NORTH COAST TRUST FUND 401k Plan overview

Plan Name	NORTH COAST TRUST FUND
Plan identification number	501

NORTH COAST TRUST FUND Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Other welfare benefit cover

401k Sponsoring company profile

BOARD OF TRUSTEES, NORTH COAST TRUST FUND has sponsored the creation of one or more 401k plans.

Company Name:	BOARD OF TRUSTEES, NORTH COAST TRUST FUND
Employer identification number (EIN):	941672782
NAIC Classification:	484120
NAIC Description:	General Freight Trucking, Long-Distance

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTH COAST TRUST FUND

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-07-01
501	2021-07-01
501	2020-07-01
501	2019-07-01
501	2018-07-01
501	2017-07-01
501	2016-07-01	MILLER KAPLAN ARASE LLP
501	2015-07-01	MILLER KAPLAN ARASE LLP		MILLER KAPLAN ARASE LLP	2017-04-14
501	2014-07-01	MILLER KAPLAN ARASE LLP		MILLER KAPLAN ARASE LLP	2016-04-15
501	2014-07-01	MILLER KAPLAN ARASE LLP		MILLER KAPLAN ARASE LLP	2016-04-19
501	2013-07-01	SANDY S. GARCIA		SANDY S. GARCIA	2015-04-07
501	2012-07-01	SANDY S. GARCIA		SANDY S. GARCIA	2014-03-26
501	2011-07-01	RAFAEL MIRANDA		JEFFERY HOPKINS	2013-04-05
501	2010-07-01	RAFAEL MIRANDA		JEFFERY HOPKINS	2012-04-11
501	2009-07-01	RAFAEL MIRANDA		JEFFERY HOPKINS	2011-04-14

Plan Statistics for NORTH COAST TRUST FUND

401k plan membership statisitcs for NORTH COAST TRUST FUND

Measure	Date	Value
2022: NORTH COAST TRUST FUND 2022 401k membership
Total participants, beginning-of-year	2022-07-01	1,369
Total number of active participants reported on line 7a of the Form 5500	2022-07-01	1,212
Number of retired or separated participants receiving benefits	2022-07-01	166
Number of other retired or separated participants entitled to future benefits	2022-07-01	0
Total of all active and inactive participants	2022-07-01	1,378
Total participants	2022-07-01	1,378
Number of employers contributing to the scheme	2022-07-01	19
2021: NORTH COAST TRUST FUND 2021 401k membership
Total participants, beginning-of-year	2021-07-01	1,570
Total number of active participants reported on line 7a of the Form 5500	2021-07-01	1,215
Number of retired or separated participants receiving benefits	2021-07-01	154
Number of other retired or separated participants entitled to future benefits	2021-07-01	0
Total of all active and inactive participants	2021-07-01	1,369
Total participants	2021-07-01	1,369
Number of employers contributing to the scheme	2021-07-01	22
2020: NORTH COAST TRUST FUND 2020 401k membership
Total participants, beginning-of-year	2020-07-01	1,383
Total number of active participants reported on line 7a of the Form 5500	2020-07-01	1,420
Number of retired or separated participants receiving benefits	2020-07-01	150
Number of other retired or separated participants entitled to future benefits	2020-07-01	0
Total of all active and inactive participants	2020-07-01	1,570
Total participants	2020-07-01	1,570
Number of employers contributing to the scheme	2020-07-01	24
2019: NORTH COAST TRUST FUND 2019 401k membership
Total participants, beginning-of-year	2019-07-01	1,344
Total number of active participants reported on line 7a of the Form 5500	2019-07-01	1,246
Number of retired or separated participants receiving benefits	2019-07-01	137
Number of other retired or separated participants entitled to future benefits	2019-07-01	0
Total of all active and inactive participants	2019-07-01	1,383
Total participants	2019-07-01	1,383
Number of employers contributing to the scheme	2019-07-01	21
2018: NORTH COAST TRUST FUND 2018 401k membership
Total participants, beginning-of-year	2018-07-01	1,322
Total number of active participants reported on line 7a of the Form 5500	2018-07-01	1,222
Number of retired or separated participants receiving benefits	2018-07-01	122
Total of all active and inactive participants	2018-07-01	1,344
Total participants	2018-07-01	1,344
Number of employers contributing to the scheme	2018-07-01	22
2017: NORTH COAST TRUST FUND 2017 401k membership
Total participants, beginning-of-year	2017-07-01	1,282
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	1,203
Number of retired or separated participants receiving benefits	2017-07-01	119
Total of all active and inactive participants	2017-07-01	1,322
Total participants	2017-07-01	1,322
Number of employers contributing to the scheme	2017-07-01	22
2016: NORTH COAST TRUST FUND 2016 401k membership
Total participants, beginning-of-year	2016-07-01	1,307
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	1,171
Number of retired or separated participants receiving benefits	2016-07-01	111
Total of all active and inactive participants	2016-07-01	1,282
Total participants	2016-07-01	1,282
Number of employers contributing to the scheme	2016-07-01	17
2015: NORTH COAST TRUST FUND 2015 401k membership
Total participants, beginning-of-year	2015-07-01	1,212
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	1,202
Number of retired or separated participants receiving benefits	2015-07-01	102
Number of other retired or separated participants entitled to future benefits	2015-07-01	0
Total of all active and inactive participants	2015-07-01	1,304
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-07-01	3
Total participants	2015-07-01	1,307
Number of participants with account balances	2015-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-07-01	0
Number of employers contributing to the scheme	2015-07-01	17
2014: NORTH COAST TRUST FUND 2014 401k membership
Total participants, beginning-of-year	2014-07-01	1,166
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	1,115
Number of retired or separated participants receiving benefits	2014-07-01	97
Number of other retired or separated participants entitled to future benefits	2014-07-01	0
Total of all active and inactive participants	2014-07-01	1,212
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	0
Total participants	2014-07-01	1,212
Number of participants with account balances	2014-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	0
Number of employers contributing to the scheme	2014-07-01	19
2013: NORTH COAST TRUST FUND 2013 401k membership
Total participants, beginning-of-year	2013-07-01	1,223
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	1,063
Number of retired or separated participants receiving benefits	2013-07-01	103
Number of other retired or separated participants entitled to future benefits	2013-07-01	0
Total of all active and inactive participants	2013-07-01	1,166
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	0
Total participants	2013-07-01	1,166
Number of participants with account balances	2013-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-07-01	0
Number of employers contributing to the scheme	2013-07-01	28
2012: NORTH COAST TRUST FUND 2012 401k membership
Total participants, beginning-of-year	2012-07-01	1,201
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	1,130
Number of retired or separated participants receiving benefits	2012-07-01	93
Number of other retired or separated participants entitled to future benefits	2012-07-01	0
Total of all active and inactive participants	2012-07-01	1,223
Total participants	2012-07-01	1,223
Number of employers contributing to the scheme	2012-07-01	19
2011: NORTH COAST TRUST FUND 2011 401k membership
Total participants, beginning-of-year	2011-07-01	1,158
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	1,109
Number of retired or separated participants receiving benefits	2011-07-01	92
Number of other retired or separated participants entitled to future benefits	2011-07-01	0
Total of all active and inactive participants	2011-07-01	1,201
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-07-01	0
Total participants	2011-07-01	1,201
Number of participants with account balances	2011-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	0
Number of employers contributing to the scheme	2011-07-01	30
2010: NORTH COAST TRUST FUND 2010 401k membership
Total participants, beginning-of-year	2010-07-01	1,195
Total number of active participants reported on line 7a of the Form 5500	2010-07-01	1,065
Number of retired or separated participants receiving benefits	2010-07-01	93
Number of other retired or separated participants entitled to future benefits	2010-07-01	0
Total of all active and inactive participants	2010-07-01	1,158
Total participants	2010-07-01	1,158
Number of employers contributing to the scheme	2010-07-01	22
2009: NORTH COAST TRUST FUND 2009 401k membership
Total participants, beginning-of-year	2009-07-01	1,197
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	1,101
Number of retired or separated participants receiving benefits	2009-07-01	94
Number of other retired or separated participants entitled to future benefits	2009-07-01	0
Total of all active and inactive participants	2009-07-01	1,195
Total participants	2009-07-01	1,195
Number of employers contributing to the scheme	2009-07-01	25

