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DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 401k Plan overview

Plan NameDAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST
Plan identification number 501

DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST Benefits

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

401k Sponsoring company profile

DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST has sponsored the creation of one or more 401k plans.

Company Name:DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST
Employer identification number (EIN):956043942
NAIC Classification:525100
NAIC Description: Insurance and Employee Benefit Funds

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-04-01ASCENCION MARQUEZ2023-02-13
5012020-04-01ASCENCION MARQUEZ2022-01-13
5012019-04-01ASCENCION MARQUEZ2020-11-03
5012018-04-01ASCENCION MARQUEZ2020-01-09
5012017-04-01
5012016-04-01
5012015-04-01
5012014-04-01
5012013-04-01
5012012-04-01ASCENCION MARQUEZ
5012011-04-01ASCENCION MARQUEZ
5012010-04-01ASCENCION MARQUEZ
5012009-04-01ASCENSION MARQUEZ

Plan Statistics for DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST

401k plan membership statisitcs for DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST

Measure Date Value
2021: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2021 401k membership
Total participants, beginning-of-year2021-04-0128
Total number of active participants reported on line 7a of the Form 55002021-04-0127
Total of all active and inactive participants2021-04-0127
Number of employers contributing to the scheme2021-04-0127
2020: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2020 401k membership
Total participants, beginning-of-year2020-04-0129
Total number of active participants reported on line 7a of the Form 55002020-04-0128
Total of all active and inactive participants2020-04-0128
Number of employers contributing to the scheme2020-04-0128
2019: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2019 401k membership
Total participants, beginning-of-year2019-04-0131
Total number of active participants reported on line 7a of the Form 55002019-04-0135
Total of all active and inactive participants2019-04-0135
Number of employers contributing to the scheme2019-04-0135
2018: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2018 401k membership
Total participants, beginning-of-year2018-04-0138
Total number of active participants reported on line 7a of the Form 55002018-04-0131
Total of all active and inactive participants2018-04-0131
Number of employers contributing to the scheme2018-04-0131
2017: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2017 401k membership
Total participants, beginning-of-year2017-04-0140
Total number of active participants reported on line 7a of the Form 55002017-04-0138
Total of all active and inactive participants2017-04-0138
Number of employers contributing to the scheme2017-04-0138
2016: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2016 401k membership
Total participants, beginning-of-year2016-04-0139
Total number of active participants reported on line 7a of the Form 55002016-04-0140
Total of all active and inactive participants2016-04-0140
Number of employers contributing to the scheme2016-04-0140
2015: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2015 401k membership
Total participants, beginning-of-year2015-04-0142
Total number of active participants reported on line 7a of the Form 55002015-04-0139
Total of all active and inactive participants2015-04-0139
Number of employers contributing to the scheme2015-04-0114
2014: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2014 401k membership
Total participants, beginning-of-year2014-04-0144
Total number of active participants reported on line 7a of the Form 55002014-04-0142
Total of all active and inactive participants2014-04-0142
Number of employers contributing to the scheme2014-04-0117
2013: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2013 401k membership
Total participants, beginning-of-year2013-04-0172
Total number of active participants reported on line 7a of the Form 55002013-04-0144
Total of all active and inactive participants2013-04-0144
Number of employers contributing to the scheme2013-04-0118
2012: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2012 401k membership
Total participants, beginning-of-year2012-04-0185
Total number of active participants reported on line 7a of the Form 55002012-04-0172
Total of all active and inactive participants2012-04-0172
Number of employers contributing to the scheme2012-04-0121
2011: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2011 401k membership
Total participants, beginning-of-year2011-04-0193
Total number of active participants reported on line 7a of the Form 55002011-04-0185
Total of all active and inactive participants2011-04-0185
Number of employers contributing to the scheme2011-04-0123
2010: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2010 401k membership
Total participants, beginning-of-year2010-04-01100
Total number of active participants reported on line 7a of the Form 55002010-04-0193
Total of all active and inactive participants2010-04-0193
Number of employers contributing to the scheme2010-04-0123
2009: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2009 401k membership
Total participants, beginning-of-year2009-04-01105
Total number of active participants reported on line 7a of the Form 55002009-04-01100
Total of all active and inactive participants2009-04-01100
Number of employers contributing to the scheme2009-04-0124

