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ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN 401k Plan overview

Plan NameROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN
Plan identification number 700

ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN Benefits

401k Plan Type
Plan Features/Benefits

    401k Sponsoring company profile

    ROCKWELL COLLINS, INC. has sponsored the creation of one or more 401k plans.

    Company Name:ROCKWELL COLLINS, INC.
    Employer identification number (EIN):522314475
    NAIC Classification:335900

    Additional information about ROCKWELL COLLINS, INC.

    Jurisdiction of Incorporation: Nevada Department of State
    Incorporation Date: 1996-10-28
    Company Identification Number: 19961215484
    Legal Registered Office Address: 701 S CARSON ST STE 200

    CARSON CITY
    United States of America (USA)
    89701

    More information about ROCKWELL COLLINS, INC.

    Form 5500 Filing Information

    Submission information for form 5500 for 401k plan ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN

    Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
    7002019-01-01
    7002018-01-01
    7002017-01-01ROSA BARONE ROSA BARONE2018-08-17
    7002016-01-01ROSA BARONE
    7002015-01-01ROSA BARONE
    7002014-01-01ROSA BARONE
    7002013-01-01ROSA BARONE ROSA BARONE2014-07-28
    7002012-01-01ROSA BARONE ROSA BARONE2013-07-24
    7002011-01-01ROSA BARONE ROSA BARONE2012-07-26
    7002009-10-01ROSA BARONE ROSA BARONE2011-05-02
    7002008-10-01
    7002007-10-01SAMUEL WOOD

    Plan Statistics for ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN

    401k plan membership statisitcs for ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN

    Measure Date Value
    2019
    Total participants, beginning-of-year2019-01-0116,207
    Total number of active participants reported on line 7a of the Form 55002019-01-010
    Number of retired or separated participants receiving benefits2019-01-010
    Number of other retired or separated participants entitled to future benefits2019-01-010
    Total of all active and inactive participants2019-01-010
    2018
    Total participants, beginning-of-year2018-01-0115,188
    Total number of active participants reported on line 7a of the Form 55002018-01-0116,132
    Number of retired or separated participants receiving benefits2018-01-0175
    Number of other retired or separated participants entitled to future benefits2018-01-010
    Total of all active and inactive participants2018-01-0116,207
    2017
    Total participants, beginning-of-year2017-01-0115,313
    Total number of active participants reported on line 7a of the Form 55002017-01-0115,120
    Number of retired or separated participants receiving benefits2017-01-0168
    Number of other retired or separated participants entitled to future benefits2017-01-010
    Total of all active and inactive participants2017-01-0115,188
    2016
    Total participants, beginning-of-year2016-01-0114,551
    Total number of active participants reported on line 7a of the Form 55002016-01-0115,249
    Number of retired or separated participants receiving benefits2016-01-0164
    Number of other retired or separated participants entitled to future benefits2016-01-010
    Total of all active and inactive participants2016-01-0115,313
    2015
    Total participants, beginning-of-year2015-01-0111,570
    Total number of active participants reported on line 7a of the Form 55002015-01-0114,551
    Number of retired or separated participants receiving benefits2015-01-010
    Number of other retired or separated participants entitled to future benefits2015-01-010
    Total of all active and inactive participants2015-01-0114,551
    2014
    Total participants, beginning-of-year2014-01-0113,847
    Total number of active participants reported on line 7a of the Form 55002014-01-0111,570
    Number of retired or separated participants receiving benefits2014-01-010
    Number of other retired or separated participants entitled to future benefits2014-01-010
    Total of all active and inactive participants2014-01-0111,570
    2013
    Total participants, beginning-of-year2013-01-0121,200
    Total number of active participants reported on line 7a of the Form 55002013-01-0113,847
    Number of retired or separated participants receiving benefits2013-01-016,683
    Number of other retired or separated participants entitled to future benefits2013-01-010
    Total of all active and inactive participants2013-01-0120,530
    2012
    Total participants, beginning-of-year2012-01-0123,315
    Total number of active participants reported on line 7a of the Form 55002012-01-0114,444
    Number of retired or separated participants receiving benefits2012-01-016,756
    Number of other retired or separated participants entitled to future benefits2012-01-010
    Total of all active and inactive participants2012-01-0121,200
    2011
    Total participants, beginning-of-year2011-01-0120,033
    Total number of active participants reported on line 7a of the Form 55002011-01-0115,555
    Number of retired or separated participants receiving benefits2011-01-017,760
    Number of other retired or separated participants entitled to future benefits2011-01-010
    Total of all active and inactive participants2011-01-0123,315
    2009
    Total participants, beginning-of-year2009-10-0119,987
    Total number of active participants reported on line 7a of the Form 55002009-10-0115,680
    Number of retired or separated participants receiving benefits2009-10-014,268
    Number of other retired or separated participants entitled to future benefits2009-10-010
    Total of all active and inactive participants2009-10-0119,948
    2007
    Total participants, beginning-of-year2007-10-0122,676
    Total number of active participants reported on line 7a of the Form 55002007-10-0115,913
    Number of retired or separated participants receiving benefits2007-10-014,842
    Number of other retired or separated participants entitled to future benefits2007-10-010
    Total of all active and inactive participants2007-10-0120,755
    Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2007-10-010
    Total participants2007-10-0120,755

