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HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameHAWAII BOILERMAKERS HEALTH AND WELFARE PLAN
Plan identification number 501

HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN Benefits

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

401k Sponsoring company profile

BOARD OF TRUSTEES OF HAWAII BOILERMAKERS HEALTH AND WELFARE FUND has sponsored the creation of one or more 401k plans.

Company Name:BOARD OF TRUSTEES OF HAWAII BOILERMAKERS HEALTH AND WELFARE FUND
Employer identification number (EIN):990111510
NAIC Classification:236200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-11-01RAYMOND MAW2023-07-27 TOM BACA2023-07-25
5012020-11-01
5012019-11-01
5012018-11-01
5012017-11-01
5012016-11-01LARRY JANSEN TOM BACA2018-08-08
5012015-11-01JOSEPH ELAYER TOM BACA2017-08-11
5012014-11-01JOSEPH ELAYER TOM BACA2016-08-12
5012013-11-01JOSEPH ELAYER TOM BACA2015-08-14
5012012-11-01JOSEPH ELAYER GARY AYCOCK2014-08-06
5012011-11-01JOSEPH ELAYER GARY AYCOCK2013-08-12
5012009-11-01TOM VALENTINE GARY AYCOCK2011-08-10
5012008-11-01

Plan Statistics for HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN

401k plan membership statisitcs for HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN

Measure Date Value
2021: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-11-010
Total number of active participants reported on line 7a of the Form 55002021-11-010
Number of retired or separated participants receiving benefits2021-11-010
Number of other retired or separated participants entitled to future benefits2021-11-010
Total of all active and inactive participants2021-11-010
2020: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-11-010
Total number of active participants reported on line 7a of the Form 55002020-11-010
Number of retired or separated participants receiving benefits2020-11-010
Number of other retired or separated participants entitled to future benefits2020-11-010
Total of all active and inactive participants2020-11-010
2019: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-11-0114
Total number of active participants reported on line 7a of the Form 55002019-11-010
Number of retired or separated participants receiving benefits2019-11-010
Number of other retired or separated participants entitled to future benefits2019-11-010
Total of all active and inactive participants2019-11-010
Number of employers contributing to the scheme2019-11-010
2018: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-11-0142
Total number of active participants reported on line 7a of the Form 55002018-11-010
Number of retired or separated participants receiving benefits2018-11-0114
Number of other retired or separated participants entitled to future benefits2018-11-010
Total of all active and inactive participants2018-11-0114
Number of employers contributing to the scheme2018-11-010
2017: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-11-013
Total number of active participants reported on line 7a of the Form 55002017-11-0142
Number of retired or separated participants receiving benefits2017-11-010
Number of other retired or separated participants entitled to future benefits2017-11-010
Total of all active and inactive participants2017-11-0142
Number of employers contributing to the scheme2017-11-012
2016: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-11-016
Total number of active participants reported on line 7a of the Form 55002016-11-013
Number of retired or separated participants receiving benefits2016-11-010
Number of other retired or separated participants entitled to future benefits2016-11-010
Total of all active and inactive participants2016-11-013
Number of employers contributing to the scheme2016-11-012
2015: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-11-017
Total number of active participants reported on line 7a of the Form 55002015-11-013
Number of retired or separated participants receiving benefits2015-11-011
Total of all active and inactive participants2015-11-014
Number of employers contributing to the scheme2015-11-013
2014: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-11-012
Total number of active participants reported on line 7a of the Form 55002014-11-017
Total of all active and inactive participants2014-11-017
Number of employers contributing to the scheme2014-11-012
2013: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-11-0119
Total number of active participants reported on line 7a of the Form 55002013-11-012
Total of all active and inactive participants2013-11-012
Number of employers contributing to the scheme2013-11-012
2012: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-11-0113
Total number of active participants reported on line 7a of the Form 55002012-11-0119
Total of all active and inactive participants2012-11-0119
Number of employers contributing to the scheme2012-11-014
2011: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-11-0150
Total number of active participants reported on line 7a of the Form 55002011-11-0112
Number of retired or separated participants receiving benefits2011-11-011
Total of all active and inactive participants2011-11-0113
Number of employers contributing to the scheme2011-11-019
2009: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-11-0150
Total number of active participants reported on line 7a of the Form 55002009-11-0146
Total of all active and inactive participants2009-11-0146
Number of employers contributing to the scheme2009-11-015