Financial Data on DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST

Measure Date Value
2023 : DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2023 401k financial data
Total plan liabilities at end of year2023-03-31$4,638
Total income from all sources2023-03-31$425,504
Expenses. Total of all expenses incurred2023-03-31$569,031
Benefits paid (including direct rollovers)2023-03-31$476,676
Total plan assets at end of year2023-03-31$168,753
Total plan assets at beginning of year2023-03-31$307,642
Value of fidelity bond covering the plan2023-03-31$1,000,000
Expenses. Other expenses not covered elsewhere2023-03-31$4,102
Other income received2023-03-31$-13,746
Net income (gross income less expenses)2023-03-31$-143,527
Net plan assets at end of year (total assets less liabilities)2023-03-31$164,115
Net plan assets at beginning of year (total assets less liabilities)2023-03-31$307,642
Total contributions received or receivable from employer(s)2023-03-31$439,250
Expenses. Administrative service providers (salaries,fees and commissions)2023-03-31$88,253
2022 : DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-03-31$-77,855
Total unrealized appreciation/depreciation of assets2022-03-31$-77,855
Total income from all sources (including contributions)2022-03-31$333,475
Total loss/gain on sale of assets2022-03-31$100,556
Total of all expenses incurred2022-03-31$656,917
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-03-31$568,923
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-03-31$303,600
Value of total assets at end of year2022-03-31$307,642
Value of total assets at beginning of year2022-03-31$631,084
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-03-31$87,994
Total interest from all sources2022-03-31$1,616
Total dividends received (eg from common stock, registered investment company shares)2022-03-31$5,558
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-03-31No
Administrative expenses professional fees incurred2022-03-31$10,770
Was this plan covered by a fidelity bond2022-03-31Yes
Value of fidelity bond cover2022-03-31$1,000,000
If this is an individual account plan, was there a blackout period2022-03-31No
Were there any nonexempt tranactions with any party-in-interest2022-03-31No
Administrative expenses (other) incurred2022-03-31$4,085
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-03-31No
Value of net income/loss2022-03-31$-323,442
Value of net assets at end of year (total assets less liabilities)2022-03-31$307,642
Value of net assets at beginning of year (total assets less liabilities)2022-03-31$631,084
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-03-31No
Were any leases to which the plan was party in default or uncollectible2022-03-31No
Investment advisory and management fees2022-03-31$4,739
Interest earned on other investments2022-03-31$1,616
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-03-31$132,452
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-03-31$150,887
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-03-31$150,887
Expenses. Payments to insurance carriers foe the provision of benefits2022-03-31$8,043
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-03-31No
Was there a failure to transmit to the plan any participant contributions2022-03-31No
Has the plan failed to provide any benefit when due under the plan2022-03-31No
Contributions received in cash from employer2022-03-31$303,600
Employer contributions (assets) at end of year2022-03-31$5,648
Employer contributions (assets) at beginning of year2022-03-31$26,191
Income. Dividends from common stock2022-03-31$5,558
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-03-31$560,880
Contract administrator fees2022-03-31$68,400
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-03-31No
Assets. Corporate common stocks other than exployer securities at end of year2022-03-31$169,542
Assets. Corporate common stocks other than exployer securities at beginning of year2022-03-31$454,006
Did the plan have assets held for investment2022-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-03-31No
Aggregate proceeds on sale of assets2022-03-31$360,658
Aggregate carrying amount (costs) on sale of assets2022-03-31$260,102
Opinion of an independent qualified public accountant for this plan2022-03-31Disclaimer
Accountancy firm name2022-03-31FRAZER, LLP
Accountancy firm EIN2022-03-31954108809
2021 : DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2021-03-31$115,018
Total unrealized appreciation/depreciation of assets2021-03-31$115,018
Total income from all sources (including contributions)2021-03-31$530,551
Total loss/gain on sale of assets2021-03-31$80,867
Total of all expenses incurred2021-03-31$665,819
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-03-31$569,075
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-03-31$322,920
Value of total assets at end of year2021-03-31$631,084
Value of total assets at beginning of year2021-03-31$766,352
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-03-31$96,744
Total interest from all sources2021-03-31$1,823
Total dividends received (eg from common stock, registered investment company shares)2021-03-31$9,923
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-03-31No
Administrative expenses professional fees incurred2021-03-31$14,620
Was this plan covered by a fidelity bond2021-03-31Yes
Value of fidelity bond cover2021-03-31$1,000,000
If this is an individual account plan, was there a blackout period2021-03-31No
Were there any nonexempt tranactions with any party-in-interest2021-03-31No
Administrative expenses (other) incurred2021-03-31$3,745
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-03-31No
Value of net income/loss2021-03-31$-135,268
Value of net assets at end of year (total assets less liabilities)2021-03-31$631,084
Value of net assets at beginning of year (total assets less liabilities)2021-03-31$766,352
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-03-31No
Were any leases to which the plan was party in default or uncollectible2021-03-31No
Investment advisory and management fees2021-03-31$9,979
Interest earned on other investments2021-03-31$1,823
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-03-31$150,887
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-03-31$184,413
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-03-31$184,413
Expenses. Payments to insurance carriers foe the provision of benefits2021-03-31$7,579
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-03-31No
Was there a failure to transmit to the plan any participant contributions2021-03-31No
Has the plan failed to provide any benefit when due under the plan2021-03-31No
Contributions received in cash from employer2021-03-31$322,920
Employer contributions (assets) at end of year2021-03-31$26,191
Employer contributions (assets) at beginning of year2021-03-31$26,181
Income. Dividends from common stock2021-03-31$9,923
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-03-31$561,496