Financial Data on NORTH COAST TRUST FUND

Measure	Date	Value
2023 : NORTH COAST TRUST FUND 2023 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-06-30	$4,665,072
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-06-30	$3,180,634
Total income from all sources (including contributions)	2023-06-30	$30,814,993
Total of all expenses incurred	2023-06-30	$28,578,348
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2023-06-30	$27,463,930
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2023-06-30	$29,515,571
Value of total assets at end of year	2023-06-30	$36,288,352
Value of total assets at beginning of year	2023-06-30	$32,567,269
Total of administrative expenses incurred including professional, contract, advisory and management fees	2023-06-30	$1,114,418
Total dividends received (eg from common stock, registered investment company shares)	2023-06-30	$997,035
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2023-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2023-06-30	$997,035
Administrative expenses professional fees incurred	2023-06-30	$459,890
Was this plan covered by a fidelity bond	2023-06-30	Yes
Value of fidelity bond cover	2023-06-30	$500,000
Were there any nonexempt tranactions with any party-in-interest	2023-06-30	No
Contributions received from participants	2023-06-30	$577,487
Value of other receiveables (less allowance for doubtful accounts) at end of year	2023-06-30	$1,656,862
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2023-06-30	$0
Other income not declared elsewhere	2023-06-30	$182,623
Administrative expenses (other) incurred	2023-06-30	$90,077
Liabilities. Value of operating payables at end of year	2023-06-30	$69,916
Liabilities. Value of operating payables at beginning of year	2023-06-30	$124,558
Total non interest bearing cash at end of year	2023-06-30	$2,733,850
Total non interest bearing cash at beginning of year	2023-06-30	$8,045,854
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2023-06-30	No
Value of net income/loss	2023-06-30	$2,236,645
Value of net assets at end of year (total assets less liabilities)	2023-06-30	$31,623,280
Value of net assets at beginning of year (total assets less liabilities)	2023-06-30	$29,386,635
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2023-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2023-06-30	No
Were any leases to which the plan was party in default or uncollectible	2023-06-30	No
Investment advisory and management fees	2023-06-30	$65,166
Value of interest in registered invesment companies (eg mutual funds) at end of year	2023-06-30	$27,778,110
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2023-06-30	$22,475,261
Expenses. Payments to insurance carriers foe the provision of benefits	2023-06-30	$22,116,046
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2023-06-30	$119,764
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2023-06-30	Yes
Was there a failure to transmit to the plan any participant contributions	2023-06-30	No
Has the plan failed to provide any benefit when due under the plan	2023-06-30	No
Contributions received in cash from employer	2023-06-30	$28,938,084
Employer contributions (assets) at end of year	2023-06-30	$2,348,445
Employer contributions (assets) at beginning of year	2023-06-30	$2,023,811
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2023-06-30	$5,347,884
Contract administrator fees	2023-06-30	$499,285
Liabilities. Value of benefit claims payable at end of year	2023-06-30	$4,595,156
Liabilities. Value of benefit claims payable at beginning of year	2023-06-30	$3,056,076
Assets. Value of buildings and other operty used in plan operation at end of year	2023-06-30	$1,771,085
Assets. Value of buildings and other operty used in plan operation at beginning of year	2023-06-30	$22,343
Did the plan have assets held for investment	2023-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2023-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2023-06-30	No
Opinion of an independent qualified public accountant for this plan	2023-06-30	Unqualified
Accountancy firm name	2023-06-30	MILLER KAPLAN ARASE LLP
Accountancy firm EIN	2023-06-30	952036255
2022 : NORTH COAST TRUST FUND 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-06-30	$3,180,634
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-06-30	$3,693,404
Total income from all sources (including contributions)	2022-06-30	$26,301,147
Total of all expenses incurred	2022-06-30	$26,316,344
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-06-30	$25,279,517
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-06-30	$28,333,111
Value of total assets at end of year	2022-06-30	$32,567,269
Value of total assets at beginning of year	2022-06-30	$33,095,236
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-06-30	$1,036,827
Total dividends received (eg from common stock, registered investment company shares)	2022-06-30	$870,886
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-06-30	$870,886
Administrative expenses professional fees incurred	2022-06-30	$384,112
Was this plan covered by a fidelity bond	2022-06-30	Yes
Value of fidelity bond cover	2022-06-30	$500,000
Were there any nonexempt tranactions with any party-in-interest	2022-06-30	No
Contributions received from participants	2022-06-30	$562,524
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-06-30	$296,249
Other income not declared elsewhere	2022-06-30	$14,385
Administrative expenses (other) incurred	2022-06-30	$88,004
Liabilities. Value of operating payables at end of year	2022-06-30	$124,558
Liabilities. Value of operating payables at beginning of year	2022-06-30	$289,873
Total non interest bearing cash at end of year	2022-06-30	$8,045,854
Total non interest bearing cash at beginning of year	2022-06-30	$5,011,377
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-06-30	No
Value of net income/loss	2022-06-30	$-15,197
Value of net assets at end of year (total assets less liabilities)	2022-06-30	$29,386,635
Value of net assets at beginning of year (total assets less liabilities)	2022-06-30	$29,401,832
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-06-30	No
Were any leases to which the plan was party in default or uncollectible	2022-06-30	No
Investment advisory and management fees	2022-06-30	$85,251
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-06-30	$22,475,261
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-06-30	$23,837,891
Expenses. Payments to insurance carriers foe the provision of benefits	2022-06-30	$20,373,071
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-06-30	$-2,917,235
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-06-30	Yes
Was there a failure to transmit to the plan any participant contributions	2022-06-30	No
Has the plan failed to provide any benefit when due under the plan	2022-06-30	No
Contributions received in cash from employer	2022-06-30	$27,770,587
Employer contributions (assets) at end of year	2022-06-30	$2,023,811
Employer contributions (assets) at beginning of year	2022-06-30	$2,313,352
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-06-30	$4,906,446
Contract administrator fees	2022-06-30	$479,460
Liabilities. Value of benefit claims payable at end of year	2022-06-30	$3,056,076
Liabilities. Value of benefit claims payable at beginning of year	2022-06-30	$3,403,531
Assets. Value of buildings and other operty used in plan operation at end of year	2022-06-30	$22,343
Assets. Value of buildings and other operty used in plan operation at beginning of year	2022-06-30	$1,636,367
Did the plan have assets held for investment	2022-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-06-30	No
Opinion of an independent qualified public accountant for this plan	2022-06-30	Unqualified
Accountancy firm name	2022-06-30	MILLER KAPLAN ARASE LLP
Accountancy firm EIN	2022-06-30	952036255
2021 : NORTH COAST TRUST FUND 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-06-30	$3,693,404
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-06-30	$2,936,322
Total income from all sources (including contributions)	2021-06-30	$31,522,817
Total of all expenses incurred	2021-06-30	$26,872,266
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-06-30	$25,978,650
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-06-30	$29,303,537
Value of total assets at end of year	2021-06-30	$33,095,236
Value of total assets at beginning of year	2021-06-30	$27,687,603
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-06-30	$893,616
Total dividends received (eg from common stock, registered investment company shares)	2021-06-30	$583,551
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-06-30	$583,551
Administrative expenses professional fees incurred	2021-06-30	$265,310
Was this plan covered by a fidelity bond	2021-06-30	Yes
Value of fidelity bond cover	2021-06-30	$500,000
Were there any nonexempt tranactions with any party-in-interest	2021-06-30	No
Contributions received from participants	2021-06-30	$491,231
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-06-30	$296,249
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-06-30	$29,298
Administrative expenses (other) incurred	2021-06-30	$72,446
Liabilities. Value of operating payables at end of year	2021-06-30	$289,873
Liabilities. Value of operating payables at beginning of year	2021-06-30	$143,922
Total non interest bearing cash at end of year	2021-06-30	$5,011,377
Total non interest bearing cash at beginning of year	2021-06-30	$3,208,305
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-06-30	No
Value of net income/loss	2021-06-30	$4,650,551
Value of net assets at end of year (total assets less liabilities)	2021-06-30	$29,401,832
Value of net assets at beginning of year (total assets less liabilities)	2021-06-30	$24,751,281
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-06-30	No
Were any leases to which the plan was party in default or uncollectible	2021-06-30	No
Investment advisory and management fees	2021-06-30	$79,281
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-06-30	$23,837,891
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-06-30	$20,471,972
Expenses. Payments to insurance carriers foe the provision of benefits	2021-06-30	$20,981,648
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-06-30	$1,635,729
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-06-30	Yes
Was there a failure to transmit to the plan any participant contributions	2021-06-30	No
Has the plan failed to provide any benefit when due under the plan	2021-06-30	No
Contributions received in cash from employer	2021-06-30	$28,812,306
Employer contributions (assets) at end of year	2021-06-30	$2,313,352
Employer contributions (assets) at beginning of year	2021-06-30	$2,357,896
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-06-30	$4,997,002
Contract administrator fees	2021-06-30	$476,579
Liabilities. Value of benefit claims payable at end of year	2021-06-30	$3,403,531
Liabilities. Value of benefit claims payable at beginning of year	2021-06-30	$2,792,400
Assets. Value of buildings and other operty used in plan operation at end of year	2021-06-30	$1,636,367
Assets. Value of buildings and other operty used in plan operation at beginning of year	2021-06-30	$1,620,132
Did the plan have assets held for investment	2021-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-06-30	No
Opinion of an independent qualified public accountant for this plan	2021-06-30	Unqualified
Accountancy firm name	2021-06-30	MILLER KAPLAN ARASE LLP
Accountancy firm EIN	2021-06-30	952036255
2020 : NORTH COAST TRUST FUND 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$2,936,322
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$2,890,992
Total income from all sources (including contributions)	2020-06-30	$26,749,181
Total of all expenses incurred	2020-06-30	$25,542,687
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-06-30	$24,569,727
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-06-30	$26,960,305
Value of total assets at end of year	2020-06-30	$27,687,603
Value of total assets at beginning of year	2020-06-30	$26,435,779
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-06-30	$972,960
Total dividends received (eg from common stock, registered investment company shares)	2020-06-30	$578,601
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-06-30	$578,601
Administrative expenses professional fees incurred	2020-06-30	$359,432
Was this plan covered by a fidelity bond	2020-06-30	Yes
Value of fidelity bond cover	2020-06-30	$500,000
Were there any nonexempt tranactions with any party-in-interest	2020-06-30	No
Contributions received from participants	2020-06-30	$529,286
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-06-30	$29,298
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-06-30	$25,008
Other income not declared elsewhere	2020-06-30	$-789,725
Administrative expenses (other) incurred	2020-06-30	$67,819
Liabilities. Value of operating payables at end of year	2020-06-30	$143,922
Liabilities. Value of operating payables at beginning of year	2020-06-30	$149,625
Total non interest bearing cash at end of year	2020-06-30	$3,208,305
Total non interest bearing cash at beginning of year	2020-06-30	$3,079,927
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-06-30	No
Value of net income/loss	2020-06-30	$1,206,494
Value of net assets at end of year (total assets less liabilities)	2020-06-30	$24,751,281
Value of net assets at beginning of year (total assets less liabilities)	2020-06-30	$23,544,787
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-06-30	No
Were any leases to which the plan was party in default or uncollectible	2020-06-30	No
Investment advisory and management fees	2020-06-30	$69,130
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-06-30	$20,471,972
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-06-30	$19,618,171
Expenses. Payments to insurance carriers foe the provision of benefits	2020-06-30	$20,120,094
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-06-30	Yes
Was there a failure to transmit to the plan any participant contributions	2020-06-30	No
Has the plan failed to provide any benefit when due under the plan	2020-06-30	No
Contributions received in cash from employer	2020-06-30	$26,431,019
Employer contributions (assets) at end of year	2020-06-30	$2,357,896
Employer contributions (assets) at beginning of year	2020-06-30	$2,157,270
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-06-30	$4,449,633
Contract administrator fees	2020-06-30	$476,579
Liabilities. Value of benefit claims payable at end of year	2020-06-30	$2,792,400
Liabilities. Value of benefit claims payable at beginning of year	2020-06-30	$2,741,367
Assets. Value of buildings and other operty used in plan operation at end of year	2020-06-30	$1,620,132
Assets. Value of buildings and other operty used in plan operation at beginning of year	2020-06-30	$1,555,403
Did the plan have assets held for investment	2020-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2020-06-30	No
Opinion of an independent qualified public accountant for this plan	2020-06-30	Unqualified
Accountancy firm name	2020-06-30	MILLER KAPLAN ARASE LLP
Accountancy firm EIN	2020-06-30	952036255
2019 : NORTH COAST TRUST FUND 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-06-30	$2,890,992
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-06-30	$2,778,718
Total income from all sources (including contributions)	2019-06-30	$27,600,491
Total of all expenses incurred	2019-06-30	$24,152,219
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-06-30	$23,273,262
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-06-30	$26,720,310
Value of total assets at end of year	2019-06-30	$26,435,779
Value of total assets at beginning of year	2019-06-30	$22,875,233
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-06-30	$878,957
Total dividends received (eg from common stock, registered investment company shares)	2019-06-30	$393,750
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-06-30	$393,750
Administrative expenses professional fees incurred	2019-06-30	$273,042