    Financial Data on ROCKWELL COLLINS, INC. EMPLOYEE HEALTH PLAN

    Measure Date Value
    2019
    Total unrealized appreciation/depreciation of assets2019-03-31$0
    Total transfer of assets from this plan2019-03-31$7,016,570
    Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-03-31$0
    Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-03-31$849,372
    Total income from all sources (including contributions)2019-03-31$16,456,997
    Total loss/gain on sale of assets2019-03-31$0
    Total of all expenses incurred2019-03-31$28,538,414
    Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-03-31$26,745,112
    Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-03-31$14,123,036
    Value of total assets at end of year2019-03-31$0
    Value of total assets at beginning of year2019-03-31$19,947,359
    Total of administrative expenses incurred including professional, contract, advisory and management fees2019-03-31$1,793,302
    Total interest from all sources2019-03-31$0
    Total dividends received (eg from common stock, registered investment company shares)2019-03-31$61,985
    Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-03-31No
    Total dividends received from registered investment company shares (eg mutual funds)2019-03-31$61,985
    Administrative expenses professional fees incurred2019-03-31$1,936
    Was this plan covered by a fidelity bond2019-03-31Yes
    Value of fidelity bond cover2019-03-31$25,000,000
    Were there any nonexempt tranactions with any party-in-interest2019-03-31No
    Contributions received from participants2019-03-31$2,930,993
    Value of other receiveables (less allowance for doubtful accounts) at end of year2019-03-31$0
    Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-03-31$22,526
    Other income not declared elsewhere2019-03-31$2,271,976
    Administrative expenses (other) incurred2019-03-31$264,909
    Liabilities. Value of operating payables at end of year2019-03-31$0
    Liabilities. Value of operating payables at beginning of year2019-03-31$849,372
    Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-03-31No
    Value of net income/loss2019-03-31$-12,081,417
    Value of net assets at end of year (total assets less liabilities)2019-03-31$0
    Value of net assets at beginning of year (total assets less liabilities)2019-03-31$19,097,987
    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
    Value of interest in registered invesment companies (eg mutual funds) at end of year2019-03-31$0
    Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-03-31$19,924,833
    Expenses. Payments to insurance carriers foe the provision of benefits2019-03-31$475,759
    Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-03-31Yes
    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$11,192,043
    Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-03-31$26,269,353
    Contract administrator fees2019-03-31$1,526,457
    Did the plan have assets held for investment2019-03-31No
    Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-03-31No
    Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-03-31Yes
    Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-03-31Yes
    Opinion of an independent qualified public accountant for this plan2019-03-31Disclaimer
    Accountancy firm name2019-03-31GRANT THORNTON LLP
    Accountancy firm EIN2019-03-31366055558
    2018
    Total unrealized appreciation/depreciation of assets2018-12-31$0
    Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$849,372
    Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$612,117
    Total income from all sources (including contributions)2018-12-31$137,415,539
    Total loss/gain on sale of assets2018-12-31$0
    Total of all expenses incurred2018-12-31$139,489,205
    Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$131,849,570
    Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$132,664,357
    Value of total assets at end of year2018-12-31$19,947,359
    Value of total assets at beginning of year2018-12-31$21,783,770
    Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$7,639,635
    Total interest from all sources2018-12-31$0
    Total dividends received (eg from common stock, registered investment company shares)2018-12-31$149,371
    Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
    Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$149,371
    Administrative expenses professional fees incurred2018-12-31$49,812
    Was this plan covered by a fidelity bond2018-12-31Yes
    Value of fidelity bond cover2018-12-31$25,000,000
    Were there any nonexempt tranactions with any party-in-interest2018-12-31No
    Contributions received from participants2018-12-31$7,252,224
    Participant contributions at end of year2018-12-31$0
    Participant contributions at beginning of year2018-12-31$868,639
    Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$22,526
    Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$6,188,262
    Other income not declared elsewhere2018-12-31$4,601,811
    Administrative expenses (other) incurred2018-12-31$609,837
    Liabilities. Value of operating payables at end of year2018-12-31$849,372
    Liabilities. Value of operating payables at beginning of year2018-12-31$612,117
    Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
    Value of net income/loss2018-12-31$-2,073,666
    Value of net assets at end of year (total assets less liabilities)2018-12-31$19,097,987
    Value of net assets at beginning of year (total assets less liabilities)2018-12-31$21,171,653
    Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
    Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
    Were any leases to which the plan was party in default or uncollectible2018-12-31No
    Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$19,924,833
    Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$4,295,865
    Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$3,020,663
    Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31Yes
    Was there a failure to transmit to the plan any participant contributions2018-12-31No
    Has the plan failed to provide any benefit when due under the plan2018-12-31No
    Contributions received in cash from employer2018-12-31$125,412,133
    Employer contributions (assets) at end of year2018-12-31$0
    Employer contributions (assets) at beginning of year2018-12-31$10,431,004
    Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$128,828,907
    Contract administrator fees2018-12-31$6,979,986
    Did the plan have assets held for investment2018-12-31Yes
    Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
    Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
    2017
    Total unrealized appreciation/depreciation of assets2017-12-31$0
    Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$612,117
    Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$1,949,861
    Total income from all sources (including contributions)2017-12-31$129,477,085
    Total loss/gain on sale of assets2017-12-31$0
    Total of all expenses incurred2017-12-31$125,999,652
    Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$118,732,854
    Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$122,832,243
    Value of total assets at end of year2017-12-31$21,783,770
    Value of total assets at beginning of year2017-12-31$19,644,081
    Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$7,266,798
    Total interest from all sources2017-12-31$0
    Total dividends received (eg from common stock, registered investment company shares)2017-12-31$41,927
    Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
    Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$41,927
    Administrative expenses professional fees incurred2017-12-31$22,804
    Was this plan covered by a fidelity bond2017-12-31Yes
    Value of fidelity bond cover2017-12-31$25,000,000
    Were there any nonexempt tranactions with any party-in-interest2017-12-31No
    Contributions received from participants2017-12-31$5,948,937
    Participant contributions at end of year2017-12-31$868,639
    Participant contributions at beginning of year2017-12-31$1,432,809
    Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$6,188,262
    Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$5,682,121
    Other income not declared elsewhere2017-12-31$6,602,915
    Administrative expenses (other) incurred2017-12-31$765,624
    Liabilities. Value of operating payables at end of year2017-12-31$612,117
    Liabilities. Value of operating payables at beginning of year2017-12-31$1,949,861
    Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
    Value of net income/loss2017-12-31$3,477,433
    Value of net assets at end of year (total assets less liabilities)2017-12-31$21,171,653
    Value of net assets at beginning of year (total assets less liabilities)2017-12-31$17,694,220
    Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
    Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
    Were any leases to which the plan was party in default or uncollectible2017-12-31No
    Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$4,295,865
    Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$2,313,008
    Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$2,768,784
    Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31Yes
    Was there a failure to transmit to the plan any participant contributions2017-12-31No
    Has the plan failed to provide any benefit when due under the plan2017-12-31No
    Contributions received in cash from employer2017-12-31$116,883,306
    Employer contributions (assets) at end of year2017-12-31$10,431,004
    Employer contributions (assets) at beginning of year2017-12-31$10,216,143
    Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$115,964,070
    Contract administrator fees2017-12-31$6,478,370
    Did the plan have assets held for investment2017-12-31Yes
    Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
    Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
    Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
    Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
    Accountancy firm name2017-12-31GRANT THORNTON LLP
    Accountancy firm EIN2017-12-31366055558
    2016
    Total unrealized appreciation/depreciation of assets2016-12-31$0
    Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$1,949,861
    Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$1,170,801
    Total income from all sources (including contributions)2016-12-31$123,192,075