Contract administrator fees2021-03-31$68,400
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-03-31No
Assets. Corporate common stocks other than exployer securities at end of year2021-03-31$454,006
Assets. Corporate common stocks other than exployer securities at beginning of year2021-03-31$555,758
Did the plan have assets held for investment2021-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-03-31No
Aggregate proceeds on sale of assets2021-03-31$438,726
Aggregate carrying amount (costs) on sale of assets2021-03-31$357,859
Opinion of an independent qualified public accountant for this plan2021-03-31Disclaimer
Accountancy firm name2021-03-31FRAZER, LLP
Accountancy firm EIN2021-03-31954108809
2020 : DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2020-03-31$-106,926
Unrealized appreciation/depreciation of other (non real estate) assets2020-03-31$-106,926
Total unrealized appreciation/depreciation of assets2020-03-31$-106,926
Total unrealized appreciation/depreciation of assets2020-03-31$-106,926
Total income from all sources (including contributions)2020-03-31$277,031
Total income from all sources (including contributions)2020-03-31$277,031
Total loss/gain on sale of assets2020-03-31$30,077
Total loss/gain on sale of assets2020-03-31$30,077
Total of all expenses incurred2020-03-31$655,058
Total of all expenses incurred2020-03-31$655,058
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-03-31$559,148
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-03-31$559,148
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-03-31$330,279
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-03-31$330,279
Value of total assets at end of year2020-03-31$766,352
Value of total assets at end of year2020-03-31$766,352
Value of total assets at beginning of year2020-03-31$1,144,379
Value of total assets at beginning of year2020-03-31$1,144,379
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-03-31$95,910
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-03-31$95,910
Total interest from all sources2020-03-31$2,750
Total interest from all sources2020-03-31$2,750
Total dividends received (eg from common stock, registered investment company shares)2020-03-31$20,851
Total dividends received (eg from common stock, registered investment company shares)2020-03-31$20,851
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-03-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-03-31No
Administrative expenses professional fees incurred2020-03-31$14,838
Administrative expenses professional fees incurred2020-03-31$14,838
Was this plan covered by a fidelity bond2020-03-31Yes
Was this plan covered by a fidelity bond2020-03-31Yes
Value of fidelity bond cover2020-03-31$1,000,000
Value of fidelity bond cover2020-03-31$1,000,000
If this is an individual account plan, was there a blackout period2020-03-31No
If this is an individual account plan, was there a blackout period2020-03-31No
Were there any nonexempt tranactions with any party-in-interest2020-03-31No
Were there any nonexempt tranactions with any party-in-interest2020-03-31No
Administrative expenses (other) incurred2020-03-31$2,663
Administrative expenses (other) incurred2020-03-31$2,663
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-03-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-03-31No
Value of net income/loss2020-03-31$-378,027
Value of net income/loss2020-03-31$-378,027
Value of net assets at end of year (total assets less liabilities)2020-03-31$766,352
Value of net assets at end of year (total assets less liabilities)2020-03-31$766,352
Value of net assets at beginning of year (total assets less liabilities)2020-03-31$1,144,379
Value of net assets at beginning of year (total assets less liabilities)2020-03-31$1,144,379
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-03-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-03-31No
Were any leases to which the plan was party in default or uncollectible2020-03-31No
Were any leases to which the plan was party in default or uncollectible2020-03-31No
Investment advisory and management fees2020-03-31$10,009
Investment advisory and management fees2020-03-31$10,009
Interest earned on other investments2020-03-31$2,750
Interest earned on other investments2020-03-31$2,750
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-03-31$184,413
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-03-31$184,413
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-03-31$203,592
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-03-31$203,592
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-03-31$203,592
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-03-31$203,592
Expenses. Payments to insurance carriers foe the provision of benefits2020-03-31$7,450
Expenses. Payments to insurance carriers foe the provision of benefits2020-03-31$7,450
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-03-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-03-31No
Was there a failure to transmit to the plan any participant contributions2020-03-31No
Was there a failure to transmit to the plan any participant contributions2020-03-31No
Has the plan failed to provide any benefit when due under the plan2020-03-31No
Has the plan failed to provide any benefit when due under the plan2020-03-31No
Contributions received in cash from employer2020-03-31$330,279
Contributions received in cash from employer2020-03-31$330,279
Employer contributions (assets) at end of year2020-03-31$26,181
Employer contributions (assets) at end of year2020-03-31$26,181
Employer contributions (assets) at beginning of year2020-03-31$44,901
Employer contributions (assets) at beginning of year2020-03-31$44,901
Income. Dividends from common stock2020-03-31$20,851
Income. Dividends from common stock2020-03-31$20,851
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-03-31$551,698
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-03-31$551,698
Contract administrator fees2020-03-31$68,400
Contract administrator fees2020-03-31$68,400
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-03-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-03-31No
Assets. Corporate common stocks other than exployer securities at end of year2020-03-31$555,758
Assets. Corporate common stocks other than exployer securities at end of year2020-03-31$555,758
Assets. Corporate common stocks other than exployer securities at beginning of year2020-03-31$895,886
Assets. Corporate common stocks other than exployer securities at beginning of year2020-03-31$895,886
Did the plan have assets held for investment2020-03-31Yes
Did the plan have assets held for investment2020-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-03-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-03-31No
Aggregate proceeds on sale of assets2020-03-31$620,165
Aggregate proceeds on sale of assets2020-03-31$620,165
Aggregate carrying amount (costs) on sale of assets2020-03-31$590,088
Aggregate carrying amount (costs) on sale of assets2020-03-31$590,088