Financial Data on HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN

Measure Date Value
2022 : HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2022 401k financial data
Total income from all sources2022-10-31$2,167
Expenses. Total of all expenses incurred2022-10-31$29,738
Total plan assets at end of year2022-10-31$372,744
Total plan assets at beginning of year2022-10-31$400,315
Value of fidelity bond covering the plan2022-10-31$50,000
Expenses. Other expenses not covered elsewhere2022-10-31$4,135
Other income received2022-10-31$2,167
Net income (gross income less expenses)2022-10-31$-27,571
Net plan assets at end of year (total assets less liabilities)2022-10-31$372,744
Net plan assets at beginning of year (total assets less liabilities)2022-10-31$400,315
Expenses. Administrative service providers (salaries,fees and commissions)2022-10-31$25,603
2021 : HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2021 401k financial data
Total income from all sources2021-10-31$113
Expenses. Total of all expenses incurred2021-10-31$26,341
Total plan assets at end of year2021-10-31$400,315
Total plan assets at beginning of year2021-10-31$426,543
Value of fidelity bond covering the plan2021-10-31$50,000
Expenses. Other expenses not covered elsewhere2021-10-31$2,389
Other income received2021-10-31$113
Net income (gross income less expenses)2021-10-31$-26,228
Net plan assets at end of year (total assets less liabilities)2021-10-31$400,315
Net plan assets at beginning of year (total assets less liabilities)2021-10-31$426,543
Expenses. Administrative service providers (salaries,fees and commissions)2021-10-31$23,952
2020 : HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2020 401k financial data
Total income from all sources2020-10-31$6,221
Expenses. Total of all expenses incurred2020-10-31$54,496
Benefits paid (including direct rollovers)2020-10-31$26,009
Total plan assets at end of year2020-10-31$426,543
Total plan assets at beginning of year2020-10-31$474,818
Value of fidelity bond covering the plan2020-10-31$50,000
Total contributions received or receivable from participants2020-10-31$2,845
Expenses. Other expenses not covered elsewhere2020-10-31$2,746
Other income received2020-10-31$3,373
Net income (gross income less expenses)2020-10-31$-48,275
Net plan assets at end of year (total assets less liabilities)2020-10-31$426,543
Net plan assets at beginning of year (total assets less liabilities)2020-10-31$474,818
Total contributions received or receivable from employer(s)2020-10-31$3
Expenses. Administrative service providers (salaries,fees and commissions)2020-10-31$25,741
2019 : HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2019 401k financial data
Total income from all sources2019-10-31$38,727
Expenses. Total of all expenses incurred2019-10-31$279,045
Benefits paid (including direct rollovers)2019-10-31$248,832
Total plan assets at end of year2019-10-31$474,818
Total plan assets at beginning of year2019-10-31$715,136
Value of fidelity bond covering the plan2019-10-31$110,000
Expenses. Other expenses not covered elsewhere2019-10-31$2,547
Other income received2019-10-31$11,525
Net income (gross income less expenses)2019-10-31$-240,318
Net plan assets at end of year (total assets less liabilities)2019-10-31$474,818
Net plan assets at beginning of year (total assets less liabilities)2019-10-31$715,136
Total contributions received or receivable from employer(s)2019-10-31$27,202
Expenses. Administrative service providers (salaries,fees and commissions)2019-10-31$27,666
2017 : HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2017 401k financial data
Total income from all sources2017-10-31$32,320
Expenses. Total of all expenses incurred2017-10-31$48,760
Benefits paid (including direct rollovers)2017-10-31$24,897
Total plan assets at end of year2017-10-31$639,847
Total plan assets at beginning of year2017-10-31$656,287
Value of fidelity bond covering the plan2017-10-31$110,000
Total contributions received or receivable from participants2017-10-31$8,343
Other income received2017-10-31$3,847
Net income (gross income less expenses)2017-10-31$-16,440
Net plan assets at end of year (total assets less liabilities)2017-10-31$639,847
Net plan assets at beginning of year (total assets less liabilities)2017-10-31$656,287
Total contributions received or receivable from employer(s)2017-10-31$20,130
Expenses. Administrative service providers (salaries,fees and commissions)2017-10-31$23,863
2016 : HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2016 401k financial data
Total income from all sources2016-10-31$30,246
Expenses. Total of all expenses incurred2016-10-31$98,263
Benefits paid (including direct rollovers)2016-10-31$61,808
Total plan assets at end of year2016-10-31$656,287
Total plan assets at beginning of year2016-10-31$724,304
Value of fidelity bond covering the plan2016-10-31$120,000
Expenses. Other expenses not covered elsewhere2016-10-31$2,097
Contributions received from other sources (not participants or employers)2016-10-31$4,472
Other income received2016-10-31$1,762
Net income (gross income less expenses)2016-10-31$-68,017
Net plan assets at end of year (total assets less liabilities)2016-10-31$656,287
Net plan assets at beginning of year (total assets less liabilities)2016-10-31$724,304
Total contributions received or receivable from employer(s)2016-10-31$24,012