    Total loss/gain on sale of assets2016-12-31$0
    Total of all expenses incurred2016-12-31$120,787,695
    Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$112,334,377
    Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$114,615,497
    Value of total assets at end of year2016-12-31$19,644,081
    Value of total assets at beginning of year2016-12-31$16,460,641
    Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$8,453,318
    Total interest from all sources2016-12-31$0
    Total dividends received (eg from common stock, registered investment company shares)2016-12-31$9,123
    Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
    Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$9,123
    Administrative expenses professional fees incurred2016-12-31$141,400
    Was this plan covered by a fidelity bond2016-12-31Yes
    Value of fidelity bond cover2016-12-31$25,000,000
    Were there any nonexempt tranactions with any party-in-interest2016-12-31No
    Contributions received from participants2016-12-31$11,401,033
    Participant contributions at end of year2016-12-31$1,432,809
    Participant contributions at beginning of year2016-12-31$1,491,562
    Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$5,682,121
    Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$1,027,174
    Other income not declared elsewhere2016-12-31$8,567,455
    Administrative expenses (other) incurred2016-12-31$1,844,225
    Liabilities. Value of operating payables at end of year2016-12-31$1,949,861
    Liabilities. Value of operating payables at beginning of year2016-12-31$1,170,801
    Total non interest bearing cash at end of year2016-12-31$-784
    Total non interest bearing cash at beginning of year2016-12-31$0
    Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
    Value of net income/loss2016-12-31$2,404,380
    Value of net assets at end of year (total assets less liabilities)2016-12-31$17,694,220
    Value of net assets at beginning of year (total assets less liabilities)2016-12-31$15,289,840
    Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
    Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
    Were any leases to which the plan was party in default or uncollectible2016-12-31No
    Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$2,313,792
    Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$2,369,099
    Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$3,073,931
    Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31Yes
    Was there a failure to transmit to the plan any participant contributions2016-12-31No
    Has the plan failed to provide any benefit when due under the plan2016-12-31No
    Contributions received in cash from employer2016-12-31$103,214,464
    Employer contributions (assets) at end of year2016-12-31$10,216,143
    Employer contributions (assets) at beginning of year2016-12-31$11,572,806
    Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$109,260,446
    Contract administrator fees2016-12-31$6,467,693
    Did the plan have assets held for investment2016-12-31Yes
    Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
    Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
    Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
    Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
    Accountancy firm name2016-12-31GRANT THORNTON LLP
    Accountancy firm EIN2016-12-31366055558
    2015
    Total unrealized appreciation/depreciation of assets2015-12-31$0
    Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$1,170,801
    Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$2,228,296
    Total income from all sources (including contributions)2015-12-31$113,930,111
    Total loss/gain on sale of assets2015-12-31$0
    Total of all expenses incurred2015-12-31$109,714,491
    Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$102,237,846
    Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$111,607,776
    Value of total assets at end of year2015-12-31$16,460,641
    Value of total assets at beginning of year2015-12-31$13,302,516
    Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$7,476,645
    Total interest from all sources2015-12-31$0
    Total dividends received (eg from common stock, registered investment company shares)2015-12-31$65
    Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
    Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$65
    Administrative expenses professional fees incurred2015-12-31$176,898
    Was this plan covered by a fidelity bond2015-12-31Yes
    Value of fidelity bond cover2015-12-31$25,000,000
    Were there any nonexempt tranactions with any party-in-interest2015-12-31No
    Contributions received from participants2015-12-31$7,875,336
    Participant contributions at end of year2015-12-31$1,491,562
    Participant contributions at beginning of year2015-12-31$1,192,089
    Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$1,027,174
    Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$50
    Other income not declared elsewhere2015-12-31$2,322,297
    Administrative expenses (other) incurred2015-12-31$1,745,930
    Liabilities. Value of operating payables at end of year2015-12-31$1,170,801
    Liabilities. Value of operating payables at beginning of year2015-12-31$2,228,296
    Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
    Value of net income/loss2015-12-31$4,215,620
    Value of net assets at end of year (total assets less liabilities)2015-12-31$15,289,840
    Value of net assets at beginning of year (total assets less liabilities)2015-12-31$11,074,220
    Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
    Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
    Were any leases to which the plan was party in default or uncollectible2015-12-31No
    Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$2,369,099
    Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$3,377,741
    Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$2,637,832
    Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-27
    Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31Yes
    Was there a failure to transmit to the plan any participant contributions2015-12-31No
    Has the plan failed to provide any benefit when due under the plan2015-12-31No
    Contributions received in cash from employer2015-12-31$103,732,440
    Employer contributions (assets) at end of year2015-12-31$11,572,806
    Employer contributions (assets) at beginning of year2015-12-31$8,732,636
    Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$99,600,014
    Contract administrator fees2015-12-31$5,553,817
    Did the plan have assets held for investment2015-12-31Yes
    Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
    Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
    Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
    Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
    Accountancy firm name2015-12-31GRANT THORNTON LLP
    Accountancy firm EIN2015-12-31366055558
    2014
    Unrealized appreciation/depreciation of other (non real estate) assets2014-12-31$-261
    Total unrealized appreciation/depreciation of assets2014-12-31$-261
    Total transfer of assets from this plan2014-12-31$14,807,234
    Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$2,228,296
    Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$630,523
    Total income from all sources (including contributions)2014-12-31$108,038,278
    Total loss/gain on sale of assets2014-12-31$0
    Total of all expenses incurred2014-12-31$110,273,769
    Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$101,541,653
    Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$106,473,228
    Value of total assets at end of year2014-12-31$13,302,516
    Value of total assets at beginning of year2014-12-31$28,747,468
    Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$8,732,116
    Total interest from all sources2014-12-31$90
    Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
    Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
    Administrative expenses professional fees incurred2014-12-31$134,477
    Was this plan covered by a fidelity bond2014-12-31Yes
    Value of fidelity bond cover2014-12-31$25,000,000
    Were there any nonexempt tranactions with any party-in-interest2014-12-31No
    Contributions received from participants2014-12-31$8,179,748
    Participant contributions at end of year2014-12-31$1,192,089
    Participant contributions at beginning of year2014-12-31$1,994,340
    Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$50
    Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$2,682,114
    Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$0
    Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$167,619
    Other income not declared elsewhere2014-12-31$1,565,221
    Administrative expenses (other) incurred2014-12-31$1,984,682
    Liabilities. Value of operating payables at end of year2014-12-31$2,228,296
    Liabilities. Value of operating payables at beginning of year2014-12-31$462,904
    Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
    Value of net income/loss2014-12-31$-2,235,491
    Value of net assets at end of year (total assets less liabilities)2014-12-31$11,074,220
    Value of net assets at beginning of year (total assets less liabilities)2014-12-31$28,116,945
    Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
    Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
    Were any leases to which the plan was party in default or uncollectible2014-12-31No
    Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$3,377,741
    Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$2,498,209
    Interest earned on other investments2014-12-31$87
    Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$3
    Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$3,322,550
    Asset value of US Government securities at end of year2014-12-31$0
    Asset value of US Government securities at beginning of year2014-12-31$2,653,723
    Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
    Was there a failure to transmit to the plan any participant contributions2014-12-31No
    Has the plan failed to provide any benefit when due under the plan2014-12-31No
    Contributions received in cash from employer2014-12-31$98,293,480
    Employer contributions (assets) at end of year2014-12-31$8,732,636
    Employer contributions (assets) at beginning of year2014-12-31$9,505,659
    Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$98,219,103
    Asset. Corporate debt instrument preferred debt at end of year2014-12-31$0
    Asset. Corporate debt instrument preferred debt at beginning of year2014-12-31$1,362,837
    Asset. Corporate debt instrument debt (other) at end of year2014-12-31$0
    Asset. Corporate debt instrument debt (other) at beginning of year2014-12-31$660,498
    Contract administrator fees2014-12-31$6,612,957
    Assets. Corporate common stocks other than exployer securities at end of year2014-12-31$0
    Assets. Corporate common stocks other than exployer securities at beginning of year2014-12-31$7,390,088
    Did the plan have assets held for investment2014-12-31Yes
    Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
    Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
    Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
    Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
    Accountancy firm name2014-12-31DELOITTE & TOUCHE LLP
    Accountancy firm EIN2014-12-31133891517
    2013
    Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$732,039
    Total unrealized appreciation/depreciation of assets2013-12-31$732,039
    Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$630,523
    Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$755,717
    Total income from all sources (including contributions)2013-12-31$156,798,421
    Total loss/gain on sale of assets2013-12-31$865,386
    Total of all expenses incurred2013-12-31$154,452,382
    Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$146,202,153
    Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$153,027,631
    Value of total assets at end of year2013-12-31$28,747,468
    Value of total assets at beginning of year2013-12-31$26,526,623
    Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$8,250,229
    Total interest from all sources2013-12-31$115,751
    Total dividends received (eg from common stock, registered investment company shares)2013-12-31$143,995
    Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
    Administrative expenses professional fees incurred2013-12-31$153,487
    Was this plan covered by a fidelity bond2013-12-31Yes
    Value of fidelity bond cover2013-12-31$25,000,000
    Were there any nonexempt tranactions with any party-in-interest2013-12-31No
    Contributions received from participants2013-12-31$30,633,500
    Participant contributions at end of year2013-12-31$1,994,340
    Participant contributions at beginning of year2013-12-31$2,043,316
    Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$2,682,114
    Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$1,073,122
    Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$167,619
    Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$365,908
    Other income not declared elsewhere2013-12-31$1,921,964
    Administrative expenses (other) incurred2013-12-31$388,321
    Liabilities. Value of operating payables at end of year2013-12-31$462,904
    Liabilities. Value of operating payables at beginning of year2013-12-31$389,809
    Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
    Value of net income/loss2013-12-31$2,346,039
    Value of net assets at end of year (total assets less liabilities)2013-12-31$28,116,945
    Value of net assets at beginning of year (total assets less liabilities)2013-12-31$25,770,906
    Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
    Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
    Were any leases to which the plan was party in default or uncollectible2013-12-31No
    Investment advisory and management fees2013-12-31$34,255
    Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$2,498,209
    Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$1,771,223
    Income. Interest from US Government securities2013-12-31$49,351
    Income. Interest from corporate debt instruments2013-12-31$65,078
    Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$1,322
    Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$14,600,083
    Asset value of US Government securities at end of year2013-12-31$2,653,723
    Asset value of US Government securities at beginning of year2013-12-31$2,641,404
    Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$-8,345
    Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31Yes
    Was there a failure to transmit to the plan any participant contributions2013-12-31No
    Has the plan failed to provide any benefit when due under the plan2013-12-31No
    Contributions received in cash from employer2013-12-31$122,394,131
    Employer contributions (assets) at end of year2013-12-31$9,505,659
    Employer contributions (assets) at beginning of year2013-12-31$11,456,684
    Income. Dividends from common stock2013-12-31$143,995
    Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$131,602,070
    Asset. Corporate debt instrument preferred debt at end of year2013-12-31$1,362,837
    Asset. Corporate debt instrument preferred debt at beginning of year2013-12-31$956,200
    Asset. Corporate debt instrument debt (other) at end of year2013-12-31$660,498
    Asset. Corporate debt instrument debt (other) at beginning of year2013-12-31$559,727
    Contract administrator fees2013-12-31$7,674,166
    Assets. Corporate common stocks other than exployer securities at end of year2013-12-31$7,390,088
    Assets. Corporate common stocks other than exployer securities at beginning of year2013-12-31$6,024,947
    Did the plan have assets held for investment2013-12-31Yes
    Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
    Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
    Aggregate proceeds on sale of assets2013-12-31$11,422,061
    Aggregate carrying amount (costs) on sale of assets2013-12-31$10,556,675
    Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
    Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
    Accountancy firm name2013-12-31DELOITTE & TOUCHE LLP
    Accountancy firm EIN2013-12-31133891517
    2012
    Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$500,439
    Total unrealized appreciation/depreciation of assets2012-12-31$500,439
    Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$755,717
    Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$1,307,340
    Total income from all sources (including contributions)2012-12-31$167,456,725
    Total loss/gain on sale of assets2012-12-31$253,603
    Total of all expenses incurred2012-12-31$164,962,145
    Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$156,186,720
    Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$165,060,587
    Value of total assets at end of year2012-12-31$26,526,623
    Value of total assets at beginning of year2012-12-31$24,583,666
    Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$8,775,425
    Total interest from all sources2012-12-31$106,810
    Total dividends received (eg from common stock, registered investment company shares)2012-12-31$144,126
    Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
    Administrative expenses professional fees incurred2012-12-31$135,504
    Was this plan covered by a fidelity bond2012-12-31Yes
    Value of fidelity bond cover2012-12-31$25,000,000
    Were there any nonexempt tranactions with any party-in-interest2012-12-31No
    Contributions received from participants2012-12-31$29,283,475
    Participant contributions at end of year2012-12-31$2,043,316
    Participant contributions at beginning of year2012-12-31$1,864,153
    Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$1,073,122
    Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$1,528,018
    Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$365,908
    Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$379,933
    Other income not declared elsewhere2012-12-31$1,379,194
    Administrative expenses (other) incurred2012-12-31$568,479
    Liabilities. Value of operating payables at end of year2012-12-31$389,809
    Liabilities. Value of operating payables at beginning of year2012-12-31$927,407
    Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
    Value of net income/loss2012-12-31$2,494,580
    Value of net assets at end of year (total assets less liabilities)2012-12-31$25,770,906
    Value of net assets at beginning of year (total assets less liabilities)2012-12-31$23,276,326
    Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
    Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
    Were any leases to which the plan was party in default or uncollectible2012-12-31No
    Investment advisory and management fees2012-12-31$30,339
    Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$1,771,223
    Income. Interest from US Government securities2012-12-31$46,168
    Income. Interest from corporate debt instruments2012-12-31$59,495
    Value of interest in common/collective trusts at end of year2012-12-31$0
    Value of interest in common/collective trusts at beginning of year2012-12-31$3,302,175
    Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$1,147
    Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$22,800,425
    Asset value of US Government securities at end of year2012-12-31$2,641,404
    Asset value of US Government securities at beginning of year2012-12-31$1,467,774
    Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$9,110
    Net investment gain or loss from common/collective trusts2012-12-31$2,856
    Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31Yes
    Was there a failure to transmit to the plan any participant contributions2012-12-31No
    Has the plan failed to provide any benefit when due under the plan2012-12-31No
    Contributions received in cash from employer2012-12-31$135,777,112
    Employer contributions (assets) at end of year2012-12-31$11,456,684
    Employer contributions (assets) at beginning of year2012-12-31$9,135,847
    Income. Dividends from common stock2012-12-31$144,126
    Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$133,386,295
    Asset. Corporate debt instrument preferred debt at end of year2012-12-31$956,200
    Asset. Corporate debt instrument preferred debt at beginning of year2012-12-31$1,041,604
    Asset. Corporate debt instrument debt (other) at end of year2012-12-31$559,727
    Asset. Corporate debt instrument debt (other) at beginning of year2012-12-31$366,204
    Contract administrator fees2012-12-31$8,041,103
    Assets. Corporate common stocks other than exployer securities at end of year2012-12-31$6,024,947