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-03-31No
Opinion of an independent qualified public accountant for this plan2020-03-31Disclaimer
Opinion of an independent qualified public accountant for this plan2020-03-31Disclaimer
Accountancy firm name2020-03-31FRAZER, LLP
Accountancy firm name2020-03-31FRAZER, LLP
Accountancy firm EIN2020-03-31954108809
Accountancy firm EIN2020-03-31954108809
2019 : DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2019-03-31$-44,730
Total unrealized appreciation/depreciation of assets2019-03-31$-44,730
Total income from all sources (including contributions)2019-03-31$407,151
Total loss/gain on sale of assets2019-03-31$56,863
Total of all expenses incurred2019-03-31$661,474
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-03-31$560,332
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-03-31$363,400
Value of total assets at end of year2019-03-31$1,144,379
Value of total assets at beginning of year2019-03-31$1,398,702
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-03-31$101,142
Total interest from all sources2019-03-31$6,627
Total dividends received (eg from common stock, registered investment company shares)2019-03-31$24,991
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-03-31No
Administrative expenses professional fees incurred2019-03-31$19,123
Was this plan covered by a fidelity bond2019-03-31Yes
Value of fidelity bond cover2019-03-31$1,000,000
If this is an individual account plan, was there a blackout period2019-03-31No
Were there any nonexempt tranactions with any party-in-interest2019-03-31No
Administrative expenses (other) incurred2019-03-31$2,468
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-03-31No
Value of net income/loss2019-03-31$-254,323
Value of net assets at end of year (total assets less liabilities)2019-03-31$1,144,379
Value of net assets at beginning of year (total assets less liabilities)2019-03-31$1,398,702
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-03-31No
Were any leases to which the plan was party in default or uncollectible2019-03-31No
Investment advisory and management fees2019-03-31$11,151
Interest earned on other investments2019-03-31$6,627
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-03-31$203,592
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-03-31$134,636
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-03-31$134,636
Expenses. Payments to insurance carriers foe the provision of benefits2019-03-31$7,387
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-03-31No
Was there a failure to transmit to the plan any participant contributions2019-03-31No
Has the plan failed to provide any benefit when due under the plan2019-03-31No
Contributions received in cash from employer2019-03-31$363,400
Employer contributions (assets) at end of year2019-03-31$44,901
Employer contributions (assets) at beginning of year2019-03-31$65,216
Income. Dividends from common stock2019-03-31$24,991
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-03-31$552,945
Contract administrator fees2019-03-31$68,400
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-03-31No
Assets. Corporate common stocks other than exployer securities at end of year2019-03-31$895,886
Assets. Corporate common stocks other than exployer securities at beginning of year2019-03-31$1,198,850
Did the plan have assets held for investment2019-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-03-31No
Aggregate proceeds on sale of assets2019-03-31$518,367
Aggregate carrying amount (costs) on sale of assets2019-03-31$461,504
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-03-31No
Opinion of an independent qualified public accountant for this plan2019-03-31Disclaimer
Accountancy firm name2019-03-31FRAZER, LLP
Accountancy firm EIN2019-03-31954108809
2018 : DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2018-03-31$-5,253
Total unrealized appreciation/depreciation of assets2018-03-31$-5,253
Total income from all sources (including contributions)2018-03-31$532,605
Total loss/gain on sale of assets2018-03-31$58,190
Total of all expenses incurred2018-03-31$878,996
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-03-31$769,005
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-03-31$441,600
Value of total assets at end of year2018-03-31$1,398,702
Value of total assets at beginning of year2018-03-31$1,745,093
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-03-31$109,991
Total interest from all sources2018-03-31$7,523
Total dividends received (eg from common stock, registered investment company shares)2018-03-31$30,545
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-03-31No
Administrative expenses professional fees incurred2018-03-31$24,105
Was this plan covered by a fidelity bond2018-03-31Yes
Value of fidelity bond cover2018-03-31$1,000,000
If this is an individual account plan, was there a blackout period2018-03-31No
Were there any nonexempt tranactions with any party-in-interest2018-03-31No
Administrative expenses (other) incurred2018-03-31$2,721
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-03-31No
Value of net income/loss2018-03-31$-346,391
Value of net assets at end of year (total assets less liabilities)2018-03-31$1,398,702
Value of net assets at beginning of year (total assets less liabilities)2018-03-31$1,745,093
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-03-31No
Were any leases to which the plan was party in default or uncollectible2018-03-31No
Investment advisory and management fees2018-03-31$14,765
Interest earned on other investments2018-03-31$7,523
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-03-31$134,636
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-03-31$102,497
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-03-31$102,497
Expenses. Payments to insurance carriers foe the provision of benefits2018-03-31$7,356
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-03-31Yes
Was there a failure to transmit to the plan any participant contributions2018-03-31No
Has the plan failed to provide any benefit when due under the plan2018-03-31No
Contributions received in cash from employer2018-03-31$441,600
Employer contributions (assets) at end of year2018-03-31$65,216
Employer contributions (assets) at beginning of year2018-03-31$71,157
Income. Dividends from common stock2018-03-31$30,545
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-03-31$761,649
Contract administrator fees2018-03-31$68,400
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-03-31No
Assets. Corporate common stocks other than exployer securities at end of year2018-03-31$1,198,850
Assets. Corporate common stocks other than exployer securities at beginning of year2018-03-31$1,571,439
Did the plan have assets held for investment2018-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-03-31No
Aggregate proceeds on sale of assets2018-03-31$959,824
Aggregate carrying amount (costs) on sale of assets2018-03-31$901,634
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-03-31No
