 2785 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $4,036 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $221,492 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 4036 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | | Insurance broker organization code? | 3 |
|
| KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 1913 |
| Policy instance | 1 |
| Insurance contract or identification number | 1913 | | Number of Individuals Covered | 80 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $651,832 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMPATHIA, INC. (National Association of Insurance Commissioners NAIC id number: 62419 ) |
| Policy contract number | |
| Policy instance | 2 |
| Number of Individuals Covered | 223 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $4,282 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER PERMANANETE (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 102560 |
| Policy instance | 3 |
| Insurance contract or identification number | 102560 | | Number of Individuals Covered | 71 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $810,925 | | 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 | 7840 |
| Policy instance | 4 |
| Insurance contract or identification number | 7840 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,913 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
| Policy contract number | 70045 |
| Policy instance | 5 |
| Insurance contract or identification number | 70045 | | Number of Individuals Covered | 585 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $67 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $3,689 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 67 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | | Insurance broker organization code? | 3 |
|
| SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
| Policy contract number | 70046 |
| Policy instance | 7 |
| Insurance contract or identification number | 70046 | | Number of Individuals Covered | 259 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $624 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $33,517 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 624 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | | Insurance broker organization code? | 3 |
|
| SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
| Policy contract number | 70046 |
| Policy instance | 7 |
| Insurance contract or identification number | 70046 | | Number of Individuals Covered | 283 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $769 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $35,687 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 769 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | | Insurance broker organization code? | 3 |
|
| SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
| Policy contract number | 70045 |
| Policy instance | 6 |
| Insurance contract or identification number | 70045 | | Number of Individuals Covered | 2638 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $4,718 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $217,959 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 4718 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | | Insurance broker organization code? | 3 |
|
| SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
| Policy contract number | 70045 |
| Policy instance | 5 |
| Insurance contract or identification number | 70045 | | Number of Individuals Covered | 308 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $76 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $3,506 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 76 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | | Insurance broker organization code? | 3 |
|
| KAISER PERMANANETE (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 102560 |
| Policy instance | 3 |
| Insurance contract or identification number | 102560 | | Number of Individuals Covered | 134 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,449,041 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMPATHIA, INC. (National Association of Insurance Commissioners NAIC id number: 62419 ) |
| Policy contract number | N/A |
| Policy instance | 2 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 199 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $3,802 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 1913 |
| Policy instance | 1 |
| Insurance contract or identification number | 1913 | | Number of Individuals Covered | 69 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $644,707 | | 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 | 7840 |
| Policy instance | 4 |
| Insurance contract or identification number | 7840 | | Number of Individuals Covered | 30 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $301,691 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
| Policy contract number | 70046 |
| Policy instance | 7 |
| Insurance contract or identification number | 70046 | | Number of Individuals Covered | 258 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $669 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $30,640 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 669 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | | Insurance broker organization code? | 3 |
|
| KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 1913 |
| Policy instance | 1 |
| Insurance contract or identification number | 1913 | | Number of Individuals Covered | 110 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,037,497 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMPATHIA, INC. (National Association of Insurance Commissioners NAIC id number: 62419 ) |
| Policy contract number | N/A |
| Policy instance | 2 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 189 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $3,610 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER PERMANANETE (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 102560 |
| Policy instance | 3 |
| Insurance contract or identification number | 102560 | | Number of Individuals Covered | 140 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $655,703 | | 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 | 7840 |
| Policy instance | 4 |
| Insurance contract or identification number | 7840 | | Number of Individuals Covered | 34 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $167,135 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
| Policy contract number | 70045 |
| Policy instance | 6 |
| Insurance contract or identification number | 70045 | | Number of Individuals Covered | 2403 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $4,344 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $188,753 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 4344 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | | Insurance broker organization code? | 3 |
|
| SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
| Policy contract number | 70045 |
| Policy instance | 5 |
| Insurance contract or identification number | 70045 | | Number of Individuals Covered | 253 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $67 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $2,899 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 67 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | | Insurance broker organization code? | 3 |
|
| SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
| Policy contract number | 70046 |
| Policy instance | 7 |
| Insurance contract or identification number | 70046 | | Number of Individuals Covered | 217 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $485 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $21,014 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 485 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | | Insurance broker organization code? | 3 |
|
| SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
| Policy contract number | 70045 |
| Policy instance | 6 |
| Insurance contract or identification number | 70045 | | Number of Individuals Covered | 2031 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $3,067 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $139,832 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 3067 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | | Insurance broker organization code? | 3 |
|
| SECURIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93742 ) |
| Policy contract number | 70045 |
| Policy instance | 5 |
| Insurance contract or identification number | 70045 | | Number of Individuals Covered | 215 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $56 | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $2,534 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 56 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | | Insurance broker organization code? | 3 |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 7840 |
| Policy instance | 4 |
| Insurance contract or identification number | 7840 | | Number of Individuals Covered | 30 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $157,062 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER PERMANANETE (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 102560 |
| Policy instance | 3 |
| Insurance contract or identification number | 102560 | | Number of Individuals Covered | 131 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $711,168 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMPATHIA, INC. (National Association of Insurance Commissioners NAIC id number: 62419 ) |
| Policy contract number | N/A |
| Policy instance | 2 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 199 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $3,821 | | 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 | 102560 |
| Policy instance | 2 |
| Insurance contract or identification number | 102560 | | Number of Individuals Covered | 1628 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,048,616 | | 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 | H56948 |
| Policy instance | 3 |
| Insurance contract or identification number | H56948 | | Number of Individuals Covered | 177 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $907,666 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) |
| Policy contract number | 1913 |
| Policy instance | 1 |
| Insurance contract or identification number | 1913 | | Number of Individuals Covered | 89 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $622,277 | | 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 | H56948 |
| Policy instance | 8 |
| Insurance contract or identification number | H56948 | | Number of Individuals Covered | 177 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $907,666 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