    Assets. Corporate common stocks other than exployer securities at beginning of year2012-12-31$5,877,891
    Did the plan have assets held for investment2012-12-31Yes
    Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
    Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
    Aggregate proceeds on sale of assets2012-12-31$9,222,384
    Aggregate carrying amount (costs) on sale of assets2012-12-31$8,968,781
    Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
    Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
    Accountancy firm name2012-12-31DELOITTE & TOUCHE LLP
    Accountancy firm EIN2012-12-31133891517
    2011
    Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$126,058
    Total unrealized appreciation/depreciation of assets2011-12-31$126,058
    Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$1,307,340
    Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$1,393,215
    Total income from all sources (including contributions)2011-12-31$169,556,544
    Total loss/gain on sale of assets2011-12-31$-178,570
    Total of all expenses incurred2011-12-31$169,859,026
    Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$160,065,932
    Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$167,417,833
    Value of total assets at end of year2011-12-31$24,583,666
    Value of total assets at beginning of year2011-12-31$24,972,023
    Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$9,793,094
    Total interest from all sources2011-12-31$109,284
    Total dividends received (eg from common stock, registered investment company shares)2011-12-31$124,759
    Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
    Administrative expenses professional fees incurred2011-12-31$166,721
    Was this plan covered by a fidelity bond2011-12-31Yes
    Value of fidelity bond cover2011-12-31$25,000,000
    Were there any nonexempt tranactions with any party-in-interest2011-12-31No
    Contributions received from participants2011-12-31$42,628,739
    Participant contributions at end of year2011-12-31$1,864,153
    Participant contributions at beginning of year2011-12-31$1,433,902
    Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$1,528,018
    Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$1,196,833
    Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$379,933
    Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$688,256
    Other income not declared elsewhere2011-12-31$1,951,306
    Administrative expenses (other) incurred2011-12-31$393,027
    Liabilities. Value of operating payables at end of year2011-12-31$927,407
    Liabilities. Value of operating payables at beginning of year2011-12-31$704,959
    Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
    Value of net income/loss2011-12-31$-302,482
    Value of net assets at end of year (total assets less liabilities)2011-12-31$23,276,326
    Value of net assets at beginning of year (total assets less liabilities)2011-12-31$23,578,808
    Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
    Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
    Were any leases to which the plan was party in default or uncollectible2011-12-31No
    Investment advisory and management fees2011-12-31$27,069
    Income. Interest from US Government securities2011-12-31$38,221
    Income. Interest from corporate debt instruments2011-12-31$70,115
    Value of interest in common/collective trusts at end of year2011-12-31$3,302,175
    Value of interest in common/collective trusts at beginning of year2011-12-31$1,643,340
    Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$948
    Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$34,007,138
    Asset value of US Government securities at end of year2011-12-31$1,467,774
    Asset value of US Government securities at beginning of year2011-12-31$1,283,379
    Net investment gain or loss from common/collective trusts2011-12-31$5,874
    Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
    Was there a failure to transmit to the plan any participant contributions2011-12-31No
    Has the plan failed to provide any benefit when due under the plan2011-12-31No
    Contributions received in cash from employer2011-12-31$124,789,094
    Employer contributions (assets) at end of year2011-12-31$9,135,847
    Employer contributions (assets) at beginning of year2011-12-31$11,566,098
    Income. Dividends from preferred stock2011-12-31$124,759
    Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$126,058,794
    Asset. Corporate debt instrument preferred debt at end of year2011-12-31$1,041,604
    Asset. Corporate debt instrument preferred debt at beginning of year2011-12-31$1,256,727
    Asset. Corporate debt instrument debt (other) at end of year2011-12-31$366,204
    Asset. Corporate debt instrument debt (other) at beginning of year2011-12-31$320,850
    Contract administrator fees2011-12-31$9,206,277
    Assets. Corporate common stocks other than exployer securities at end of year2011-12-31$5,877,891
    Assets. Corporate common stocks other than exployer securities at beginning of year2011-12-31$6,270,894
    Did the plan have assets held for investment2011-12-31Yes
    Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
    Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
    Aggregate proceeds on sale of assets2011-12-31$13,257,428
    Aggregate carrying amount (costs) on sale of assets2011-12-31$13,435,998
    Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
    Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
    Accountancy firm name2011-12-31DELOITTE & TOUCHE LLP
    Accountancy firm EIN2011-12-31133891517
    2010
    Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$402,852
    Total unrealized appreciation/depreciation of assets2010-12-31$402,852
    Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$1,393,215
    Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$527,513
    Total income from all sources (including contributions)2010-12-31$41,105,065
    Total loss/gain on sale of assets2010-12-31$129,118
    Total of all expenses incurred2010-12-31$41,399,848
    Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$38,761,621
    Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$40,017,611
    Value of total assets at end of year2010-12-31$24,972,023
    Value of total assets at beginning of year2010-12-31$24,401,104
    Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$2,638,227
    Total interest from all sources2010-12-31$31,649
    Total dividends received (eg from common stock, registered investment company shares)2010-12-31$32,249
    Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
    Administrative expenses professional fees incurred2010-12-31$85,642
    Was this plan covered by a fidelity bond2010-12-31Yes
    Value of fidelity bond cover2010-12-31$25,000,000
    Were there any nonexempt tranactions with any party-in-interest2010-12-31No
    Contributions received from participants2010-12-31$5,214,946
    Participant contributions at end of year2010-12-31$1,433,902
    Participant contributions at beginning of year2010-12-31$3,369,287
    Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$1,196,833
    Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$1,043,050
    Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$688,256
    Other income not declared elsewhere2010-12-31$489,262
    Administrative expenses (other) incurred2010-12-31$214,958
    Liabilities. Value of operating payables at end of year2010-12-31$704,959
    Liabilities. Value of operating payables at beginning of year2010-12-31$527,513
    Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
    Value of net income/loss2010-12-31$-294,783
    Value of net assets at end of year (total assets less liabilities)2010-12-31$23,578,808
    Value of net assets at beginning of year (total assets less liabilities)2010-12-31$23,873,591
    Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
    Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
    Were any leases to which the plan was party in default or uncollectible2010-12-31No
    Investment advisory and management fees2010-12-31$6,832
    Income. Interest from US Government securities2010-12-31$10,718
    Income. Interest from corporate debt instruments2010-12-31$20,799
    Value of interest in common/collective trusts at end of year2010-12-31$1,643,340
    Value of interest in common/collective trusts at beginning of year2010-12-31$215,426
    Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$132
    Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$7,568,299
    Asset value of US Government securities at end of year2010-12-31$1,283,379
    Asset value of US Government securities at beginning of year2010-12-31$1,347,870
    Net investment gain or loss from common/collective trusts2010-12-31$2,324
    Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
    Was there a failure to transmit to the plan any participant contributions2010-12-31No
    Has the plan failed to provide any benefit when due under the plan2010-12-31No
    Contributions received in cash from employer2010-12-31$34,802,665
    Employer contributions (assets) at end of year2010-12-31$11,566,098
    Employer contributions (assets) at beginning of year2010-12-31$10,630,713
    Income. Dividends from common stock2010-12-31$32,249
    Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$31,193,322
    Asset. Corporate debt instrument preferred debt at end of year2010-12-31$1,256,727
    Asset. Corporate debt instrument preferred debt at beginning of year2010-12-31$1,410,195
    Asset. Corporate debt instrument debt (other) at end of year2010-12-31$320,850
    Asset. Corporate debt instrument debt (other) at beginning of year2010-12-31$434,305
    Contract administrator fees2010-12-31$2,330,795
    Assets. Corporate common stocks other than exployer securities at end of year2010-12-31$6,270,894
    Assets. Corporate common stocks other than exployer securities at beginning of year2010-12-31$5,950,258
    Did the plan have assets held for investment2010-12-31Yes
    Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
    Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
    Aggregate proceeds on sale of assets2010-12-31$3,571,194
    Aggregate carrying amount (costs) on sale of assets2010-12-31$3,442,076
    Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
    Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
    Accountancy firm name2010-12-31DELOITTE & TOUCHE LLP
    Accountancy firm EIN2010-12-31133891517