Opinion of an independent qualified public accountant for this plan2018-03-31Disclaimer
Accountancy firm name2018-03-31FRAZER, LLP
Accountancy firm EIN2018-03-31954108809
2017 : DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2017-03-31$172,623
Total unrealized appreciation/depreciation of assets2017-03-31$172,623
Total income from all sources (including contributions)2017-03-31$639,275
Total loss/gain on sale of assets2017-03-31$-12,293
Total of all expenses incurred2017-03-31$787,986
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-03-31$688,917
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-03-31$431,480
Value of total assets at end of year2017-03-31$1,745,093
Value of total assets at beginning of year2017-03-31$1,893,804
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-03-31$99,069
Total interest from all sources2017-03-31$11,695
Total dividends received (eg from common stock, registered investment company shares)2017-03-31$35,770
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-03-31No
Administrative expenses professional fees incurred2017-03-31$10,620
Was this plan covered by a fidelity bond2017-03-31Yes
Value of fidelity bond cover2017-03-31$1,000,000
If this is an individual account plan, was there a blackout period2017-03-31No
Were there any nonexempt tranactions with any party-in-interest2017-03-31No
Administrative expenses (other) incurred2017-03-31$3,665
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-03-31No
Value of net income/loss2017-03-31$-148,711
Value of net assets at end of year (total assets less liabilities)2017-03-31$1,745,093
Value of net assets at beginning of year (total assets less liabilities)2017-03-31$1,893,804
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-03-31No
Were any leases to which the plan was party in default or uncollectible2017-03-31No
Investment advisory and management fees2017-03-31$16,384
Interest earned on other investments2017-03-31$11,695
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-03-31$102,497
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-03-31$242,925
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-03-31$242,925
Expenses. Payments to insurance carriers foe the provision of benefits2017-03-31$7,381
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-03-31Yes
Was there a failure to transmit to the plan any participant contributions2017-03-31No
Has the plan failed to provide any benefit when due under the plan2017-03-31No
Contributions received in cash from employer2017-03-31$431,480
Employer contributions (assets) at end of year2017-03-31$71,157
Employer contributions (assets) at beginning of year2017-03-31$50,772
Income. Dividends from common stock2017-03-31$35,770
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-03-31$681,536
Contract administrator fees2017-03-31$68,400
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-03-31No
Assets. Corporate common stocks other than exployer securities at end of year2017-03-31$1,571,439
Assets. Corporate common stocks other than exployer securities at beginning of year2017-03-31$1,600,107
Did the plan have assets held for investment2017-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-03-31No
Aggregate proceeds on sale of assets2017-03-31$485,091
Aggregate carrying amount (costs) on sale of assets2017-03-31$497,384
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-03-31No
Opinion of an independent qualified public accountant for this plan2017-03-31Disclaimer
Accountancy firm name2017-03-31FRAZER, LLP
Accountancy firm EIN2017-03-31954108809
2016 : DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2016-03-31$-199,488
Total unrealized appreciation/depreciation of assets2016-03-31$-199,488
Total income from all sources (including contributions)2016-03-31$326,694
Total loss/gain on sale of assets2016-03-31$31,365
Total of all expenses incurred2016-03-31$745,952
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-03-31$646,955
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-03-31$443,440
Value of total assets at end of year2016-03-31$1,893,804
Value of total assets at beginning of year2016-03-31$2,313,062
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-03-31$98,997
Total interest from all sources2016-03-31$15,383
Total dividends received (eg from common stock, registered investment company shares)2016-03-31$35,994
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-03-31No
Administrative expenses professional fees incurred2016-03-31$11,550
Was this plan covered by a fidelity bond2016-03-31Yes
Value of fidelity bond cover2016-03-31$3,000,000
If this is an individual account plan, was there a blackout period2016-03-31No
Were there any nonexempt tranactions with any party-in-interest2016-03-31No
Administrative expenses (other) incurred2016-03-31$816
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-03-31No
Value of net income/loss2016-03-31$-419,258
Value of net assets at end of year (total assets less liabilities)2016-03-31$1,893,804
Value of net assets at beginning of year (total assets less liabilities)2016-03-31$2,313,062
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-03-31No
Were any leases to which the plan was party in default or uncollectible2016-03-31No
Investment advisory and management fees2016-03-31$18,231
Interest earned on other investments2016-03-31$15,383
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-03-31$242,925
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-03-31$279,794
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-03-31$279,794
Expenses. Payments to insurance carriers foe the provision of benefits2016-03-31$7,407
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-03-31Yes
Was there a failure to transmit to the plan any participant contributions2016-03-31No
Has the plan failed to provide any benefit when due under the plan2016-03-31No
Contributions received in cash from employer2016-03-31$443,440
Employer contributions (assets) at end of year2016-03-31$50,772
Employer contributions (assets) at beginning of year2016-03-31$48,912
Income. Dividends from common stock2016-03-31$35,994
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-03-31$639,548
Contract administrator fees2016-03-31$68,400
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-03-31No
Assets. Corporate common stocks other than exployer securities at end of year2016-03-31$1,600,107
Assets. Corporate common stocks other than exployer securities at beginning of year2016-03-31$1,984,356
Did the plan have assets held for investment2016-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-03-31No
Aggregate proceeds on sale of assets2016-03-31$727,735
Aggregate carrying amount (costs) on sale of assets2016-03-31$696,370
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-03-31No
Opinion of an independent qualified public accountant for this plan2016-03-31Disclaimer
Accountancy firm name2016-03-31FRAZER, LLP
Accountancy firm EIN2016-03-31954108809
