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KAISER FOUNDATION HEALTH PLAN OF HAWAII 401k Plan overview

Plan NameKAISER FOUNDATION HEALTH PLAN OF HAWAII
Plan identification number 502

KAISER FOUNDATION HEALTH PLAN OF HAWAII Benefits

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

401k Sponsoring company profile

HONOLULU COMMUNITY ACTION PROGRAM, INC. has sponsored the creation of one or more 401k plans.

Company Name:HONOLULU COMMUNITY ACTION PROGRAM, INC.
Employer identification number (EIN):990140622
NAIC Classification:624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KAISER FOUNDATION HEALTH PLAN OF HAWAII

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022014-07-01JOCELYN BANKS
5022014-07-01DEREK NISHIMURA
5022013-07-01DEREK NISHIMURA
5022012-07-01DEREK NISHIMURA
5022011-07-01DEREK NISHIMURA
5022010-07-01DEREK NISHIMURA
5022009-07-01DEREK NISHIMURA

Plan Statistics for KAISER FOUNDATION HEALTH PLAN OF HAWAII

401k plan membership statisitcs for KAISER FOUNDATION HEALTH PLAN OF HAWAII

Measure Date Value
2014: KAISER FOUNDATION HEALTH PLAN OF HAWAII 2014 401k membership
Total participants, beginning-of-year2014-07-01204
Total number of active participants reported on line 7a of the Form 55002014-07-010
Total of all active and inactive participants2014-07-010
Total participants2014-07-010
2013: KAISER FOUNDATION HEALTH PLAN OF HAWAII 2013 401k membership
Total participants, beginning-of-year2013-07-01217
Total number of active participants reported on line 7a of the Form 55002013-07-01204
Total of all active and inactive participants2013-07-01204
Total participants2013-07-01204
2012: KAISER FOUNDATION HEALTH PLAN OF HAWAII 2012 401k membership
Total participants, beginning-of-year2012-07-01199
Total number of active participants reported on line 7a of the Form 55002012-07-01194
Total of all active and inactive participants2012-07-01194
Total participants2012-07-01194
2011: KAISER FOUNDATION HEALTH PLAN OF HAWAII 2011 401k membership
Total participants, beginning-of-year2011-07-01200
Total number of active participants reported on line 7a of the Form 55002011-07-01197
Total of all active and inactive participants2011-07-01197
Total participants2011-07-01197
2010: KAISER FOUNDATION HEALTH PLAN OF HAWAII 2010 401k membership
Total participants, beginning-of-year2010-07-01202
Total number of active participants reported on line 7a of the Form 55002010-07-01196
Total of all active and inactive participants2010-07-01196
Total participants2010-07-01196
2009: KAISER FOUNDATION HEALTH PLAN OF HAWAII 2009 401k membership
Total participants, beginning-of-year2009-07-01195
Total number of active participants reported on line 7a of the Form 55002009-07-01203
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-01203
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-07-010
Total participants2009-07-01203

Form 5500 Responses for KAISER FOUNDATION HEALTH PLAN OF HAWAII

2014: KAISER FOUNDATION HEALTH PLAN OF HAWAII 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedYes
2014-07-01This submission is the final filingYes
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: KAISER FOUNDATION HEALTH PLAN OF HAWAII 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: KAISER FOUNDATION HEALTH PLAN OF HAWAII 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: KAISER FOUNDATION HEALTH PLAN OF HAWAII 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2010: KAISER FOUNDATION HEALTH PLAN OF HAWAII 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Submission has been amendedNo
2010-07-01This submission is the final filingNo
2010-07-01This return/report is a short plan year return/report (less than 12 months)No
2010-07-01Plan is a collectively bargained planNo
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan benefit arrangement – InsuranceYes
2009: KAISER FOUNDATION HEALTH PLAN OF HAWAII 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number32
Policy instance 1
Insurance contract or identification number32
Number of Individuals Covered191
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,076,202
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 number000032
Policy instance 1
Insurance contract or identification number000032
Number of Individuals Covered204
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,136,946
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number00032
Policy instance 1
Insurance contract or identification number00032
Number of Individuals Covered217
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,411,368
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number00032
Policy instance 1
Insurance contract or identification number00032
Number of Individuals Covered197
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,049,071
KAISER PERMANENTE (National Association of Insurance Commissioners NAIC id number: 60053 )
Policy contract number00032
Policy instance 1
Insurance contract or identification number00032
Number of Individuals Covered196
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $974,202

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