Was this plan covered by a fidelity bond	2019-06-30	Yes
Value of fidelity bond cover	2019-06-30	$500,000
Were there any nonexempt tranactions with any party-in-interest	2019-06-30	No
Contributions received from participants	2019-06-30	$530,098
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-06-30	$25,008
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-06-30	$23,696
Administrative expenses (other) incurred	2019-06-30	$61,237
Liabilities. Value of operating payables at end of year	2019-06-30	$149,625
Liabilities. Value of operating payables at beginning of year	2019-06-30	$77,916
Total non interest bearing cash at end of year	2019-06-30	$3,079,927
Total non interest bearing cash at beginning of year	2019-06-30	$3,920,693
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-06-30	No
Value of net income/loss	2019-06-30	$3,448,272
Value of net assets at end of year (total assets less liabilities)	2019-06-30	$23,544,787
Value of net assets at beginning of year (total assets less liabilities)	2019-06-30	$20,096,515
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-06-30	No
Were any leases to which the plan was party in default or uncollectible	2019-06-30	No
Investment advisory and management fees	2019-06-30	$72,682
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-06-30	$19,618,171
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-06-30	$16,767,640
Expenses. Payments to insurance carriers foe the provision of benefits	2019-06-30	$19,100,532
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-06-30	$486,431
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-06-30	Yes
Was there a failure to transmit to the plan any participant contributions	2019-06-30	No
Has the plan failed to provide any benefit when due under the plan	2019-06-30	No
Contributions received in cash from employer	2019-06-30	$26,190,212
Employer contributions (assets) at end of year	2019-06-30	$2,157,270
Employer contributions (assets) at beginning of year	2019-06-30	$2,125,495
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-06-30	$4,172,730
Contract administrator fees	2019-06-30	$471,996
Liabilities. Value of benefit claims payable at end of year	2019-06-30	$2,741,367
Liabilities. Value of benefit claims payable at beginning of year	2019-06-30	$2,700,802
Assets. Value of buildings and other operty used in plan operation at end of year	2019-06-30	$1,555,403
Assets. Value of buildings and other operty used in plan operation at beginning of year	2019-06-30	$37,709
Did the plan have assets held for investment	2019-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-06-30	No
Opinion of an independent qualified public accountant for this plan	2019-06-30	Unqualified
Accountancy firm name	2019-06-30	MILLER KAPLAN ARASE LLP
Accountancy firm EIN	2019-06-30	952036255
2018 : NORTH COAST TRUST FUND 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$2,778,718
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$2,614,214
Total income from all sources (including contributions)	2018-06-30	$26,474,867
Total of all expenses incurred	2018-06-30	$23,291,379
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-06-30	$22,463,616
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-06-30	$25,866,126
Value of total assets at end of year	2018-06-30	$22,875,233
Value of total assets at beginning of year	2018-06-30	$19,527,241
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-06-30	$827,763
Total dividends received (eg from common stock, registered investment company shares)	2018-06-30	$388,651
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-06-30	$388,651
Administrative expenses professional fees incurred	2018-06-30	$253,495
Was this plan covered by a fidelity bond	2018-06-30	Yes
Value of fidelity bond cover	2018-06-30	$500,000
Were there any nonexempt tranactions with any party-in-interest	2018-06-30	No
Contributions received from participants	2018-06-30	$551,186
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-06-30	$23,696
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-06-30	$1,004
Administrative expenses (other) incurred	2018-06-30	$62,662
Liabilities. Value of operating payables at end of year	2018-06-30	$77,916
Liabilities. Value of operating payables at beginning of year	2018-06-30	$53,415
Total non interest bearing cash at end of year	2018-06-30	$3,920,693
Total non interest bearing cash at beginning of year	2018-06-30	$3,117,458
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-06-30	No
Value of net income/loss	2018-06-30	$3,183,488
Value of net assets at end of year (total assets less liabilities)	2018-06-30	$20,096,515
Value of net assets at beginning of year (total assets less liabilities)	2018-06-30	$16,913,027
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-06-30	No
Were any leases to which the plan was party in default or uncollectible	2018-06-30	No
Investment advisory and management fees	2018-06-30	$57,746
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-06-30	$16,767,640
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-06-30	$14,164,310
Expenses. Payments to insurance carriers foe the provision of benefits	2018-06-30	$18,485,201
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-06-30	$220,090
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-06-30	Yes
Was there a failure to transmit to the plan any participant contributions	2018-06-30	No
Has the plan failed to provide any benefit when due under the plan	2018-06-30	No
Contributions received in cash from employer	2018-06-30	$25,314,940
Employer contributions (assets) at end of year	2018-06-30	$2,125,495
Employer contributions (assets) at beginning of year	2018-06-30	$2,174,937
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-06-30	$3,978,415
Contract administrator fees	2018-06-30	$453,860
Liabilities. Value of benefit claims payable at end of year	2018-06-30	$2,700,802
Liabilities. Value of benefit claims payable at beginning of year	2018-06-30	$2,560,799
Assets. Value of buildings and other operty used in plan operation at end of year	2018-06-30	$37,709
Assets. Value of buildings and other operty used in plan operation at beginning of year	2018-06-30	$69,532
Did the plan have assets held for investment	2018-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-06-30	No
Opinion of an independent qualified public accountant for this plan	2018-06-30	Unqualified
Accountancy firm name	2018-06-30	MILLER KAPLAN ARASE LLP
Accountancy firm EIN	2018-06-30	952036255
2017 : NORTH COAST TRUST FUND 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$2,614,214
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$2,700,137
Total income from all sources (including contributions)	2017-06-30	$26,467,497
Total of all expenses incurred	2017-06-30	$23,612,265
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-06-30	$22,741,023
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-06-30	$25,559,058
Value of total assets at end of year	2017-06-30	$19,527,241
Value of total assets at beginning of year	2017-06-30	$16,757,932
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-06-30	$871,242
Total dividends received (eg from common stock, registered investment company shares)	2017-06-30	$309,219
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-06-30	$309,219
Administrative expenses professional fees incurred	2017-06-30	$243,399
Was this plan covered by a fidelity bond	2017-06-30	Yes
Value of fidelity bond cover	2017-06-30	$500,000
Were there any nonexempt tranactions with any party-in-interest	2017-06-30	No
Contributions received from participants	2017-06-30	$554,194
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-06-30	$1,004
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-06-30	$29,387
Administrative expenses (other) incurred	2017-06-30	$128,054
Liabilities. Value of operating payables at end of year	2017-06-30	$53,415
Liabilities. Value of operating payables at beginning of year	2017-06-30	$57,531
Total non interest bearing cash at end of year	2017-06-30	$3,117,458
Total non interest bearing cash at beginning of year	2017-06-30	$1,850,655
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-06-30	No
Value of net income/loss	2017-06-30	$2,855,232
Value of net assets at end of year (total assets less liabilities)	2017-06-30	$16,913,027
Value of net assets at beginning of year (total assets less liabilities)	2017-06-30	$14,057,795
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-06-30	No
Were any leases to which the plan was party in default or uncollectible	2017-06-30	No
Investment advisory and management fees	2017-06-30	$56,596
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-06-30	$14,164,310
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-06-30	$12,849,071
Expenses. Payments to insurance carriers foe the provision of benefits	2017-06-30	$18,733,544
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-06-30	$599,220
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-06-30	Yes
Was there a failure to transmit to the plan any participant contributions	2017-06-30	No
Has the plan failed to provide any benefit when due under the plan	2017-06-30	No
Contributions received in cash from employer	2017-06-30	$25,004,864
Employer contributions (assets) at end of year	2017-06-30	$2,174,937
Employer contributions (assets) at beginning of year	2017-06-30	$2,003,926
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-06-30	$4,007,479
Contract administrator fees	2017-06-30	$443,193
Liabilities. Value of benefit claims payable at end of year	2017-06-30	$2,560,799
Liabilities. Value of benefit claims payable at beginning of year	2017-06-30	$2,642,606
Assets. Value of buildings and other operty used in plan operation at end of year	2017-06-30	$69,532
Assets. Value of buildings and other operty used in plan operation at beginning of year	2017-06-30	$24,893
Did the plan have assets held for investment	2017-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-06-30	No
Opinion of an independent qualified public accountant for this plan	2017-06-30	Unqualified
Accountancy firm name	2017-06-30	MILLER KAPLAN ARASE LLP
Accountancy firm EIN	2017-06-30	952036255
2016 : NORTH COAST TRUST FUND 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$2,700,137
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$2,827,298
Total income from all sources (including contributions)	2016-06-30	$23,932,593
Total of all expenses incurred	2016-06-30	$22,563,480
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-06-30	$21,664,587
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-06-30	$23,913,893
Value of total assets at end of year	2016-06-30	$16,757,932
Value of total assets at beginning of year	2016-06-30	$15,515,980
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-06-30	$898,893
Total dividends received (eg from common stock, registered investment company shares)	2016-06-30	$579,778
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-06-30	$579,778
Administrative expenses professional fees incurred	2016-06-30	$255,648
Was this plan covered by a fidelity bond	2016-06-30	Yes
Value of fidelity bond cover	2016-06-30	$500,000
Were there any nonexempt tranactions with any party-in-interest	2016-06-30	No
Contributions received from participants	2016-06-30	$504,111
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-06-30	$29,387
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-06-30	$552,139
Other income not declared elsewhere	2016-06-30	$29,387
Administrative expenses (other) incurred	2016-06-30	$128,754
Liabilities. Value of operating payables at end of year	2016-06-30	$57,531
Liabilities. Value of operating payables at beginning of year	2016-06-30	$109,871
Total non interest bearing cash at end of year	2016-06-30	$1,850,655
Total non interest bearing cash at beginning of year	2016-06-30	$512,583
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-06-30	No
Value of net income/loss	2016-06-30	$1,369,113
Value of net assets at end of year (total assets less liabilities)	2016-06-30	$14,057,795
Value of net assets at beginning of year (total assets less liabilities)	2016-06-30	$12,688,682
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-06-30	No
Were any leases to which the plan was party in default or uncollectible	2016-06-30	No
Investment advisory and management fees	2016-06-30	$51,636
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-06-30	$12,849,071
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-06-30	$12,592,311
Expenses. Payments to insurance carriers foe the provision of benefits	2016-06-30	$17,544,574
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-06-30	$-590,465
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-06-30	Yes
Was there a failure to transmit to the plan any participant contributions	2016-06-30	No
Has the plan failed to provide any benefit when due under the plan	2016-06-30	No
Contributions received in cash from employer	2016-06-30	$23,409,782
Employer contributions (assets) at end of year	2016-06-30	$2,003,926
Employer contributions (assets) at beginning of year	2016-06-30	$1,835,186
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-06-30	$4,120,013
Contract administrator fees	2016-06-30	$462,855
Liabilities. Value of benefit claims payable at end of year	2016-06-30	$2,642,606
Liabilities. Value of benefit claims payable at beginning of year	2016-06-30	$2,717,427
Assets. Value of buildings and other operty used in plan operation at end of year	2016-06-30	$24,893
Assets. Value of buildings and other operty used in plan operation at beginning of year	2016-06-30	$23,761
Did the plan have assets held for investment	2016-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-06-30	No
Opinion of an independent qualified public accountant for this plan	2016-06-30	Unqualified
Accountancy firm name	2016-06-30	MILLER KAPLAN ARASE LLP
Accountancy firm EIN	2016-06-30	952036255
2015 : NORTH COAST TRUST FUND 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$2,827,298
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$2,739,198
Total income from all sources (including contributions)	2015-06-30	$22,795,997
Total of all expenses incurred	2015-06-30	$22,927,508
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-06-30	$22,122,650
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-06-30	$21,576,115
Value of total assets at end of year	2015-06-30	$15,515,980
Value of total assets at beginning of year	2015-06-30	$15,559,391
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-06-30	$804,858
Total dividends received (eg from common stock, registered investment company shares)	2015-06-30	$495,371
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-06-30	$495,371
Administrative expenses professional fees incurred	2015-06-30	$247,135
Was this plan covered by a fidelity bond	2015-06-30	Yes
Value of fidelity bond cover	2015-06-30	$500,000
Were there any nonexempt tranactions with any party-in-interest	2015-06-30	No
Contributions received from participants	2015-06-30	$534,561
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-06-30	$552,139
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-06-30	$149,033
Other income not declared elsewhere	2015-06-30	$1,309,982
Administrative expenses (other) incurred	2015-06-30	$129,868
Liabilities. Value of operating payables at end of year	2015-06-30	$109,871
Liabilities. Value of operating payables at beginning of year	2015-06-30	$112,766
Total non interest bearing cash at end of year	2015-06-30	$512,583
Total non interest bearing cash at beginning of year	2015-06-30	$962,017
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Value of net income/loss	2015-06-30	$-131,511
Value of net assets at end of year (total assets less liabilities)	2015-06-30	$12,688,682
Value of net assets at beginning of year (total assets less liabilities)	2015-06-30	$12,820,193
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-06-30	No
Were any leases to which the plan was party in default or uncollectible	2015-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-06-30	$12,592,311