Expenses. Administrative service providers (salaries,fees and commissions)2016-10-31$34,358
2015 : HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2015 401k financial data
Total plan liabilities at beginning of year2015-10-31$134
Total income from all sources2015-10-31$39,655
Expenses. Total of all expenses incurred2015-10-31$72,107
Benefits paid (including direct rollovers)2015-10-31$33,240
Total plan assets at end of year2015-10-31$724,304
Total plan assets at beginning of year2015-10-31$756,890
Value of fidelity bond covering the plan2015-10-31$110,000
Expenses. Other expenses not covered elsewhere2015-10-31$3,442
Other income received2015-10-31$542
Net income (gross income less expenses)2015-10-31$-32,452
Net plan assets at end of year (total assets less liabilities)2015-10-31$724,304
Net plan assets at beginning of year (total assets less liabilities)2015-10-31$756,756
Total contributions received or receivable from employer(s)2015-10-31$39,113
Expenses. Administrative service providers (salaries,fees and commissions)2015-10-31$35,425
2014 : HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2014 401k financial data
Total plan liabilities at end of year2014-10-31$134
Total plan liabilities at beginning of year2014-10-31$9,358
Total income from all sources2014-10-31$26,854
Expenses. Total of all expenses incurred2014-10-31$88,755
Benefits paid (including direct rollovers)2014-10-31$44,007
Total plan assets at end of year2014-10-31$756,890
Total plan assets at beginning of year2014-10-31$828,015
Value of fidelity bond covering the plan2014-10-31$110,000
Expenses. Other expenses not covered elsewhere2014-10-31$1,285
Other income received2014-10-31$832
Net income (gross income less expenses)2014-10-31$-61,901
Net plan assets at end of year (total assets less liabilities)2014-10-31$756,756
Net plan assets at beginning of year (total assets less liabilities)2014-10-31$818,657
Total contributions received or receivable from employer(s)2014-10-31$26,022
Expenses. Administrative service providers (salaries,fees and commissions)2014-10-31$43,463
2013 : HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2013 401k financial data
Total plan liabilities at end of year2013-10-31$9,358
Total plan liabilities at beginning of year2013-10-31$2,285
Total income from all sources2013-10-31$115,889
Expenses. Total of all expenses incurred2013-10-31$202,454
Benefits paid (including direct rollovers)2013-10-31$147,338
Total plan assets at end of year2013-10-31$828,015
Total plan assets at beginning of year2013-10-31$907,507
Value of fidelity bond covering the plan2013-10-31$170,000
Expenses. Other expenses not covered elsewhere2013-10-31$2,011
Contributions received from other sources (not participants or employers)2013-10-31$2,564
Other income received2013-10-31$1,051
Net income (gross income less expenses)2013-10-31$-86,565
Net plan assets at end of year (total assets less liabilities)2013-10-31$818,657
Net plan assets at beginning of year (total assets less liabilities)2013-10-31$905,222
Total contributions received or receivable from employer(s)2013-10-31$112,274
Expenses. Administrative service providers (salaries,fees and commissions)2013-10-31$53,105
2012 : HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2012 401k financial data
Total plan liabilities at end of year2012-10-31$2,285
Total plan liabilities at beginning of year2012-10-31$10,077
Total income from all sources2012-10-31$62,909
Expenses. Total of all expenses incurred2012-10-31$231,308
Benefits paid (including direct rollovers)2012-10-31$170,911
Total plan assets at end of year2012-10-31$907,507
Total plan assets at beginning of year2012-10-31$1,083,698
Value of fidelity bond covering the plan2012-10-31$170,000
Contributions received from other sources (not participants or employers)2012-10-31$9,928
Other income received2012-10-31$1,973
Net income (gross income less expenses)2012-10-31$-168,399
Net plan assets at end of year (total assets less liabilities)2012-10-31$905,222
Net plan assets at beginning of year (total assets less liabilities)2012-10-31$1,073,621
Total contributions received or receivable from employer(s)2012-10-31$51,008
Expenses. Administrative service providers (salaries,fees and commissions)2012-10-31$60,397
2011 : HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2011 401k financial data
Total plan liabilities at end of year2011-10-31$10,077
Total plan liabilities at beginning of year2011-10-31$2,343
Total income from all sources2011-10-31$224,791
Expenses. Total of all expenses incurred2011-10-31$309,598
Benefits paid (including direct rollovers)2011-10-31$248,552
Total plan assets at end of year2011-10-31$1,083,698
Total plan assets at beginning of year2011-10-31$1,160,771
Value of fidelity bond covering the plan2011-10-31$200,000
Total contributions received or receivable from participants2011-10-31$13,332
Other income received2011-10-31$1,488
Net income (gross income less expenses)2011-10-31$-84,807
Net plan assets at end of year (total assets less liabilities)2011-10-31$1,073,621
Net plan assets at beginning of year (total assets less liabilities)2011-10-31$1,158,428
Total contributions received or receivable from employer(s)2011-10-31$209,971
Expenses. Administrative service providers (salaries,fees and commissions)2011-10-31$61,046