2015 : DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2015-03-31$76,640
Total unrealized appreciation/depreciation of assets2015-03-31$76,640
Total income from all sources (including contributions)2015-03-31$697,602
Total loss/gain on sale of assets2015-03-31$93,603
Total of all expenses incurred2015-03-31$758,768
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-03-31$657,318
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-03-31$476,560
Value of total assets at end of year2015-03-31$2,313,062
Value of total assets at beginning of year2015-03-31$2,374,228
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-03-31$101,450
Total interest from all sources2015-03-31$18,828
Total dividends received (eg from common stock, registered investment company shares)2015-03-31$31,971
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-03-31No
Administrative expenses professional fees incurred2015-03-31$11,695
Was this plan covered by a fidelity bond2015-03-31Yes
Value of fidelity bond cover2015-03-31$3,000,000
If this is an individual account plan, was there a blackout period2015-03-31No
Were there any nonexempt tranactions with any party-in-interest2015-03-31No
Administrative expenses (other) incurred2015-03-31$724
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-03-31No
Value of net income/loss2015-03-31$-61,166
Value of net assets at end of year (total assets less liabilities)2015-03-31$2,313,062
Value of net assets at beginning of year (total assets less liabilities)2015-03-31$2,374,228
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-03-31No
Were any leases to which the plan was party in default or uncollectible2015-03-31No
Investment advisory and management fees2015-03-31$20,631
Interest earned on other investments2015-03-31$18,828
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-03-31$279,794
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-03-31$276,397
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-03-31$276,397
Expenses. Payments to insurance carriers foe the provision of benefits2015-03-31$9,641
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-03-31Yes
Was there a failure to transmit to the plan any participant contributions2015-03-31No
Has the plan failed to provide any benefit when due under the plan2015-03-31No
Contributions received in cash from employer2015-03-31$476,560
Employer contributions (assets) at end of year2015-03-31$48,912
Employer contributions (assets) at beginning of year2015-03-31$139,420
Income. Dividends from common stock2015-03-31$31,971
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-03-31$647,677
Contract administrator fees2015-03-31$68,400
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-03-31No
Assets. Corporate common stocks other than exployer securities at end of year2015-03-31$1,984,356
Assets. Corporate common stocks other than exployer securities at beginning of year2015-03-31$1,958,411
Did the plan have assets held for investment2015-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-03-31No
Aggregate proceeds on sale of assets2015-03-31$532,293
Aggregate carrying amount (costs) on sale of assets2015-03-31$438,690
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-03-31No
Opinion of an independent qualified public accountant for this plan2015-03-31Disclaimer
Accountancy firm name2015-03-31FRAZER, LLP
Accountancy firm EIN2015-03-31954108809
2014 : DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-03-31$112,603
Total unrealized appreciation/depreciation of assets2014-03-31$112,603
Total income from all sources (including contributions)2014-03-31$1,176,728
Total loss/gain on sale of assets2014-03-31$467,015
Total of all expenses incurred2014-03-31$773,174
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-03-31$681,511
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-03-31$549,240
Value of total assets at end of year2014-03-31$2,374,228
Value of total assets at beginning of year2014-03-31$1,970,674
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-03-31$91,663
Total interest from all sources2014-03-31$4,592
Total dividends received (eg from common stock, registered investment company shares)2014-03-31$43,278
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-03-31No
Administrative expenses professional fees incurred2014-03-31$10,050
Was this plan covered by a fidelity bond2014-03-31Yes
Value of fidelity bond cover2014-03-31$3,000,000
If this is an individual account plan, was there a blackout period2014-03-31No
Were there any nonexempt tranactions with any party-in-interest2014-03-31No
Administrative expenses (other) incurred2014-03-31$1,368
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-03-31No
Value of net income/loss2014-03-31$403,554
Value of net assets at end of year (total assets less liabilities)2014-03-31$2,374,228
Value of net assets at beginning of year (total assets less liabilities)2014-03-31$1,970,674
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-03-31No
Were any leases to which the plan was party in default or uncollectible2014-03-31No
Investment advisory and management fees2014-03-31$11,845
Interest earned on other investments2014-03-31$4,592
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-03-31$276,397
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-03-31$267,464
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-03-31$267,464
Expenses. Payments to insurance carriers foe the provision of benefits2014-03-31$18,050
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-03-31Yes
Was there a failure to transmit to the plan any participant contributions2014-03-31No
Has the plan failed to provide any benefit when due under the plan2014-03-31No
Contributions received in cash from employer2014-03-31$549,240
Employer contributions (assets) at end of year2014-03-31$139,420
Employer contributions (assets) at beginning of year2014-03-31$171,860
Income. Dividends from common stock2014-03-31$43,278
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-03-31$663,461
Contract administrator fees2014-03-31$68,400
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-03-31No
Assets. Corporate common stocks other than exployer securities at end of year2014-03-31$1,958,411
Assets. Corporate common stocks other than exployer securities at beginning of year2014-03-31$1,531,350
Did the plan have assets held for investment2014-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-03-31No
Aggregate proceeds on sale of assets2014-03-31$5,179,637
Aggregate carrying amount (costs) on sale of assets2014-03-31$4,712,622
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-03-31No
Opinion of an independent qualified public accountant for this plan2014-03-31Disclaimer
Accountancy firm name2014-03-31FRAZER, LLP
Accountancy firm EIN2014-03-31954108809
2013 : DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-03-31$191,699
Total unrealized appreciation/depreciation of assets2013-03-31$191,699
Total income from all sources (including contributions)2013-03-31$1,022,197