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-06-30	$12,795,132
Expenses. Payments to insurance carriers foe the provision of benefits	2015-06-30	$16,012,413
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-06-30	$-585,471
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-06-30	Yes
Was there a failure to transmit to the plan any participant contributions	2015-06-30	No
Has the plan failed to provide any benefit when due under the plan	2015-06-30	No
Contributions received in cash from employer	2015-06-30	$21,041,554
Employer contributions (assets) at end of year	2015-06-30	$1,835,186
Employer contributions (assets) at beginning of year	2015-06-30	$1,625,147
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-06-30	$6,110,237
Contract administrator fees	2015-06-30	$427,855
Liabilities. Value of benefit claims payable at end of year	2015-06-30	$2,717,427
Liabilities. Value of benefit claims payable at beginning of year	2015-06-30	$2,626,432
Assets. Value of buildings and other operty used in plan operation at end of year	2015-06-30	$23,761
Assets. Value of buildings and other operty used in plan operation at beginning of year	2015-06-30	$28,062
Did the plan have assets held for investment	2015-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-06-30	No
Opinion of an independent qualified public accountant for this plan	2015-06-30	Unqualified
Accountancy firm name	2015-06-30	MILLER KAPLAN ARASE LLP
Accountancy firm EIN	2015-06-30	952036255
2014 : NORTH COAST TRUST FUND 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$2,739,198
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$2,195,772
Total income from all sources (including contributions)	2014-06-30	$21,351,902
Total of all expenses incurred	2014-06-30	$20,310,010
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-06-30	$19,584,767
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-06-30	$20,324,987
Value of total assets at end of year	2014-06-30	$15,559,391
Value of total assets at beginning of year	2014-06-30	$13,974,073
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-06-30	$725,243
Total dividends received (eg from common stock, registered investment company shares)	2014-06-30	$331,562
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-06-30	$331,562
Administrative expenses professional fees incurred	2014-06-30	$198,749
Was this plan covered by a fidelity bond	2014-06-30	Yes
Value of fidelity bond cover	2014-06-30	$500,000
Were there any nonexempt tranactions with any party-in-interest	2014-06-30	No
Contributions received from participants	2014-06-30	$622,303
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-06-30	$149,033
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-06-30	$18,138
Other income not declared elsewhere	2014-06-30	$168,822
Administrative expenses (other) incurred	2014-06-30	$104,870
Liabilities. Value of operating payables at end of year	2014-06-30	$112,766
Liabilities. Value of operating payables at beginning of year	2014-06-30	$44,837
Total non interest bearing cash at end of year	2014-06-30	$962,017
Total non interest bearing cash at beginning of year	2014-06-30	$945,681
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Value of net income/loss	2014-06-30	$1,041,892
Value of net assets at end of year (total assets less liabilities)	2014-06-30	$12,820,193
Value of net assets at beginning of year (total assets less liabilities)	2014-06-30	$11,778,301
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-06-30	No
Were any leases to which the plan was party in default or uncollectible	2014-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-06-30	$12,795,132
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-06-30	$11,542,885
Expenses. Payments to insurance carriers foe the provision of benefits	2014-06-30	$15,228,447
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-06-30	$526,531
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-06-30	Yes
Was there a failure to transmit to the plan any participant contributions	2014-06-30	No
Has the plan failed to provide any benefit when due under the plan	2014-06-30	No
Contributions received in cash from employer	2014-06-30	$19,702,684
Employer contributions (assets) at end of year	2014-06-30	$1,625,147
Employer contributions (assets) at beginning of year	2014-06-30	$1,448,851
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-06-30	$4,356,320
Contract administrator fees	2014-06-30	$421,624
Liabilities. Value of benefit claims payable at end of year	2014-06-30	$2,626,432
Liabilities. Value of benefit claims payable at beginning of year	2014-06-30	$2,150,935
Assets. Value of buildings and other operty used in plan operation at end of year	2014-06-30	$28,062
Assets. Value of buildings and other operty used in plan operation at beginning of year	2014-06-30	$18,518
Did the plan have assets held for investment	2014-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-06-30	No
Opinion of an independent qualified public accountant for this plan	2014-06-30	Unqualified
Accountancy firm name	2014-06-30	MILLER KAPLAN ARASE LLP
Accountancy firm EIN	2014-06-30	952036255
2013 : NORTH COAST TRUST FUND 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$2,195,772
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$2,040,019
Total income from all sources (including contributions)	2013-06-30	$19,039,770
Total of all expenses incurred	2013-06-30	$19,051,132
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-06-30	$18,344,085
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-06-30	$18,283,319
Value of total assets at end of year	2013-06-30	$13,974,073
Value of total assets at beginning of year	2013-06-30	$13,829,682
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-06-30	$707,047
Total dividends received (eg from common stock, registered investment company shares)	2013-06-30	$324,602
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-06-30	$324,602
Administrative expenses professional fees incurred	2013-06-30	$213,179
Was this plan covered by a fidelity bond	2013-06-30	Yes
Value of fidelity bond cover	2013-06-30	$500,000
Were there any nonexempt tranactions with any party-in-interest	2013-06-30	No
Contributions received from participants	2013-06-30	$680,025
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-06-30	$18,138
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-06-30	$21,714
Other income not declared elsewhere	2013-06-30	$183,462
Administrative expenses (other) incurred	2013-06-30	$84,423
Liabilities. Value of operating payables at end of year	2013-06-30	$44,837
Liabilities. Value of operating payables at beginning of year	2013-06-30	$68,382
Total non interest bearing cash at end of year	2013-06-30	$945,681
Total non interest bearing cash at beginning of year	2013-06-30	$1,673,806
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Value of net income/loss	2013-06-30	$-11,362
Value of net assets at end of year (total assets less liabilities)	2013-06-30	$11,778,301
Value of net assets at beginning of year (total assets less liabilities)	2013-06-30	$11,789,663
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-06-30	No
Were any leases to which the plan was party in default or uncollectible	2013-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-06-30	$11,542,885
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-06-30	$10,721,767
Expenses. Payments to insurance carriers foe the provision of benefits	2013-06-30	$13,972,308
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-06-30	$248,387
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-06-30	Yes
Was there a failure to transmit to the plan any participant contributions	2013-06-30	No
Has the plan failed to provide any benefit when due under the plan	2013-06-30	No
Contributions received in cash from employer	2013-06-30	$17,603,294
Employer contributions (assets) at end of year	2013-06-30	$1,448,851
Employer contributions (assets) at beginning of year	2013-06-30	$1,391,619
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-06-30	$4,371,777
Contract administrator fees	2013-06-30	$409,445
Liabilities. Value of benefit claims payable at end of year	2013-06-30	$2,150,935
Liabilities. Value of benefit claims payable at beginning of year	2013-06-30	$1,971,637
Assets. Value of buildings and other operty used in plan operation at end of year	2013-06-30	$18,518
Assets. Value of buildings and other operty used in plan operation at beginning of year	2013-06-30	$20,776
Did the plan have assets held for investment	2013-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-06-30	No
Opinion of an independent qualified public accountant for this plan	2013-06-30	Unqualified
Accountancy firm name	2013-06-30	MILLER KAPLAN ARASE LLP
Accountancy firm EIN	2013-06-30	952036255
2012 : NORTH COAST TRUST FUND 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$2,040,019
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$2,106,947
Total income from all sources (including contributions)	2012-06-30	$18,946,548
Total of all expenses incurred	2012-06-30	$18,072,035
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-06-30	$17,381,122
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-06-30	$17,443,383
Value of total assets at end of year	2012-06-30	$13,829,682
Value of total assets at beginning of year	2012-06-30	$13,022,097
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-06-30	$690,913
Total dividends received (eg from common stock, registered investment company shares)	2012-06-30	$422,043
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-06-30	$422,043
Administrative expenses professional fees incurred	2012-06-30	$190,659
Was this plan covered by a fidelity bond	2012-06-30	Yes
Value of fidelity bond cover	2012-06-30	$500,000
Were there any nonexempt tranactions with any party-in-interest	2012-06-30	No
Contributions received from participants	2012-06-30	$597,003
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-06-30	$21,714
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-06-30	$30,209
Other income not declared elsewhere	2012-06-30	$969,629
Administrative expenses (other) incurred	2012-06-30	$100,132
Liabilities. Value of operating payables at end of year	2012-06-30	$68,382
Liabilities. Value of operating payables at beginning of year	2012-06-30	$49,011
Total non interest bearing cash at end of year	2012-06-30	$1,673,806
Total non interest bearing cash at beginning of year	2012-06-30	$1,782,849
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Value of net income/loss	2012-06-30	$874,513
Value of net assets at end of year (total assets less liabilities)	2012-06-30	$11,789,663
Value of net assets at beginning of year (total assets less liabilities)	2012-06-30	$10,915,150
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-06-30	No
Were any leases to which the plan was party in default or uncollectible	2012-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-06-30	$10,721,767
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-06-30	$9,884,276
Expenses. Payments to insurance carriers foe the provision of benefits	2012-06-30	$12,900,250
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-06-30	$111,493
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-06-30	Yes
Was there a failure to transmit to the plan any participant contributions	2012-06-30	No
Has the plan failed to provide any benefit when due under the plan	2012-06-30	No
Contributions received in cash from employer	2012-06-30	$16,846,380
Employer contributions (assets) at end of year	2012-06-30	$1,391,619
Employer contributions (assets) at beginning of year	2012-06-30	$1,301,241
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-06-30	$4,480,872
Contract administrator fees	2012-06-30	$400,122
Liabilities. Value of benefit claims payable at end of year	2012-06-30	$1,971,637
Liabilities. Value of benefit claims payable at beginning of year	2012-06-30	$2,057,936
Assets. Value of buildings and other operty used in plan operation at end of year	2012-06-30	$20,776
Assets. Value of buildings and other operty used in plan operation at beginning of year	2012-06-30	$23,522
Did the plan have assets held for investment	2012-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-06-30	No
Opinion of an independent qualified public accountant for this plan	2012-06-30	Unqualified
Accountancy firm name	2012-06-30	MILLER KAPLAN ARASE LLP
Accountancy firm EIN	2012-06-30	952036255
2011 : NORTH COAST TRUST FUND 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$2,106,947
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$2,049,769
Total income from all sources (including contributions)	2011-06-30	$18,401,979
Total of all expenses incurred	2011-06-30	$17,730,217
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-06-30	$17,071,676
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-06-30	$16,495,981
Value of total assets at end of year	2011-06-30	$13,022,097
Value of total assets at beginning of year	2011-06-30	$12,293,157
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-06-30	$658,541
Total dividends received (eg from common stock, registered investment company shares)	2011-06-30	$382,104
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-06-30	$382,104
Administrative expenses professional fees incurred	2011-06-30	$188,268
Was this plan covered by a fidelity bond	2011-06-30	Yes
Value of fidelity bond cover	2011-06-30	$500,000
Were there any nonexempt tranactions with any party-in-interest	2011-06-30	No
Contributions received from participants	2011-06-30	$657,514
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-06-30	$30,209
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-06-30	$149,703
Other income not declared elsewhere	2011-06-30	$1,015,732
Administrative expenses (other) incurred	2011-06-30	$98,643
Liabilities. Value of operating payables at end of year	2011-06-30	$49,011
Liabilities. Value of operating payables at beginning of year	2011-06-30	$58,834
Total non interest bearing cash at end of year	2011-06-30	$1,782,849
Total non interest bearing cash at beginning of year	2011-06-30	$582,594
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Value of net income/loss	2011-06-30	$671,762
Value of net assets at end of year (total assets less liabilities)	2011-06-30	$10,915,150
Value of net assets at beginning of year (total assets less liabilities)	2011-06-30	$10,243,388
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-06-30	No
Were any leases to which the plan was party in default or uncollectible	2011-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-06-30	$9,884,276
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-06-30	$10,276,185
Expenses. Payments to insurance carriers foe the provision of benefits	2011-06-30	$11,927,299
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-06-30	$508,162
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-06-30	Yes
Was there a failure to transmit to the plan any participant contributions	2011-06-30	No
Has the plan failed to provide any benefit when due under the plan	2011-06-30	No
Contributions received in cash from employer	2011-06-30	$15,838,467
Employer contributions (assets) at end of year	2011-06-30	$1,301,241
Employer contributions (assets) at beginning of year	2011-06-30	$1,259,161
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-06-30	$5,144,377
Contract administrator fees	2011-06-30	$371,630
Liabilities. Value of benefit claims payable at end of year	2011-06-30	$2,057,936
Liabilities. Value of benefit claims payable at beginning of year	2011-06-30	$1,990,935
Assets. Value of buildings and other operty used in plan operation at end of year	2011-06-30	$23,522
Assets. Value of buildings and other operty used in plan operation at beginning of year	2011-06-30	$25,514
Did the plan have assets held for investment	2011-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-06-30	No
Opinion of an independent qualified public accountant for this plan	2011-06-30	Unqualified
Accountancy firm name	2011-06-30	MILLER, KAPLAN, ARASE & CO., LLP
Accountancy firm EIN	2011-06-30	952036255