Form 5500 Responses for HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN

2021: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-11-01Type of plan entityMulti-employer plan
2021-11-01Submission has been amendedNo
2021-11-01This submission is the final filingNo
2021-11-01This return/report is a short plan year return/report (less than 12 months)No
2021-11-01Plan is a collectively bargained planYes
2021-11-01Plan funding arrangement – TrustYes
2021-11-01Plan benefit arrangement – InsuranceYes
2020: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-11-01Type of plan entityMulti-employer plan
2020-11-01Plan is a collectively bargained planYes
2020-11-01Plan funding arrangement – TrustYes
2020-11-01Plan benefit arrangement – InsuranceYes
2019: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-11-01Type of plan entityMulti-employer plan
2019-11-01Plan is a collectively bargained planYes
2019-11-01Plan funding arrangement – TrustYes
2019-11-01Plan benefit arrangement – InsuranceYes
2018: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-11-01Type of plan entityMulti-employer plan
2018-11-01Plan is a collectively bargained planYes
2018-11-01Plan funding arrangement – TrustYes
2018-11-01Plan benefit arrangement – InsuranceYes
2017: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-11-01Type of plan entityMulti-employer plan
2017-11-01Plan is a collectively bargained planYes
2017-11-01Plan funding arrangement – TrustYes
2017-11-01Plan benefit arrangement – InsuranceYes
2016: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-11-01Type of plan entityMulti-employer plan
2016-11-01Plan is a collectively bargained planYes
2016-11-01Plan funding arrangement – TrustYes
2016-11-01Plan benefit arrangement – InsuranceYes
2015: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-11-01Type of plan entityMulti-employer plan
2015-11-01Plan is a collectively bargained planYes
2015-11-01Plan funding arrangement – TrustYes
2015-11-01Plan benefit arrangement – InsuranceYes
2015-11-01Plan benefit arrangement - TrustYes
2014: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-11-01Type of plan entityMulti-employer plan
2014-11-01Plan is a collectively bargained planYes
2014-11-01Plan funding arrangement – TrustYes
2014-11-01Plan benefit arrangement – InsuranceYes
2014-11-01Plan benefit arrangement - TrustYes
2013: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2013 form 5500 responses
2013-11-01Type of plan entityMulti-employer plan
2013-11-01Plan is a collectively bargained planYes
2013-11-01Plan funding arrangement – TrustYes
2013-11-01Plan benefit arrangement – InsuranceYes
2013-11-01Plan benefit arrangement - TrustYes
2012: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2012 form 5500 responses
2012-11-01Type of plan entityMulti-employer plan
2012-11-01Plan is a collectively bargained planYes
2012-11-01Plan funding arrangement – TrustYes
2012-11-01Plan benefit arrangement – InsuranceYes
2012-11-01Plan benefit arrangement - TrustYes
2011: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2011 form 5500 responses
2011-11-01Type of plan entityMulti-employer plan
2011-11-01Plan is a collectively bargained planYes
2011-11-01Plan funding arrangement – TrustYes
2011-11-01Plan benefit arrangement – InsuranceYes
2011-11-01Plan benefit arrangement - TrustYes
2009: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2009 form 5500 responses
2009-11-01Type of plan entityMulti-employer plan
2009-11-01This submission is the final filingNo
2009-11-01Plan is a collectively bargained planYes
2009-11-01Plan funding arrangement – TrustYes
2009-11-01Plan benefit arrangement – InsuranceYes
2009-11-01Plan benefit arrangement - TrustYes
2008: HAWAII BOILERMAKERS HEALTH AND WELFARE PLAN 2008 form 5500 responses
2008-11-01Type of plan entityMulti-employer plan
2008-11-01Submission has been amendedNo
2008-11-01This submission is the final filingNo
2008-11-01This return/report is a short plan year return/report (less than 12 months)No
2008-11-01Plan is a collectively bargained planNo

Insurance Providers Used on plan

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number1579
Policy instance 1
Insurance contract or identification number1579
Number of Individuals Covered1
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,713
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number169-0001
Policy instance 2
Insurance contract or identification number169-0001
Number of Individuals Covered0
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,296
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 number1579
Policy instance 1
Insurance contract or identification number1579
Number of Individuals Covered25
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $261,992
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number169-0001
Policy instance 2
Insurance contract or identification number169-0001
Number of Individuals Covered14
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,165
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number169-0001
Policy instance 2
Insurance contract or identification number169-0001
Number of Individuals Covered59
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,063
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 number1579
Policy instance 1
Insurance contract or identification number1579
Number of Individuals Covered59
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $143,547
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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