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SDSU FOUNDATION HEALTH VEBA PLAN FOR POST RETIREMENT HEALTH CARE BENEFITS 401k Plan overview

Plan NameSDSU FOUNDATION HEALTH VEBA PLAN FOR POST RETIREMENT HEALTH CARE BENEFITS
Plan identification number 504

SDSU FOUNDATION HEALTH VEBA PLAN FOR POST RETIREMENT HEALTH CARE BENEFITS Benefits

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

401k Sponsoring company profile

SAN DIEGO STATE UNIVERSITY FOUNDATION has sponsored the creation of one or more 401k plans.

Company Name:SAN DIEGO STATE UNIVERSITY FOUNDATION
Employer identification number (EIN):956042721
NAIC Classification:611000

Additional information about SAN DIEGO STATE UNIVERSITY FOUNDATION

Jurisdiction of Incorporation: California Department of State
Incorporation Date: 0000-00-00
Company Identification Number: C0192019
Legal Registered Office Address: 5250 Campanile DriveSan DiegoCA92182-1947


United States of America (USA)

More information about SAN DIEGO STATE UNIVERSITY FOUNDATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SDSU FOUNDATION HEALTH VEBA PLAN FOR POST RETIREMENT HEALTH CARE BENEFITS

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042022-01-01
5042021-01-01

Plan Statistics for SDSU FOUNDATION HEALTH VEBA PLAN FOR POST RETIREMENT HEALTH CARE BENEFITS

401k plan membership statisitcs for SDSU FOUNDATION HEALTH VEBA PLAN FOR POST RETIREMENT HEALTH CARE BENEFITS

Measure Date Value
2022: SDSU FOUNDATION HEALTH VEBA PLAN FOR POST RETIREMENT HEALTH CARE BENEFITS 2022 401k membership
Total participants, beginning-of-year2022-01-0187
Total number of active participants reported on line 7a of the Form 55002022-01-010
Number of retired or separated participants receiving benefits2022-01-0183
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-0183
2021: SDSU FOUNDATION HEALTH VEBA PLAN FOR POST RETIREMENT HEALTH CARE BENEFITS 2021 401k membership
Total participants, beginning-of-year2021-01-0187
Total number of active participants reported on line 7a of the Form 55002021-01-010
Number of retired or separated participants receiving benefits2021-01-0187
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-0187

Financial Data on SDSU FOUNDATION HEALTH VEBA PLAN FOR POST RETIREMENT HEALTH CARE BENEFITS

Measure Date Value
2022 : SDSU FOUNDATION HEALTH VEBA PLAN FOR POST RETIREMENT HEALTH CARE BENEFITS 2022 401k financial data
Total plan liabilities at end of year2022-12-31$157,153
Total plan liabilities at beginning of year2022-12-31$158,502
Total income from all sources2022-12-31$-1,908,881
Expenses. Total of all expenses incurred2022-12-31$413,290
Benefits paid (including direct rollovers)2022-12-31$357,360
Total plan assets at end of year2022-12-31$12,915,097
Total plan assets at beginning of year2022-12-31$15,238,617
Value of fidelity bond covering the plan2022-12-31$15,000,000
Total contributions received or receivable from participants2022-12-31$74,105
Other income received2022-12-31$-1,930,235
Net income (gross income less expenses)2022-12-31$-2,322,171
Net plan assets at end of year (total assets less liabilities)2022-12-31$12,757,944
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$15,080,115
Total contributions received or receivable from employer(s)2022-12-31$-52,751
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$55,930
2021 : SDSU FOUNDATION HEALTH VEBA PLAN FOR POST RETIREMENT HEALTH CARE BENEFITS 2021 401k financial data
Transfers to/from the plan2021-12-31$13,957,346
Total plan liabilities at end of year2021-12-31$158,502
Total plan liabilities at beginning of year2021-12-31$0
Total income from all sources2021-12-31$1,506,881
Expenses. Total of all expenses incurred2021-12-31$384,112
Benefits paid (including direct rollovers)2021-12-31$299,133
Total plan assets at end of year2021-12-31$15,238,617
Total plan assets at beginning of year2021-12-31$0
Value of fidelity bond covering the plan2021-12-31$15,000,000
Total contributions received or receivable from participants2021-12-31$64,200
Other income received2021-12-31$1,463,398
Net income (gross income less expenses)2021-12-31$1,122,769
Net plan assets at end of year (total assets less liabilities)2021-12-31$15,080,115
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$0
Total contributions received or receivable from employer(s)2021-12-31$-20,717
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$84,979

Form 5500 Responses for SDSU FOUNDATION HEALTH VEBA PLAN FOR POST RETIREMENT HEALTH CARE BENEFITS

2022: SDSU FOUNDATION HEALTH VEBA PLAN FOR POST RETIREMENT HEALTH CARE BENEFITS 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: SDSU FOUNDATION HEALTH VEBA PLAN FOR POST RETIREMENT HEALTH CARE BENEFITS 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01First time form 5500 has been submittedYes
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3341296
Policy instance 1
Insurance contract or identification number3341296
Number of Individuals Covered87
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,660
Total amount of fees paid to insurance companyUSD $56
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $66,478
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,364
Amount paid for insurance broker fees56
Additional information about fees paid to insurance brokerSERVICE/GENERAL AGENT PAYMENTS
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number104306
Policy instance 2
Insurance contract or identification number104306
Number of Individuals Covered72
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $735
Total amount of fees paid to insurance companyUSD $14
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $227,678
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $735
Amount paid for insurance broker fees14
Additional information about fees paid to insurance brokerBONUS COMMISSIONS
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3341296
Policy instance 1
Insurance contract or identification number3341296
Number of Individuals Covered87
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,544
Total amount of fees paid to insurance companyUSD $2
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $61,804
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,268
Amount paid for insurance broker fees2
Additional information about fees paid to insurance brokerSERVICE/GENERAL AGENT PAYMENTS
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number104306
Policy instance 2
Insurance contract or identification number104306
Number of Individuals Covered72
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $634
Total amount of fees paid to insurance companyUSD $42
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $210,506
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $634
Amount paid for insurance broker fees42
Additional information about fees paid to insurance brokerBONUS COMMISSIONS
Insurance broker organization code?3

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