Form 5500 Responses for NORTH COAST TRUST FUND

2022: NORTH COAST TRUST FUND 2022 form 5500 responses
2022-07-01	Type of plan entity	Multi-employer plan
2022-07-01	Plan is a collectively bargained plan	Yes
2022-07-01	Plan funding arrangement – Trust	Yes
2022-07-01	Plan benefit arrangement – Insurance	Yes
2022-07-01	Plan benefit arrangement - Trust	Yes
2021: NORTH COAST TRUST FUND 2021 form 5500 responses
2021-07-01	Type of plan entity	Multi-employer plan
2021-07-01	Plan is a collectively bargained plan	Yes
2021-07-01	Plan funding arrangement – Trust	Yes
2021-07-01	Plan benefit arrangement – Insurance	Yes
2021-07-01	Plan benefit arrangement - Trust	Yes
2020: NORTH COAST TRUST FUND 2020 form 5500 responses
2020-07-01	Type of plan entity	Multi-employer plan
2020-07-01	Plan is a collectively bargained plan	Yes
2020-07-01	Plan funding arrangement – Trust	Yes
2020-07-01	Plan benefit arrangement – Insurance	Yes
2020-07-01	Plan benefit arrangement - Trust	Yes
2019: NORTH COAST TRUST FUND 2019 form 5500 responses
2019-07-01	Type of plan entity	Multi-employer plan
2019-07-01	Plan is a collectively bargained plan	Yes
2019-07-01	Plan funding arrangement – Trust	Yes
2019-07-01	Plan benefit arrangement – Insurance	Yes
2019-07-01	Plan benefit arrangement - Trust	Yes
2018: NORTH COAST TRUST FUND 2018 form 5500 responses
2018-07-01	Type of plan entity	Multi-employer plan
2018-07-01	Plan is a collectively bargained plan	Yes
2018-07-01	Plan funding arrangement – Trust	Yes
2018-07-01	Plan benefit arrangement – Insurance	Yes
2018-07-01	Plan benefit arrangement - Trust	Yes
2017: NORTH COAST TRUST FUND 2017 form 5500 responses
2017-07-01	Type of plan entity	Multi-employer plan
2017-07-01	Plan is a collectively bargained plan	Yes
2017-07-01	Plan funding arrangement – Trust	Yes
2017-07-01	Plan benefit arrangement – Insurance	Yes
2017-07-01	Plan benefit arrangement - Trust	Yes
2016: NORTH COAST TRUST FUND 2016 form 5500 responses
2016-07-01	Type of plan entity	Multi-employer plan
2016-07-01	Plan is a collectively bargained plan	Yes
2016-07-01	Plan funding arrangement – Trust	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement - Trust	Yes
2015: NORTH COAST TRUST FUND 2015 form 5500 responses
2015-07-01	Type of plan entity	Multi-employer plan
2015-07-01	Plan is a collectively bargained plan	Yes
2015-07-01	Plan funding arrangement – Trust	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement - Trust	Yes
2014: NORTH COAST TRUST FUND 2014 form 5500 responses
2014-07-01	Type of plan entity	Multi-employer plan
2014-07-01	Submission has been amended	Yes
2014-07-01	Plan is a collectively bargained plan	Yes
2014-07-01	Plan funding arrangement – Trust	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement - Trust	Yes
2013: NORTH COAST TRUST FUND 2013 form 5500 responses
2013-07-01	Type of plan entity	Multi-employer plan
2013-07-01	Plan is a collectively bargained plan	Yes
2013-07-01	Plan funding arrangement – Trust	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement - Trust	Yes
2012: NORTH COAST TRUST FUND 2012 form 5500 responses
2012-07-01	Type of plan entity	Multi-employer plan
2012-07-01	Plan is a collectively bargained plan	Yes
2012-07-01	Plan funding arrangement – Trust	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement - Trust	Yes
2011: NORTH COAST TRUST FUND 2011 form 5500 responses
2011-07-01	Type of plan entity	Multi-employer plan
2011-07-01	Plan is a collectively bargained plan	Yes
2011-07-01	Plan funding arrangement – Trust	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement - Trust	Yes
2010: NORTH COAST TRUST FUND 2010 form 5500 responses
2010-07-01	Type of plan entity	Multi-employer plan
2010-07-01	Plan is a collectively bargained plan	Yes
2010-07-01	Plan funding arrangement – Trust	Yes
2010-07-01	Plan benefit arrangement – Insurance	Yes
2010-07-01	Plan benefit arrangement - Trust	Yes
2009: NORTH COAST TRUST FUND 2009 form 5500 responses
2009-07-01	Type of plan entity	Multi-employer plan
2009-07-01	Plan is a collectively bargained plan	Yes
2009-07-01	Plan funding arrangement – Trust	Yes
2009-07-01	Plan benefit arrangement – Insurance	Yes
2009-07-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