    Form 5500 Responses

    2019
    2019-01-01Type of plan entitySingle employer plan
    2019-01-01Submission has been amendedNo
    2019-01-01This submission is the final filingYes
    2019-01-01This return/report is a short plan year return/report (less than 12 months)Yes
    2019-01-01Plan is a collectively bargained planYes
    2019-01-01Plan funding arrangement – InsuranceYes
    2019-01-01Plan funding arrangement – TrustYes
    2019-01-01Plan funding arrangement – General assets of the sponsorYes
    2019-01-01Plan benefit arrangement – InsuranceYes
    2019-01-01Plan benefit arrangement - TrustYes
    2019-01-01Plan benefit arrangement – General assets of the sponsorYes
    2018
    2018-01-01Type of plan entitySingle employer plan
    2018-01-01Submission has been amendedNo
    2018-01-01This submission is the final filingNo
    2018-01-01This return/report is a short plan year return/report (less than 12 months)No
    2018-01-01Plan is a collectively bargained planYes
    2018-01-01Plan funding arrangement – InsuranceYes
    2018-01-01Plan funding arrangement – TrustYes
    2018-01-01Plan funding arrangement – General assets of the sponsorYes
    2018-01-01Plan benefit arrangement – InsuranceYes
    2018-01-01Plan benefit arrangement - TrustYes
    2018-01-01Plan benefit arrangement – General assets of the sponsorYes
    2017
    2017-01-01Type of plan entitySingle employer plan
    2017-01-01Submission has been amendedNo
    2017-01-01This submission is the final filingNo
    2017-01-01This return/report is a short plan year return/report (less than 12 months)No
    2017-01-01Plan is a collectively bargained planYes
    2017-01-01Plan funding arrangement – InsuranceYes
    2017-01-01Plan funding arrangement – TrustYes
    2017-01-01Plan funding arrangement – General assets of the sponsorYes
    2017-01-01Plan benefit arrangement – InsuranceYes
    2017-01-01Plan benefit arrangement - TrustYes
    2017-01-01Plan benefit arrangement – General assets of the sponsorYes
    2016
    2016-01-01Type of plan entitySingle employer plan
    2016-01-01Submission has been amendedNo
    2016-01-01This submission is the final filingNo
    2016-01-01This return/report is a short plan year return/report (less than 12 months)No
    2016-01-01Plan is a collectively bargained planYes
    2016-01-01Plan funding arrangement – InsuranceYes
    2016-01-01Plan funding arrangement – TrustYes
    2016-01-01Plan funding arrangement – General assets of the sponsorYes
    2016-01-01Plan benefit arrangement – InsuranceYes
    2016-01-01Plan benefit arrangement - TrustYes
    2016-01-01Plan benefit arrangement – General assets of the sponsorYes
    2015
    2015-01-01Type of plan entitySingle employer plan
    2015-01-01Submission has been amendedNo
    2015-01-01This submission is the final filingNo
    2015-01-01This return/report is a short plan year return/report (less than 12 months)No
    2015-01-01Plan is a collectively bargained planYes
    2015-01-01Plan funding arrangement – InsuranceYes
    2015-01-01Plan funding arrangement – TrustYes
    2015-01-01Plan funding arrangement – General assets of the sponsorYes
    2015-01-01Plan benefit arrangement – InsuranceYes
    2015-01-01Plan benefit arrangement - TrustYes
    2015-01-01Plan benefit arrangement – General assets of the sponsorYes
    2014
    2014-01-01Type of plan entitySingle employer plan
    2014-01-01Submission has been amendedNo
    2014-01-01This submission is the final filingNo
    2014-01-01This return/report is a short plan year return/report (less than 12 months)No
    2014-01-01Plan is a collectively bargained planYes
    2014-01-01Plan funding arrangement – InsuranceYes
    2014-01-01Plan funding arrangement – TrustYes
    2014-01-01Plan funding arrangement – General assets of the sponsorYes
    2014-01-01Plan benefit arrangement – InsuranceYes
    2014-01-01Plan benefit arrangement - TrustYes
    2014-01-01Plan benefit arrangement – General assets of the sponsorYes
    2013
    2013-01-01Type of plan entitySingle employer plan
    2013-01-01Submission has been amendedNo
    2013-01-01This submission is the final filingNo
    2013-01-01This return/report is a short plan year return/report (less than 12 months)No
    2013-01-01Plan is a collectively bargained planYes
    2013-01-01Plan funding arrangement – InsuranceYes
    2013-01-01Plan funding arrangement – TrustYes
    2013-01-01Plan funding arrangement – General assets of the sponsorYes
    2013-01-01Plan benefit arrangement – InsuranceYes
    2013-01-01Plan benefit arrangement - TrustYes
    2013-01-01Plan benefit arrangement – General assets of the sponsorYes
    2012
    2012-01-01Type of plan entitySingle employer plan
    2012-01-01Submission has been amendedNo
    2012-01-01This submission is the final filingNo
    2012-01-01This return/report is a short plan year return/report (less than 12 months)No
    2012-01-01Plan is a collectively bargained planYes
    2012-01-01Plan funding arrangement – InsuranceYes
    2012-01-01Plan funding arrangement – TrustYes
    2012-01-01Plan funding arrangement – General assets of the sponsorYes
    2012-01-01Plan benefit arrangement – InsuranceYes
    2012-01-01Plan benefit arrangement - TrustYes
    2012-01-01Plan benefit arrangement – General assets of the sponsorYes
    2011
    2011-01-01Type of plan entitySingle employer plan
    2011-01-01Submission has been amendedNo
    2011-01-01This submission is the final filingNo
    2011-01-01This return/report is a short plan year return/report (less than 12 months)No
    2011-01-01Plan is a collectively bargained planYes
    2011-01-01Plan funding arrangement – InsuranceYes
    2011-01-01Plan funding arrangement – TrustYes
    2011-01-01Plan funding arrangement – General assets of the sponsorYes
    2011-01-01Plan benefit arrangement – InsuranceYes
    2011-01-01Plan benefit arrangement - TrustYes
    2011-01-01Plan benefit arrangement – General assets of the sponsorYes
    2009
    2009-10-01Type of plan entitySingle employer plan
    2009-10-01Submission has been amendedNo
    2009-10-01This submission is the final filingNo
    2009-10-01This return/report is a short plan year return/report (less than 12 months)No
    2009-10-01Plan is a collectively bargained planYes
    2009-10-01Plan funding arrangement – InsuranceYes
    2009-10-01Plan funding arrangement – TrustYes
    2009-10-01Plan funding arrangement – General assets of the sponsorYes
    2009-10-01Plan benefit arrangement – InsuranceYes
    2009-10-01Plan benefit arrangement - TrustYes
    2009-10-01Plan benefit arrangement – General assets of the sponsorYes
    2008
    2008-10-01Type of plan entitySingle employer plan
    2008-10-01Submission has been amendedYes
    2008-10-01This submission is the final filingNo
    2008-10-01This return/report is a short plan year return/report (less than 12 months)No
    2008-10-01Plan is a collectively bargained planNo
    2007
    2007-10-01Type of plan entitySingle employer plan
    2007-10-01Submission has been amendedYes
    2007-10-01This submission is the final filingNo
    2007-10-01This return/report is a short plan year return/report (less than 12 months)No
    2007-10-01Plan is a collectively bargained planYes
    2007-10-01Plan funding arrangement – InsuranceYes
    2007-10-01Plan funding arrangement – TrustYes
    2007-10-01Plan funding arrangement – General assets of the sponsorYes
    2007-10-01Plan benefit arrangement – InsuranceYes
    2007-10-01Plan benefit arrangement - TrustYes
    2007-10-01Plan benefit arrangement – General assets of the sponsorYes