Total of all expenses incurred2013-03-31$923,984
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-03-31$847,353
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-03-31$789,360
Value of total assets at end of year2013-03-31$1,970,674
Value of total assets at beginning of year2013-03-31$1,872,461
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-03-31$76,631
Total interest from all sources2013-03-31$338
Total dividends received (eg from common stock, registered investment company shares)2013-03-31$40,800
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-03-31No
Administrative expenses professional fees incurred2013-03-31$8,400
Was this plan covered by a fidelity bond2013-03-31Yes
Value of fidelity bond cover2013-03-31$3,000,000
If this is an individual account plan, was there a blackout period2013-03-31No
Were there any nonexempt tranactions with any party-in-interest2013-03-31No
Administrative expenses (other) incurred2013-03-31$1,471
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-03-31No
Value of net income/loss2013-03-31$98,213
Value of net assets at end of year (total assets less liabilities)2013-03-31$1,970,674
Value of net assets at beginning of year (total assets less liabilities)2013-03-31$1,872,461
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-03-31No
Were any leases to which the plan was party in default or uncollectible2013-03-31No
Interest earned on other investments2013-03-31$338
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-03-31$267,464
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-03-31$188,871
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-03-31$188,871
Expenses. Payments to insurance carriers foe the provision of benefits2013-03-31$12,853
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-03-31No
Was there a failure to transmit to the plan any participant contributions2013-03-31No
Has the plan failed to provide any benefit when due under the plan2013-03-31No
Contributions received in cash from employer2013-03-31$789,360
Employer contributions (assets) at end of year2013-03-31$171,860
Employer contributions (assets) at beginning of year2013-03-31$60,540
Income. Dividends from common stock2013-03-31$40,800
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-03-31$834,500
Contract administrator fees2013-03-31$66,760
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-03-31No
Assets. Corporate common stocks other than exployer securities at end of year2013-03-31$1,531,350
Assets. Corporate common stocks other than exployer securities at beginning of year2013-03-31$1,623,050
Did the plan have assets held for investment2013-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-03-31No
Opinion of an independent qualified public accountant for this plan2013-03-31Unqualified
Accountancy firm name2013-03-31FRAZER, LLP
Accountancy firm EIN2013-03-31954108809
2012 : DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2012 401k financial data
Total income from all sources2012-03-31$833,273
Expenses. Total of all expenses incurred2012-03-31$1,041,414
Benefits paid (including direct rollovers)2012-03-31$957,418
Total plan assets at end of year2012-03-31$1,872,461
Total plan assets at beginning of year2012-03-31$2,080,602
Value of fidelity bond covering the plan2012-03-31$3,000,000
Other income received2012-03-31$-104,207
Net income (gross income less expenses)2012-03-31$-208,141
Net plan assets at end of year (total assets less liabilities)2012-03-31$1,872,461
Net plan assets at beginning of year (total assets less liabilities)2012-03-31$2,080,602
Total contributions received or receivable from employer(s)2012-03-31$937,480
Expenses. Administrative service providers (salaries,fees and commissions)2012-03-31$83,996
2011 : DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-03-31$143,943
Total unrealized appreciation/depreciation of assets2011-03-31$143,943
Total income from all sources (including contributions)2011-03-31$1,206,611
Total of all expenses incurred2011-03-31$1,081,352
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-03-31$992,513
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-03-31$1,029,480
Value of total assets at end of year2011-03-31$2,080,602
Value of total assets at beginning of year2011-03-31$1,955,343
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-03-31$88,839
Total interest from all sources2011-03-31$2,938
Total dividends received (eg from common stock, registered investment company shares)2011-03-31$30,250
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-03-31No
Administrative expenses professional fees incurred2011-03-31$8,930
Was this plan covered by a fidelity bond2011-03-31Yes
Value of fidelity bond cover2011-03-31$3,000,000
If this is an individual account plan, was there a blackout period2011-03-31No
Were there any nonexempt tranactions with any party-in-interest2011-03-31No
Administrative expenses (other) incurred2011-03-31$1,499
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-03-31No
Value of net income/loss2011-03-31$125,259
Value of net assets at end of year (total assets less liabilities)2011-03-31$2,080,602
Value of net assets at beginning of year (total assets less liabilities)2011-03-31$1,955,343
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-03-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-03-31No
Were any leases to which the plan was party in default or uncollectible2011-03-31No
Interest earned on other investments2011-03-31$2,938
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-03-31$289,892
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-03-31$185,265
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-03-31$185,265
Expenses. Payments to insurance carriers foe the provision of benefits2011-03-31$12,393
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-03-31No
Was there a failure to transmit to the plan any participant contributions2011-03-31No
Has the plan failed to provide any benefit when due under the plan2011-03-31No
Contributions received in cash from employer2011-03-31$1,029,480
Employer contributions (assets) at end of year2011-03-31$24,660
Employer contributions (assets) at beginning of year2011-03-31$17,478
Income. Dividends from common stock2011-03-31$30,250
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-03-31$980,120
Contract administrator fees2011-03-31$78,410
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-03-31No
Assets. Corporate common stocks other than exployer securities at end of year2011-03-31$1,766,050
Assets. Corporate common stocks other than exployer securities at beginning of year2011-03-31$1,752,600
Did the plan have assets held for investment2011-03-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-03-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-03-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-03-31No
Opinion of an independent qualified public accountant for this plan2011-03-31Unqualified
Accountancy firm name2011-03-31FRAZER, LLP
Accountancy firm EIN2011-03-31954108809