NEWPORT DENTAL PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	NP3006-500C
Policy instance	3
Insurance contract or identification number NP3006-500C Number of Individuals Covered 93 Insurance policy start date 2022-07-01 Insurance policy end date 2023-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $63,594 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	00866601
Policy instance	1
Insurance contract or identification number 00866601 Number of Individuals Covered 1096 Insurance policy start date 2022-07-01 Insurance policy end date 2023-06-30 Vision Insurance Welfare Benefit Yes 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 number	9060
Policy instance	2
Insurance contract or identification number 9060 Number of Individuals Covered 1524 Insurance policy start date 2021-11-01 Insurance policy end date 2022-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,267,360 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: 00000 )
Policy contract number	76185
Policy instance	4
Insurance contract or identification number 76185 Number of Individuals Covered 108 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $19,097 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract number	G3129, C4413
Policy instance	5
Insurance contract or identification number G3129, C4413 Number of Individuals Covered 2300 Insurance policy start date 2021-09-01 Insurance policy end date 2022-08-31 Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $85,036 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740299-000
Policy instance	6
Insurance contract or identification number 740299-000 Number of Individuals Covered 43 Insurance policy start date 2022-07-01 Insurance policy end date 2023-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $6,136 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740298-000
Policy instance	7
Insurance contract or identification number 740298-000 Number of Individuals Covered 137 Insurance policy start date 2022-07-01 Insurance policy end date 2023-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $37,333 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number	0717714
Policy instance	8
Insurance contract or identification number 0717714 Number of Individuals Covered 152 Insurance policy start date 2022-07-01 Insurance policy end date 2023-06-30 Welfare Benefit Premiums Paid to Carrier USD $49,791 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number	72270-7-EXRK
Policy instance	9
Insurance contract or identification number 72270-7-EXRK Number of Individuals Covered 287 Insurance policy start date 2022-07-01 Insurance policy end date 2023-06-30 Total amount of commissions paid to insurance broker USD $51,664 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,033,276 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $51,664 Insurance broker organization code? 3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	35207
Policy instance	6
Insurance contract or identification number 35207 Number of Individuals Covered 12 Insurance policy start date 2020-11-01 Insurance policy end date 2021-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $99,418 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 number	600829
Policy instance	4
Insurance contract or identification number 600829 Number of Individuals Covered 218 Insurance policy start date 2020-11-01 Insurance policy end date 2021-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,413,231 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 number	19751
Policy instance	5
Insurance contract or identification number 19751 Number of Individuals Covered 199 Insurance policy start date 2020-11-01 Insurance policy end date 2021-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,392,365 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 number	34617
Policy instance	3
Insurance contract or identification number 34617 Number of Individuals Covered 344 Insurance policy start date 2020-11-01 Insurance policy end date 2021-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $2,313,860 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 number	9060
Policy instance	2
Insurance contract or identification number 9060 Number of Individuals Covered 1536 Insurance policy start date 2020-11-01 Insurance policy end date 2021-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $10,953,715 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	00866601
Policy instance	1
Insurance contract or identification number 00866601 Number of Individuals Covered 1098 Insurance policy start date 2021-07-01 Insurance policy end date 2022-06-30 Vision Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
NEWPORT DENTAL PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	NP3006-500C
Policy instance	7
Insurance contract or identification number NP3006-500C Number of Individuals Covered 95 Insurance policy start date 2021-07-01 Insurance policy end date 2022-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $64,569 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: 00000 )
Policy contract number	76185
Policy instance	8
Insurance contract or identification number 76185 Number of Individuals Covered 101 Insurance policy start date 2021-07-01 Insurance policy end date 2022-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $17,154 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740298-000
Policy instance	11
Insurance contract or identification number 740298-000 Number of Individuals Covered 133 Insurance policy start date 2021-07-01 Insurance policy end date 2022-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $40,477 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number	706353-EXRSK
Policy instance	13
Insurance contract or identification number 706353-EXRSK Insurance policy start date 2021-07-01 Insurance policy end date 2022-06-30 Health Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number	0717714
Policy instance	12
Insurance contract or identification number 0717714 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740299-000
Policy instance	10
Insurance contract or identification number 740299-000 Dental Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract number	G3129, C4413
Policy instance	9
Insurance contract or identification number G3129, C4413 Number of Individuals Covered 2287 Insurance policy start date 2020-09-01 Insurance policy end date 2021-08-31 Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $88,565 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 number	600829
Policy instance	4
Insurance contract or identification number 600829 Number of Individuals Covered 230 Insurance policy start date 2019-11-01 Insurance policy end date 2020-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,443,860 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 number	34617
Policy instance	3
Insurance contract or identification number 34617 Number of Individuals Covered 333 Insurance policy start date 2019-11-01 Insurance policy end date 2020-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $2,263,354 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	00866601
Policy instance	1
Insurance contract or identification number 00866601 Number of Individuals Covered 1098 Insurance policy start date 2020-07-01 Insurance policy end date 2021-06-30 Vision Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number	0717714
Policy instance	12
Insurance contract or identification number 0717714 Number of Individuals Covered 162 Insurance policy start date 2020-07-01 Insurance policy end date 2021-06-30 Welfare Benefit Premiums Paid to Carrier USD $3,765,247 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 number	9060
Policy instance	2
Insurance contract or identification number 9060 Number of Individuals Covered 1523 Insurance policy start date 2019-11-01 Insurance policy end date 2020-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $10,608,023 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740299-000
Policy instance	10
Insurance contract or identification number 740299-000 Number of Individuals Covered 92 Insurance policy start date 2020-07-01 Insurance policy end date 2021-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $10,860 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract number	G3129, C4413
Policy instance	9
Insurance contract or identification number G3129, C4413 Number of Individuals Covered 2335 Insurance policy start date 2019-09-01 Insurance policy end date 2020-08-31 Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $88,126 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: 00000 )
Policy contract number	76185
Policy instance	8
Insurance contract or identification number 76185 Number of Individuals Covered 98 Insurance policy start date 2020-07-01 Insurance policy end date 2021-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $13,582 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
NEWPORT DENTAL PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	NP3006-500C
Policy instance	7
Insurance contract or identification number NP3006-500C Number of Individuals Covered 101 Insurance policy start date 2020-07-01 Insurance policy end date 2021-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $68,679 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 number	35207
Policy instance	6
Insurance contract or identification number 35207 Number of Individuals Covered 18 Insurance policy start date 2019-11-01 Insurance policy end date 2020-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $172,365 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 number	19751
Policy instance	5
Insurance contract or identification number 19751 Number of Individuals Covered 195 Insurance policy start date 2019-11-01 Insurance policy end date 2020-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,290,014 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740298-000
Policy instance	11
Insurance contract or identification number 740298-000 Number of Individuals Covered 173 Insurance policy start date 2020-07-01 Insurance policy end date 2021-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $41,487 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number	HCL34867
Policy instance	13
Insurance contract or identification number HCL34867 Number of Individuals Covered 287 Insurance policy start date 2020-07-01 Insurance policy end date 2021-06-30 Total amount of commissions paid to insurance broker USD $40,065 Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $801,292 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $40,065 Insurance broker organization code? 3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	00866601
Policy instance	1
Insurance contract or identification number 00866601 Number of Individuals Covered 1000 Insurance policy start date 2019-07-01 Insurance policy end date 2020-06-30 Vision Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number	0717714
Policy instance	12
Insurance contract or identification number 0717714 Number of Individuals Covered 482 Insurance policy start date 2019-07-01 Insurance policy end date 2020-06-30 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $3,691,132 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number	HCL34867
Policy instance	13
Insurance contract or identification number HCL34867 Number of Individuals Covered 258 Insurance policy start date 2019-07-01 Insurance policy end date 2020-06-30 Total amount of commissions paid to insurance broker USD $30,297 Welfare Benefit Premiums Paid to Carrier USD $575,635 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $30,297 Insurance broker organization code? 3
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740298-000
Policy instance	11
Insurance contract or identification number 740298-000 Number of Individuals Covered 123 Insurance policy start date 2019-07-01 Insurance policy end date 2020-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $36,940 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740299-000
Policy instance	10
Insurance contract or identification number 740299-000 Number of Individuals Covered 93 Insurance policy start date 2019-07-01 Insurance policy end date 2020-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $11,213 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: 00000 )
Policy contract number	76185
Policy instance	8
Insurance contract or identification number 76185 Number of Individuals Covered 80 Insurance policy start date 2019-07-01 Insurance policy end date 2020-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $14,410 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
NEWPORT DENTAL PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	NP3006-500C
Policy instance	7
Insurance contract or identification number NP3006-500C Number of Individuals Covered 92 Insurance policy start date 2019-07-01 Insurance policy end date 2020-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $61,833 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 number	35207
Policy instance	6
Insurance contract or identification number 35207 Number of Individuals Covered 18 Insurance policy start date 2018-11-01 Insurance policy end date 2019-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $218,151 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 number	9060
Policy instance	2
Insurance contract or identification number 9060 Number of Individuals Covered 1488 Insurance policy start date 2018-11-01 Insurance policy end date 2019-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $9,762,741 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract number	G3129, C4413
Policy instance	9
Insurance contract or identification number G3129, C4413 Number of Individuals Covered 2305 Insurance policy start date 2018-09-01 Insurance policy end date 2019-08-31 Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $88,127 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 number	34617
Policy instance	3
Insurance contract or identification number 34617 Number of Individuals Covered 339 Insurance policy start date 2018-11-01 Insurance policy end date 2019-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $2,030,295 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 number	19751
Policy instance	5
Insurance contract or identification number 19751 Number of Individuals Covered 176 Insurance policy start date 2018-11-01 Insurance policy end date 2019-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,138,232 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 number	600829
Policy instance	4
Insurance contract or identification number 600829 Number of Individuals Covered 234 Insurance policy start date 2018-11-01 Insurance policy end date 2019-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,395,234 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number	706353-EXRSK
Policy instance	13
Insurance contract or identification number 706353-EXRSK Number of Individuals Covered 240 Insurance policy start date 2018-07-01 Insurance policy end date 2019-06-30 Total amount of commissions paid to insurance broker USD $27,580 Welfare Benefit Premiums Paid to Carrier USD $524,020 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $27,580 Insurance broker organization code? 3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	19751
Policy instance	4
Insurance contract or identification number 19751 Number of Individuals Covered 170 Insurance policy start date 2017-11-01 Insurance policy end date 2018-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,252,719 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number	0717714
Policy instance	10