    Insurance Providers Used on plan

    KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number124746
    Policy instance 4
    Insurance contract or identification number124746
    Number of Individuals Covered0
    Insurance policy start date2019-01-01
    Insurance policy end date2019-03-31
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $220,910
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
    Policy contract number2685
    Policy instance 3
    Insurance contract or identification number2685
    Number of Individuals Covered0
    Insurance policy start date2019-01-01
    Insurance policy end date2019-03-31
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $102,672
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
    Policy contract number468864
    Policy instance 2
    Insurance contract or identification number468864
    Number of Individuals Covered0
    Insurance policy start date2019-01-01
    Insurance policy end date2019-03-31
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $70,726
    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: 00000 )
    Policy contract number291
    Policy instance 1
    Insurance contract or identification number291
    Number of Individuals Covered0
    Insurance policy start date2019-01-01
    Insurance policy end date2019-03-31
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $175,074
    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: 00000 )
    Policy contract number124746
    Policy instance 1
    Insurance contract or identification number124746
    Number of Individuals Covered279
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $1,818,105
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
    Policy contract number2685
    Policy instance 2
    Insurance contract or identification number2685
    Number of Individuals Covered72
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $357,902
    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: 00000 )
    Policy contract number291
    Policy instance 3
    Insurance contract or identification number291
    Number of Individuals Covered31
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $100,660
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
    Policy contract number468864
    Policy instance 4
    Insurance contract or identification number468864
    Number of Individuals Covered72
    Insurance policy start date2018-01-01
    Insurance policy end date2018-12-31
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $400,243
    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: 00000 )
    Policy contract number124746
    Policy instance 4
    Insurance contract or identification number124746
    Number of Individuals Covered371
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $1,806,421
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
    Policy contract number2685
    Policy instance 3
    Insurance contract or identification number2685
    Number of Individuals Covered86
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $450,436
    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: 00000 )
    Policy contract number291
    Policy instance 1
    Insurance contract or identification number291
    Number of Individuals Covered30
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $183,822
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
    Policy contract number468864
    Policy instance 2
    Insurance contract or identification number468864
    Number of Individuals Covered81
    Insurance policy start date2017-01-01
    Insurance policy end date2017-12-31
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $386,599
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
    Policy contract number2685
    Policy instance 1
    Insurance contract or identification number2685
    Number of Individuals Covered121
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $581,841
    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: 00000 )
    Policy contract number124746
    Policy instance 2
    Insurance contract or identification number124746
    Number of Individuals Covered419
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $1,656,545
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    AETNA GLOBAL BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number299486
    Policy instance 3
    Insurance contract or identification number299486
    Number of Individuals Covered112
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    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 BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $392,151
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    AETNA GLOBAL BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number299486
    Policy instance 3
    Insurance contract or identification number299486
    Number of Individuals Covered98
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    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 BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $752,818
    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: 00000 )
    Policy contract number124746
    Policy instance 2
    Insurance contract or identification number124746
    Number of Individuals Covered449
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $4,258
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $1,753,465
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $4,258
    Insurance broker organization code?3
    Insurance broker nameTOWERS WATSON DELAWARE, INC.
    KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
    Policy contract number2685
    Policy instance 1
    Insurance contract or identification number2685
    Number of Individuals Covered118
    Insurance policy start date2014-01-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $1,841
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $546,769
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,841
    Insurance broker organization code?3
    Insurance broker nameTOWERS WATSON DELAWARE INC.
    AETNA GLOBAL BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number299486
    Policy instance 9
    Insurance contract or identification number299486
    Number of Individuals Covered500
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $36,418
    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 BenefitYes
    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 $2,180,376
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $36,418
    Insurance broker organization code?3
    Insurance broker nameTOWERS WATSON DELAWARE INC.
    KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
    Policy contract number20430
    Policy instance 8
    Insurance contract or identification number20430
    Number of Individuals Covered48
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $3,907
    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 BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $194,913
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $3,907
    Insurance broker organization code?3
    Insurance broker nameTOWERS WATSON DELAWARE INC
    HEALTH FIRST HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95019 )
    Policy contract number111099
    Policy instance 7
    Insurance contract or identification number111099
    Number of Individuals Covered1186
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $135,352
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $6,338,168
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $135,352
    Insurance broker organization code?3
    Insurance broker nameTOWERS WATSON DELAWARE INC
    HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
    Policy contract number64301 1
    Policy instance 5
    Insurance contract or identification number64301 1
    Number of Individuals Covered0
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $9,561
    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: 00000 )
    Policy contract number124746
    Policy instance 4
    Insurance contract or identification number124746
    Number of Individuals Covered644
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $55,240
    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 BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $2,873,258
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $55,240
    Insurance broker organization code?3
    Insurance broker nameTOWERS WATSON DELAWARE, INC.
    COVENTRY HEALTH CARE OF KANSAS, INC. (National Association of Insurance Commissioners NAIC id number: 95489 )
    Policy contract number3700790000
    Policy instance 3
    Insurance contract or identification number3700790000
    Number of Individuals Covered16
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $2,249
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $112,435
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $2,249
    Insurance broker organization code?3
    Insurance broker nameWATSON WYATT INSURANCE CONS. INC.
    KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
    Policy contract number5527
    Policy instance 2
    Insurance contract or identification number5527
    Number of Individuals Covered116
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    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 BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $554,007
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
    Policy contract number2685
    Policy instance 1
    Insurance contract or identification number2685
    Number of Individuals Covered209
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $23,342
    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 BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $1,135,344
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $23,342
    Insurance broker organization code?3
    Insurance broker nameTOWERS WATSON DELAWARE INC.
    KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number291
    Policy instance 6
    Insurance contract or identification number291
    Number of Individuals Covered106
    Insurance policy start date2013-01-01
    Insurance policy end date2013-12-31
    Total amount of commissions paid to insurance brokerUSD $4,114
    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 BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $584,348
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $4,114
    Insurance broker organization code?3
    Insurance broker nameTOWERS WATSON DELAWARE, INC.
    SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 )
    Policy contract numberG1009275 1001
    Policy instance 10
    Insurance contract or identification numberG1009275 1001
    Number of Individuals Covered283
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $26,916
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $1,348,128
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $26,916
    Insurance broker organization code?3
    Insurance broker nameTOWERS WATSON DELAWARE, INC.
    AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
    Policy contract number468864
    Policy instance 7
    Insurance contract or identification number468864
    Number of Individuals Covered170
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $14,368
    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 BenefitYes
    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 $564,794
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $14,368
    Insurance broker organization code?3
    Insurance broker nameTOWERS WATSON DELAWARE INC.
    KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
    Policy contract number2685
    Policy instance 1
    Insurance contract or identification number2685
    Number of Individuals Covered371
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $38,440
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $1,569,937
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $35,138
    Insurance broker organization code?3
    Insurance broker nameWATSON WYATT INS CONSULTING, INC.
    KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
    Policy contract number20430
    Policy instance 12
    Insurance contract or identification number20430
    Number of Individuals Covered59
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $33,548
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $671,626
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $33,548
    Insurance broker organization code?3
    Insurance broker nameTOWERS WATSON DELAWARE INC
    HEALTH FIRST HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95019 )
    Policy contract number111099
    Policy instance 11
    Insurance contract or identification number111099
    Number of Individuals Covered2268
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $289,475
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $9,649,179
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $289,475
    Insurance broker organization code?3
    Insurance broker nameWATSON WYATT WORLDWIDE
    PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 )
    Policy contract number778262 S001
    Policy instance 9
    Insurance contract or identification number778262 S001
    Number of Individuals Covered118
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $608,507
    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: 00000 )
    Policy contract number291
    Policy instance 8
    Insurance contract or identification number291
    Number of Individuals Covered163
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $14,747
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $1,097,527
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $14,747
    Insurance broker organization code?3
    Insurance broker nameTOWERS WATSON DELAWARE, INC.
    HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
    Policy contract number64301 1
    Policy instance 6
    Insurance contract or identification number64301 1
    Number of Individuals Covered12
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $45,784
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    AETNA GLOBAL BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number299486
    Policy instance 13
    Insurance contract or identification number299486
    Number of Individuals Covered563
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $23,426
    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 BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $1,744,798
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $23,426
    Insurance broker organization code?3
    Insurance broker nameTOWERS WATSON
    KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
    Policy contract number5527
    Policy instance 2
    Insurance contract or identification number5527
    Number of Individuals Covered149
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $1,635
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $637,436
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,635
    Insurance broker organization code?3
    Insurance broker nameWATSON WYATT INS CONSULTING INC
    DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number02033
    Policy instance 3
    Insurance contract or identification number02033
    Number of Individuals Covered496
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $1,010
    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 BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $201,992
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,010
    Insurance broker organization code?3
    Insurance broker nameTOWERS WATSON DELAWARE