Form 5500 Responses for DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST

2021: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2021 form 5500 responses
2021-04-01Type of plan entityMulti-employer plan
2021-04-01Plan is a collectively bargained planYes
2021-04-01Plan funding arrangement – Section 412(e)(3) insurance ContractsYes
2021-04-01Plan benefit arrangement – InsuranceYes
2021-04-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes
2020: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2020 form 5500 responses
2020-04-01Type of plan entityMulti-employer plan
2020-04-01Plan is a collectively bargained planYes
2020-04-01Plan funding arrangement – Section 412(e)(3) insurance ContractsYes
2020-04-01Plan benefit arrangement – InsuranceYes
2020-04-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes
2019: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2019 form 5500 responses
2019-04-01Type of plan entityMulti-employer plan
2019-04-01Plan is a collectively bargained planYes
2019-04-01Plan funding arrangement – Section 412(e)(3) insurance ContractsYes
2019-04-01Plan benefit arrangement – InsuranceYes
2019-04-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes
2018: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2018 form 5500 responses
2018-04-01Type of plan entityMulti-employer plan
2018-04-01Plan is a collectively bargained planYes
2018-04-01Plan funding arrangement – Section 412(e)(3) insurance ContractsYes
2018-04-01Plan benefit arrangement – InsuranceYes
2018-04-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes
2017: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2017 form 5500 responses
2017-04-01Type of plan entityMulti-employer plan
2017-04-01Plan is a collectively bargained planYes
2017-04-01Plan funding arrangement – Section 412(e)(3) insurance ContractsYes
2017-04-01Plan benefit arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes
2016: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2016 form 5500 responses
2016-04-01Type of plan entityMulti-employer plan
2016-04-01Plan is a collectively bargained planYes
2016-04-01Plan funding arrangement – Section 412(e)(3) insurance ContractsYes
2016-04-01Plan benefit arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes
2015: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2015 form 5500 responses
2015-04-01Type of plan entityMulti-employer plan
2015-04-01Plan is a collectively bargained planYes
2015-04-01Plan funding arrangement – Section 412(e)(3) insurance ContractsYes
2015-04-01Plan benefit arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes
2014: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2014 form 5500 responses
2014-04-01Type of plan entityMulti-employer plan
2014-04-01Plan is a collectively bargained planYes
2014-04-01Plan funding arrangement – Section 412(e)(3) insurance ContractsYes
2014-04-01Plan benefit arrangement – InsuranceYes
2014-04-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes
2013: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2013 form 5500 responses
2013-04-01Type of plan entityMulti-employer plan
2013-04-01Plan is a collectively bargained planYes
2013-04-01Plan funding arrangement – Section 412(e)(3) insurance ContractsYes
2013-04-01Plan benefit arrangement – InsuranceYes
2013-04-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes
2012: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2012 form 5500 responses
2012-04-01Type of plan entityMulti-employer plan
2012-04-01Plan is a collectively bargained planYes
2012-04-01Plan funding arrangement – Section 412(e)(3) insurance ContractsYes
2012-04-01Plan benefit arrangement – InsuranceYes
2012-04-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes
2011: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2011 form 5500 responses
2011-04-01Type of plan entityMulti-employer plan
2011-04-01Plan is a collectively bargained planYes
2011-04-01Plan funding arrangement – Section 412(e)(3) insurance ContractsYes
2011-04-01Plan benefit arrangement – InsuranceYes
2011-04-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes
2010: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2010 form 5500 responses
2010-04-01Type of plan entityMulti-employer plan
2010-04-01Plan is a collectively bargained planYes
2010-04-01Plan funding arrangement – Section 412(e)(3) insurance ContractsYes
2010-04-01Plan benefit arrangement – InsuranceYes
2010-04-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes
2009: DAIRY EMPLOYEES UNION LOCAL 17 CLA EMPLOYEES HEALTH & WELFARE TRUST 2009 form 5500 responses
2009-04-01Type of plan entityMulti-employer plan
2009-04-01This submission is the final filingNo
2009-04-01Plan is a collectively bargained planYes
2009-04-01Plan funding arrangement – Section 412(e)(3) insurance ContractsYes
2009-04-01Plan benefit arrangement – InsuranceYes
2009-04-01Plan benefit arrangement – Section 412(e)(3) insurance ContractsYes

Insurance Providers Used on plan

UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number002494
Policy instance 2
Insurance contract or identification number002494
Number of Individuals Covered15
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $9,160
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,160
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number102585
Policy instance 1
Insurance contract or identification number102585
Number of Individuals Covered6
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number002494
Policy instance 2
Insurance contract or identification number002494
Number of Individuals Covered20
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $11,090
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,090
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number102585
Policy instance 1
Insurance contract or identification number102585
Number of Individuals Covered6
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $45
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees45
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number002494
Policy instance 2
Insurance contract or identification number002494
Number of Individuals Covered20
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $11,299
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,299
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number102585
Policy instance 1
Insurance contract or identification number102585
Number of Individuals Covered16
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $100
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees100
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number102585
Policy instance 1
Insurance contract or identification number102585
Number of Individuals Covered16
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $130
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees130
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number002494
Policy instance 2
Insurance contract or identification number002494
Number of Individuals Covered22
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $10,645
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,645
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number102585
Policy instance 1
Insurance contract or identification number102585
Number of Individuals Covered21
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $321
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees321
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number002494
Policy instance 2
Insurance contract or identification number002494
Number of Individuals Covered23
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $29,786
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,786
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number002494
Policy instance 2
Insurance contract or identification number002494
Number of Individuals Covered26
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $38,362
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,362
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameBURNHAM BENEFITS INSURANCE SERVICES
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number102585
Policy instance 1
Insurance contract or identification number102585
Number of Individuals Covered33
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $541
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees541
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameBURNHAM BENEFITS INSURANCE SERVICES
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number002494
Policy instance 2
Insurance contract or identification number002494
Number of Individuals Covered26
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
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 number102585
Policy instance 1
Insurance contract or identification number102585
Number of Individuals Covered38
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number002494
Policy instance 2
Insurance contract or identification number002494
Number of Individuals Covered28
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $11,303
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,303
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameBURNHAM BENEFITS INSURANCE
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number102585
Policy instance 1
Insurance contract or identification number102585
Number of Individuals Covered49
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
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 number102585
Policy instance 1
Insurance contract or identification number102585
Number of Individuals Covered68
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number002494
Policy instance 2
Insurance contract or identification number002494
Number of Individuals Covered28
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $10,401
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,401
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameBURNHAM BENEFITS INSURANCE
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number002494
Policy instance 2
Insurance contract or identification number002494
Number of Individuals Covered39
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $12,779
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,779
Insurance broker organization code?3
Insurance broker nameBURNHAM BENEFITS INS SVCS
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number02585-00
Policy instance 1
Insurance contract or identification number02585-00
Number of Individuals Covered106
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
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 number02585-00
Policy instance 1
Insurance contract or identification number02585-00
Number of Individuals Covered124
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number002494
Policy instance 2
Insurance contract or identification number002494
Number of Individuals Covered46
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $13,361
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
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 number102585-0000
Policy instance 1
Insurance contract or identification number102585-0000
Number of Individuals Covered120
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number002494
Policy instance 2
Insurance contract or identification number002494
Number of Individuals Covered54
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $13,578
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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