Insurance contract or identification number 0717714 Number of Individuals Covered 162 Insurance policy start date 2018-07-01 Insurance policy end date 2019-06-30 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $3,774,297 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740298-000
Policy instance	9
Insurance contract or identification number 740298-000 Number of Individuals Covered 142 Insurance policy start date 2018-07-01 Insurance policy end date 2019-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $33,796 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740299-000
Policy instance	8
Insurance contract or identification number 740299-000 Number of Individuals Covered 118 Insurance policy start date 2018-07-01 Insurance policy end date 2019-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $11,919 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract number	G3129, C4413
Policy instance	7
Insurance contract or identification number G3129, C4413 Number of Individuals Covered 2287 Insurance policy start date 2017-09-01 Insurance policy end date 2018-08-31 Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $86,062 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: 00000 )
Policy contract number	76185
Policy instance	6
Insurance contract or identification number 76185 Number of Individuals Covered 98 Insurance policy start date 2018-07-01 Insurance policy end date 2019-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $12,835 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 number	9060
Policy instance	2
Insurance contract or identification number 9060 Number of Individuals Covered 1478 Insurance policy start date 2017-11-01 Insurance policy end date 2018-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $8,528,799 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 number	34617
Policy instance	3
Insurance contract or identification number 34617 Number of Individuals Covered 270 Insurance policy start date 2017-11-01 Insurance policy end date 2018-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $2,183,719 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	00866601
Policy instance	1
Insurance contract or identification number 00866601 Number of Individuals Covered 985 Insurance policy start date 2018-07-01 Insurance policy end date 2019-06-30 Vision Insurance Welfare Benefit Yes 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 number	600829
Policy instance	12
Insurance contract or identification number 600829 Number of Individuals Covered 241 Insurance policy start date 2017-11-01 Insurance policy end date 2018-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,697,093 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
NEWPORT DENTAL PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	NP3006-500C
Policy instance	5
Insurance contract or identification number NP3006-500C Number of Individuals Covered 94 Insurance policy start date 2018-07-01 Insurance policy end date 2019-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $63,517 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 number	35207
Policy instance	11
Insurance contract or identification number 35207 Number of Individuals Covered 45 Insurance policy start date 2017-11-01 Insurance policy end date 2018-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $476,012 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract number	G3129, C4413
Policy instance	9
Insurance contract or identification number G3129, C4413 Insurance policy start date 2017-09-01 Insurance policy end date 2019-08-31 Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $82,554 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	9060
Policy instance	2
Insurance contract or identification number 9060 Number of Individuals Covered 1390 Insurance policy start date 2016-11-01 Insurance policy end date 2017-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $9,604,879 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 number	34617
Policy instance	3
Insurance contract or identification number 34617 Number of Individuals Covered 268 Insurance policy start date 2016-11-01 Insurance policy end date 2017-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,581,983 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 number	19751
Policy instance	5
Insurance contract or identification number 19751 Number of Individuals Covered 170 Insurance policy start date 2016-11-01 Insurance policy end date 2017-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,252,719 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 number	35207
Policy instance	6
Insurance contract or identification number 35207 Number of Individuals Covered 65 Insurance policy start date 2016-11-01 Insurance policy end date 2017-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $298,506 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
NEWPORT DENTAL PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	NP3006-500C
Policy instance	7
Insurance contract or identification number NP3006-500C Insurance policy start date 2017-07-01 Insurance policy end date 2018-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $56,896 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? Yes
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	76185
Policy instance	8
Insurance contract or identification number 76185 Number of Individuals Covered 108 Insurance policy start date 2017-07-01 Insurance policy end date 2018-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $14,457 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740299-000
Policy instance	10
Insurance contract or identification number 740299-000 Number of Individuals Covered 136 Insurance policy start date 2017-07-01 Insurance policy end date 2018-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $16,046 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740298-000
Policy instance	11
Insurance contract or identification number 740298-000 Number of Individuals Covered 149 Insurance policy start date 2017-07-01 Insurance policy end date 2018-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $37,838 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 number	600829
Policy instance	4
Insurance contract or identification number 600829 Number of Individuals Covered 259 Insurance policy start date 2016-11-01 Insurance policy end date 2017-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $645,640 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number	947-4695
Policy instance	13
Insurance contract or identification number 947-4695 Number of Individuals Covered 230 Insurance policy start date 2017-07-01 Insurance policy end date 2018-06-30 Total amount of commissions paid to insurance broker USD $28,107 Welfare Benefit Premiums Paid to Carrier USD $562,136 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number	0717714
Policy instance	12
Insurance contract or identification number 0717714 Number of Individuals Covered 165 Insurance policy start date 2017-07-01 Insurance policy end date 2018-06-30 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $3,645,497 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	00866601
Policy instance	1
Insurance contract or identification number 00866601 Number of Individuals Covered 1037 Insurance policy start date 2017-07-01 Insurance policy end date 2018-06-30 Vision Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740298-000
Policy instance	11
Insurance contract or identification number 740298-000 Number of Individuals Covered 171 Insurance policy start date 2015-07-01 Insurance policy end date 2016-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $48,505 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	00866601
Policy instance	1
Insurance contract or identification number 00866601 Number of Individuals Covered 1006 Insurance policy start date 2015-07-01 Insurance policy end date 2016-06-30 Vision Insurance Welfare Benefit Yes 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 number	34617
Policy instance	3
Insurance contract or identification number 34617 Number of Individuals Covered 322 Insurance policy start date 2014-11-01 Insurance policy end date 2015-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,268,914 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number	0717714
Policy instance	12
Insurance contract or identification number 0717714 Number of Individuals Covered 197 Insurance policy start date 2015-07-01 Insurance policy end date 2016-06-30 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $4,555,739 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740299-000
Policy instance	10
Insurance contract or identification number 740299-000 Number of Individuals Covered 149 Insurance policy start date 2015-07-01 Insurance policy end date 2016-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $17,648 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract number	G3129, C4413
Policy instance	9
Insurance contract or identification number G3129, C4413 Number of Individuals Covered 2126 Insurance policy start date 2014-09-01 Insurance policy end date 2015-08-31 Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $90,406 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: 00000 )
Policy contract number	76185
Policy instance	8
Insurance contract or identification number 76185 Number of Individuals Covered 139 Insurance policy start date 2015-07-01 Insurance policy end date 2016-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $15,201 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
NEWPORT DENTAL PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	NP3006-500C
Policy instance	7
Insurance contract or identification number NP3006-500C Number of Individuals Covered 83 Insurance policy start date 2015-07-01 Insurance policy end date 2016-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $55,292 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 number	35207
Policy instance	6
Insurance contract or identification number 35207 Number of Individuals Covered 50 Insurance policy start date 2014-11-01 Insurance policy end date 2015-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $139,786 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 number	19751
Policy instance	5
Insurance contract or identification number 19751 Number of Individuals Covered 145 Insurance policy start date 2014-11-01 Insurance policy end date 2015-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $621,887 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 number	600829
Policy instance	4
Insurance contract or identification number 600829 Number of Individuals Covered 159 Insurance policy start date 2014-11-01 Insurance policy end date 2015-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $490,109 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 number	9060
Policy instance	2
Insurance contract or identification number 9060 Number of Individuals Covered 1382 Insurance policy start date 2014-11-01 Insurance policy end date 2015-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $7,015,591 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract number	C9707
Policy instance	13
Insurance contract or identification number C9707 Number of Individuals Covered 248 Insurance policy start date 2015-07-01 Insurance policy end date 2016-06-30 Welfare Benefit Premiums Paid to Carrier USD $587,728 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 number	600829
Policy instance	4
Insurance contract or identification number 600829 Number of Individuals Covered 157 Insurance policy start date 2013-11-01 Insurance policy end date 2014-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $575,636 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 number	19751
Policy instance	5
Insurance contract or identification number 19751 Number of Individuals Covered 141 Insurance policy start date 2013-11-01 Insurance policy end date 2014-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $712,198 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 number	34617
Policy instance	3
Insurance contract or identification number 34617 Number of Individuals Covered 305 Insurance policy start date 2013-11-01 Insurance policy end date 2014-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,279,488 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 number	9060
Policy instance	2
Insurance contract or identification number 9060 Number of Individuals Covered 1284 Insurance policy start date 2013-11-01 Insurance policy end date 2014-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $6,963,828 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	00866601
Policy instance	1
Insurance contract or identification number 00866601 Number of Individuals Covered 951 Insurance policy start date 2014-07-01 Insurance policy end date 2015-06-30 Vision Insurance Welfare Benefit Yes 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 number	35207
Policy instance	6
Insurance contract or identification number 35207 Number of Individuals Covered 50 Insurance policy start date 2013-11-01 Insurance policy end date 2014-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $158,163 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
NEWPORT DENTAL PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	NP3006-500C
Policy instance	7
Insurance contract or identification number NP3006-500C Number of Individuals Covered 78 Insurance policy start date 2014-07-01 Insurance policy end date 2015-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $51,847 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract number	G3129, C4413
Policy instance	8
Insurance contract or identification number G3129, C4413 Number of Individuals Covered 2030 Insurance policy start date 2013-09-01 Insurance policy end date 2014-08-31 Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $86,767 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740298-000
Policy instance	9
Insurance contract or identification number 740298-000 Number of Individuals Covered 145 Insurance policy start date 2014-07-01 Insurance policy end date 2015-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $18,516 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	240573
Policy instance	11
Insurance contract or identification number 240573 Number of Individuals Covered 0 Insurance policy start date 2014-07-01 Insurance policy end date 2015-06-30 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $27,780 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract number	C9707
Policy instance	12
Insurance contract or identification number C9707 Number of Individuals Covered 227 Insurance policy start date 2014-07-01 Insurance policy end date 2015-06-30 Welfare Benefit Premiums Paid to Carrier USD $562,633 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number	0717714
Policy instance	13
Insurance contract or identification number 0717714 Number of Individuals Covered 193 Insurance policy start date 2014-07-01 Insurance policy end date 2015-06-30 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $4,971,151 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740298-000
Policy instance	10
Insurance contract or identification number 740298-000 Number of Individuals Covered 144 Insurance policy start date 2014-07-01 Insurance policy end date 2015-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $42,161 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 number	34617
Policy instance	3
Insurance contract or identification number 34617 Number of Individuals Covered 260 Insurance policy start date 2012-11-01 Insurance policy end date 2013-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,096,895 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 number	19751
Policy instance	5
Insurance contract or identification number 19751 Number of Individuals Covered 173 Insurance policy start date 2012-11-01 Insurance policy end date 2013-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,918,072 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 number	9060