    COVENTRY HEALTH CARE OF KANSAS, INC. (National Association of Insurance Commissioners NAIC id number: 95489 )
    Policy contract number3700790000
    Policy instance 4
    Insurance contract or identification number3700790000
    Number of Individuals Covered207
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $22,270
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $1,113,513
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $22,270
    Insurance broker organization code?3
    Insurance broker nameWATSON WYATT INS. CONSULTING INC.
    KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number124746
    Policy instance 5
    Insurance contract or identification number124746
    Number of Individuals Covered717
    Insurance policy start date2012-01-01
    Insurance policy end date2012-12-31
    Total amount of commissions paid to insurance brokerUSD $68,978
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $3,352,531
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $68,978
    Insurance broker organization code?3
    Insurance broker nameTOWERS WATSON DELAWARE, INC.
    HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract number*Q8316
    Policy instance 7
    Insurance contract or identification number*Q8316
    Number of Individuals Covered4066
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $7,146,189
    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: 00000 )
    Policy contract number124746
    Policy instance 8
    Insurance contract or identification number124746
    Number of Individuals Covered994
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $131,694
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $4,245,649
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
    Policy contract number20430
    Policy instance 9
    Insurance contract or identification number20430
    Number of Individuals Covered85
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $10,317
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $372,000
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
    Policy contract number2685
    Policy instance 10
    Insurance contract or identification number2685
    Number of Individuals Covered329
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $39,470
    Total amount of fees paid to insurance companyUSD $1,067
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $1,338,342
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HEALTH FIRST HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95019 )
    Policy contract number111099
    Policy instance 6
    Insurance contract or identification number111099
    Number of Individuals Covered2310
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $297,835
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $9,926,426
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    COVENTRY HEALTH CARE OF KANSAS, INC. (National Association of Insurance Commissioners NAIC id number: 95489 )
    Policy contract number500466
    Policy instance 13
    Insurance contract or identification number500466
    Number of Individuals Covered257
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $35,320
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $1,177,334
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 )
    Policy contract number778262
    Policy instance 14
    Insurance contract or identification number778262
    Number of Individuals Covered46
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $564,217
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 )
    Policy contract numberG1009275 1001
    Policy instance 15
    Insurance contract or identification numberG1009275 1001
    Number of Individuals Covered394
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $44,803
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $1,494,029
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 )
    Policy contract number018137
    Policy instance 16
    Insurance contract or identification number018137
    Number of Individuals Covered74
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $279,018
    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: 00000 )
    Policy contract number291
    Policy instance 11
    Insurance contract or identification number291
    Number of Individuals Covered262
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $26,941
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $1,558,399
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 52566 )
    Policy contract number02033
    Policy instance 5
    Insurance contract or identification number02033
    Number of Individuals Covered553
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $1,141
    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 BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
    Policy contract number64301 1
    Policy instance 4
    Insurance contract or identification number64301 1
    Number of Individuals Covered11
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $49,685
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 )
    Policy contract numberUS250716
    Policy instance 3
    Insurance contract or identification numberUS250716
    Number of Individuals Covered2
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $3,673
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract numberUS250571
    Policy instance 2
    Insurance contract or identification numberUS250571
    Number of Individuals Covered290
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $309,379
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
    Policy contract number468864-ERG
    Policy instance 1
    Insurance contract or identification number468864-ERG
    Number of Individuals Covered174
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $27,950
    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 BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $422,409
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
    Policy contract number5527
    Policy instance 12
    Insurance contract or identification number5527
    Number of Individuals Covered186
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    Total amount of commissions paid to insurance brokerUSD $18,397
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $679,519
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 )
    Policy contract number465488
    Policy instance 17
    Insurance contract or identification number465488
    Number of Individuals Covered1492
    Insurance policy start date2011-01-01
    Insurance policy end date2011-12-31
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $2,901,130
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
    Policy contract number20430
    Policy instance 11
    Insurance contract or identification number20430
    Number of Individuals Covered98
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $10,631
    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 BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $355,076
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $10,631
    Insurance broker organization code?3
    Insurance broker nameWATSON WYATT & COMPANY
    HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract numberQ3401
    Policy instance 8
    Insurance contract or identification numberQ3401
    Number of Individuals Covered98
    Insurance policy start date2010-10-01
    Insurance policy end date2010-12-31
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $41,200
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract numberQ0846
    Policy instance 7
    Insurance contract or identification numberQ0846
    Number of Individuals Covered2182
    Insurance policy start date2010-10-01
    Insurance policy end date2010-12-31
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $909,646
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HEALTH FIRST HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95019 )
    Policy contract number111099
    Policy instance 6
    Insurance contract or identification number111099
    Number of Individuals Covered2204
    Insurance policy start date2010-10-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $71,510
    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 BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $2,165,180
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $71,510
    Insurance broker organization code?3
    Insurance broker nameWATSON WYATT WORLDWIDE
    DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number02033
    Policy instance 5
    Insurance contract or identification number02033
    Number of Individuals Covered490
    Insurance policy start date2010-10-01
    Insurance policy end date2010-12-30
    Total amount of commissions paid to insurance brokerUSD $234
    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 BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $234
    Insurance broker organization code?3
    Insurance broker nameWATSON WYATT WORLDWIDE
    HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
    Policy contract number64301 1
    Policy instance 4
    Insurance contract or identification number64301 1
    Number of Individuals Covered12
    Insurance policy start date2010-10-01
    Insurance policy end date2010-12-31
    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 BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $12,485
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95590 )
    Policy contract numberUS381580
    Policy instance 3
    Insurance contract or identification numberUS381580
    Number of Individuals Covered24
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    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 BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $191,352
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
    Policy contract number*Q8231
    Policy instance 9
    Insurance contract or identification number*Q8231
    Number of Individuals Covered2095
    Insurance policy start date2010-10-01
    Insurance policy end date2010-12-31
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $783,489
    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: 00000 )
    Policy contract number124746
    Policy instance 10
    Insurance contract or identification number124746
    Number of Individuals Covered1166
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $110,836
    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 BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $3,967,005
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $110,836
    Insurance broker organization code?3
    Insurance broker nameWATSON WYATT & COMPANY
    AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 )
    Policy contract numberUS250716
    Policy instance 2
    Insurance contract or identification numberUS250716
    Number of Individuals Covered2
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    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 BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $3,385
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    SELECTHEALTH (National Association of Insurance Commissioners NAIC id number: 95153 )
    Policy contract numberG1009275 1001
    Policy instance 18
    Insurance contract or identification numberG1009275 1001
    Number of Individuals Covered414
    Insurance policy start date2010-10-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $10,413
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $346,520
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $10,413
    Insurance broker organization code?3
    Insurance broker nameTOWERS WATSON DELAWARE, INC.
    PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 )
    Policy contract number778262
    Policy instance 17
    Insurance contract or identification number778262
    Number of Individuals Covered45
    Insurance policy start date2010-10-01
    Insurance policy end date2010-12-31
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $117,690
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 )
    Policy contract number465488
    Policy instance 19
    Insurance contract or identification number465488
    Number of Individuals Covered1077
    Insurance policy start date2010-10-01
    Insurance policy end date2010-12-31
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $478,795
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    PREFERRED PLUS OF KANSAS (National Association of Insurance Commissioners NAIC id number: 95390 )
    Policy contract number500466
    Policy instance 16
    Insurance contract or identification number500466
    Number of Individuals Covered250
    Insurance policy start date2010-10-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $7,168
    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 BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $238,935
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $7,168
    Insurance broker organization code?3
    Insurance broker nameWATSON WYATT
    UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 )
    Policy contract number018137
    Policy instance 15
    Insurance contract or identification number018137
    Number of Individuals Covered79
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    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 BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $271,141
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
    Policy contract number5527
    Policy instance 14
    Insurance contract or identification number5527
    Number of Individuals Covered153
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $13,458
    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 BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $491,290
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $13,458
    Insurance broker organization code?3
    Insurance broker nameWATSON WYATT INS CONSULTING INC
    KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract number291
    Policy instance 13
    Insurance contract or identification number291
    Number of Individuals Covered439
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $36,237
    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 BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $2,574,800
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $36,237
    Insurance broker organization code?3
    Insurance broker nameWATSON WYATT & COMPANY
    KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
    Policy contract number2685
    Policy instance 12
    Insurance contract or identification number2685
    Number of Individuals Covered274
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    Total amount of commissions paid to insurance brokerUSD $30,227
    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 BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $970,893
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $30,227
    Insurance broker organization code?3
    Insurance broker nameWATSON WYATT INS CONSULTING, INC.
    AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
    Policy contract numberUS250571
    Policy instance 1
    Insurance contract or identification numberUS250571
    Number of Individuals Covered317
    Insurance policy start date2010-01-01
    Insurance policy end date2010-12-31
    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 BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $333,220
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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