Policy instance	2
Insurance contract or identification number 9060 Number of Individuals Covered 1202 Insurance policy start date 2012-11-01 Insurance policy end date 2013-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $5,436,477 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	00866601
Policy instance	1
Insurance contract or identification number 00866601 Number of Individuals Covered 944 Insurance policy start date 2013-07-01 Insurance policy end date 2014-06-30 Vision Insurance Welfare Benefit Yes 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 number	35207
Policy instance	6
Insurance contract or identification number 35207 Number of Individuals Covered 62 Insurance policy start date 2012-11-01 Insurance policy end date 2013-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $166,536 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
NEWPORT DENTAL PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	NP3006-500C
Policy instance	7
Insurance contract or identification number NP3006-500C Number of Individuals Covered 85 Insurance policy start date 2013-07-01 Insurance policy end date 2014-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $55,592 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract number	G3129, C4413
Policy instance	8
Insurance contract or identification number G3129, C4413 Number of Individuals Covered 2010 Insurance policy start date 2012-09-01 Insurance policy end date 2013-08-31 Temporary Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $83,453 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740298-000
Policy instance	10
Insurance contract or identification number 740298-000 Number of Individuals Covered 114 Insurance policy start date 2013-07-01 Insurance policy end date 2014-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $37,389 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	240573
Policy instance	11
Insurance contract or identification number 240573 Number of Individuals Covered 17 Insurance policy start date 2013-07-01 Insurance policy end date 2014-06-30 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $87,285 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract number	C9707
Policy instance	12
Insurance contract or identification number C9707 Number of Individuals Covered 244 Insurance policy start date 2013-07-01 Insurance policy end date 2014-06-30 Welfare Benefit Premiums Paid to Carrier USD $517,118 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number	0717714
Policy instance	13
Insurance contract or identification number 0717714 Number of Individuals Covered 205 Insurance policy start date 2013-07-01 Insurance policy end date 2014-06-30 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $4,782,536 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740299-000
Policy instance	9
Insurance contract or identification number 740299-000 Number of Individuals Covered 137 Insurance policy start date 2013-07-01 Insurance policy end date 2014-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $16,616 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 number	600829
Policy instance	4
Insurance contract or identification number 600829 Number of Individuals Covered 125 Insurance policy start date 2012-11-01 Insurance policy end date 2013-10-31 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $486,972 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	00866601
Policy instance	1
Insurance contract or identification number 00866601 Number of Individuals Covered 911 Insurance policy start date 2012-07-01 Insurance policy end date 2013-06-30 Vision Insurance Welfare Benefit Yes 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 number	9060
Policy instance	2
Insurance contract or identification number 9060 Number of Individuals Covered 892 Insurance policy start date 2012-07-01 Insurance policy end date 2013-06-30 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $4,638,920 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 number	34617
Policy instance	3
Insurance contract or identification number 34617 Number of Individuals Covered 255 Insurance policy start date 2012-07-01 Insurance policy end date 2013-06-30 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,163,200 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 number	600829
Policy instance	4
Insurance contract or identification number 600829 Number of Individuals Covered 143 Insurance policy start date 2012-07-01 Insurance policy end date 2013-06-30 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $530,972 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 number	19751
Policy instance	5
Insurance contract or identification number 19751 Number of Individuals Covered 448 Insurance policy start date 2012-07-01 Insurance policy end date 2013-06-30 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $2,213,002 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 number	35207
Policy instance	6
Insurance contract or identification number 35207 Number of Individuals Covered 25 Insurance policy start date 2012-07-01 Insurance policy end date 2013-06-30 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $153,088 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740299-000
Policy instance	9
Insurance contract or identification number 740299-000 Number of Individuals Covered 125 Insurance policy start date 2012-07-01 Insurance policy end date 2013-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $15,177 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract number	C9707
Policy instance	8
Insurance contract or identification number C9707 Number of Individuals Covered 233 Insurance policy start date 2012-07-01 Insurance policy end date 2013-06-30 Welfare Benefit Premiums Paid to Carrier USD $477,723 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740298-000
Policy instance	10
Insurance contract or identification number 740298-000 Number of Individuals Covered 163 Insurance policy start date 2012-07-01 Insurance policy end date 2013-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $36,772 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	240573
Policy instance	11
Insurance contract or identification number 240573 Number of Individuals Covered 16 Insurance policy start date 2012-07-01 Insurance policy end date 2013-06-30 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $70,534 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 number	9060
Policy instance	8
Insurance contract or identification number 9060 Number of Individuals Covered 870 Insurance policy start date 2011-07-01 Insurance policy end date 2012-06-30 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $4,310,266 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract number	C9707
Policy instance	2
Insurance contract or identification number C9707 Number of Individuals Covered 223 Insurance policy start date 2011-07-01 Insurance policy end date 2012-06-30 Welfare Benefit Premiums Paid to Carrier USD $367,943 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	00866601
Policy instance	3
Insurance contract or identification number 00866601 Number of Individuals Covered 932 Insurance policy start date 2011-07-01 Insurance policy end date 2012-06-30 Vision Insurance Welfare Benefit Yes 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 number	34617
Policy instance	4
Insurance contract or identification number 34617 Number of Individuals Covered 235 Insurance policy start date 2011-07-01 Insurance policy end date 2012-06-30 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $975,409 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 number	19751
Policy instance	5
Insurance contract or identification number 19751 Number of Individuals Covered 422 Insurance policy start date 2011-07-01 Insurance policy end date 2012-06-30 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,908,571 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract number	G3129, C4413
Policy instance	6
Insurance contract or identification number G3129, C4413 Number of Individuals Covered 2035 Insurance policy start date 2010-09-01 Insurance policy end date 2011-08-31 Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $76,716 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740298-000
Policy instance	7
Insurance contract or identification number 740298-000 Number of Individuals Covered 147 Insurance policy start date 2011-07-01 Insurance policy end date 2012-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $35,930 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740299-000
Policy instance	9
Insurance contract or identification number 740299-000 Number of Individuals Covered 136 Insurance policy start date 2011-07-01 Insurance policy end date 2012-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $16,165 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 number	600829
Policy instance	10
Insurance contract or identification number 600829 Number of Individuals Covered 146 Insurance policy start date 2011-07-01 Insurance policy end date 2012-06-30 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $438,908 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 number	35207
Policy instance	11
Insurance contract or identification number 35207 Number of Individuals Covered 18 Insurance policy start date 2011-07-01 Insurance policy end date 2012-06-30 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $106,120 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
MANAGED HEALTH NETWORK (National Association of Insurance Commissioners NAIC id number: 52411 )
Policy contract number	8827
Policy instance	12
Insurance contract or identification number 8827 Number of Individuals Covered 257 Insurance policy start date 2011-07-01 Insurance policy end date 2012-06-30 Total amount of commissions paid to insurance broker USD $1,485 Other welfare benefits provided INTEGRATED PLAN PREMIUMS Welfare Benefit Premiums Paid to Carrier USD $29,691 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
NEWPORT DENTAL PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	NP3006-500C
Policy instance	1
Insurance contract or identification number NP3006-500C Number of Individuals Covered 97 Insurance policy start date 2011-07-01 Insurance policy end date 2012-06-30 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $62,878 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number	0717714
Policy instance	13
Insurance contract or identification number 0717714 Number of Individuals Covered 793 Insurance policy start date 2011-07-01 Insurance policy end date 2012-06-30 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $4,389,971 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 number	19751
Policy instance	4
Insurance contract or identification number 19751 Number of Individuals Covered 392 Insurance policy start date 2010-07-01 Insurance policy end date 2011-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,737,474 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740298-000
Policy instance	1
Insurance contract or identification number 740298-000 Number of Individuals Covered 151 Insurance policy start date 2010-07-01 Insurance policy end date 2011-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $38,285 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. (National Association of Insurance Commissioners NAIC id number: 95789 )
Policy contract number	740299-000
Policy instance	5
Insurance contract or identification number 740299-000 Number of Individuals Covered 135 Insurance policy start date 2010-07-01 Insurance policy end date 2011-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $19,783 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: )
Policy contract number	00866601
Policy instance	6
Insurance contract or identification number 00866601 Number of Individuals Covered 961 Insurance policy start date 2010-07-01 Insurance policy end date 2011-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Vision Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number	0717714
Policy instance	7
Insurance contract or identification number 0717714 Number of Individuals Covered 793 Insurance policy start date 2010-07-01 Insurance policy end date 2011-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $4,000,938 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract number	C-9707
Policy instance	2
Insurance contract or identification number C-9707 Number of Individuals Covered 230 Insurance policy start date 2010-09-01 Insurance policy end date 2011-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Welfare Benefit Premiums Paid to Carrier USD $270,389 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 number	35207
Policy instance	13
Insurance contract or identification number 35207 Number of Individuals Covered 13 Insurance policy start date 2010-07-01 Insurance policy end date 2011-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $125,257 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
NEWPORT DENTAL PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	NP3006-500C
Policy instance	8
Insurance contract or identification number NP3006-500C Number of Individuals Covered 94 Insurance policy start date 2010-07-01 Insurance policy end date 2011-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $60,718 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 number	34617
Policy instance	10
Insurance contract or identification number 34617 Number of Individuals Covered 248 Insurance policy start date 2010-07-01 Insurance policy end date 2011-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $990,115 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 number	19751
Policy instance	11
Insurance contract or identification number 19751 Number of Individuals Covered 392 Insurance policy start date 2010-07-01 Insurance policy end date 2011-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $1,737,474 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 number	101281
Policy instance	9
Insurance contract or identification number 101281 Number of Individuals Covered 0 Insurance policy start date 2010-07-01 Insurance policy end date 2011-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $3,657 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 69744 )
Policy contract number	G3129, C4413
Policy instance	12
Insurance contract or identification number G3129, C4413 Number of Individuals Covered 2104 Insurance policy start date 2009-09-01 Insurance policy end date 2010-08-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit Yes Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Welfare Benefit Premiums Paid to Carrier USD $79,752 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	240573
Policy instance	14
Insurance contract or identification number 240573 Number of Individuals Covered 12 Insurance policy start date 2010-07-01 Insurance policy end date 2011-06-30 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $46,129 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
MANAGED HEALTH NETWORK (National Association of Insurance Commissioners NAIC id number: 52411 )
Policy contract number	8827
Policy instance	3
Insurance contract or identification number 8827 Number of Individuals Covered 268 Insurance policy start date 2010-07-01 Insurance policy end date 2011-06-30 Total amount of commissions paid to insurance broker USD $3,307 Total amount of fees paid to insurance company USD $0 Other welfare benefits provided INTEGRATED PLAN PREMIUMS Welfare Benefit Premiums Paid to Carrier USD $66,134 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No

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