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UNION ROOFERS HEALTH & WELFARE FUND 401k Plan overview

Plan NameUNION ROOFERS HEALTH & WELFARE FUND
Plan identification number 502

UNION ROOFERS HEALTH & WELFARE FUND Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

UNION ROOFERS HEALTH & WELFARE FUND has sponsored the creation of one or more 401k plans.

Company Name:UNION ROOFERS HEALTH & WELFARE FUND
Employer identification number (EIN):951856197
NAIC Classification:238100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UNION ROOFERS HEALTH & WELFARE FUND

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-09-01ERNEST J GLASGOW2024-04-25 ZACK BEASLEY2024-04-25
5022021-09-01BRENT BEASLEY2023-06-15 EARNEST GLASGOW2023-06-15
5022020-09-01BRENT BEASLEY2022-06-13
5022020-09-01BRENT R BEASLEY2023-01-18
5022019-09-01BRENT BEASLEY2021-05-24 ERNEST GLASGOW2021-05-24
5022019-09-01BRENT BEASLEY2022-01-04 ERNEST GLASGOW2022-01-04
5022018-09-01BRENT BEASLEY2020-06-30 ERNEST GLASGOW2020-06-30
5022017-09-01BRENT BEASLEY2019-06-13 ERNEST GLASGOW2019-06-13
5022016-09-01
5022015-09-01
5022014-09-01
5022013-09-01
5022012-09-01CLIFF SMITH
5022011-09-01BRENT BEASLEY
5022009-09-01BILL PETERS

Plan Statistics for UNION ROOFERS HEALTH & WELFARE FUND

401k plan membership statisitcs for UNION ROOFERS HEALTH & WELFARE FUND

Measure Date Value
2022: UNION ROOFERS HEALTH & WELFARE FUND 2022 401k membership
Total participants, beginning-of-year2022-09-011,032
Total number of active participants reported on line 7a of the Form 55002022-09-011,025
Number of retired or separated participants receiving benefits2022-09-0128
Total of all active and inactive participants2022-09-011,053
Total participants2022-09-011,053
Number of employers contributing to the scheme2022-09-01108
2021: UNION ROOFERS HEALTH & WELFARE FUND 2021 401k membership
Total participants, beginning-of-year2021-09-011,175
Total number of active participants reported on line 7a of the Form 55002021-09-011,004
Number of retired or separated participants receiving benefits2021-09-0128
Total of all active and inactive participants2021-09-011,032
Total participants2021-09-011,032
Number of employers contributing to the scheme2021-09-01108
2020: UNION ROOFERS HEALTH & WELFARE FUND 2020 401k membership
Total participants, beginning-of-year2020-09-011,277
Total number of active participants reported on line 7a of the Form 55002020-09-011,247
Number of retired or separated participants receiving benefits2020-09-0130
Total of all active and inactive participants2020-09-011,277
Total participants2020-09-011,277
Number of employers contributing to the scheme2020-09-0182
2019: UNION ROOFERS HEALTH & WELFARE FUND 2019 401k membership
Total participants, beginning-of-year2019-09-011,011
Total number of active participants reported on line 7a of the Form 55002019-09-011,247
Number of retired or separated participants receiving benefits2019-09-0130
Total of all active and inactive participants2019-09-011,277
Number of employers contributing to the scheme2019-09-0182
2018: UNION ROOFERS HEALTH & WELFARE FUND 2018 401k membership
Total participants, beginning-of-year2018-09-01889
Total number of active participants reported on line 7a of the Form 55002018-09-01979
Total of all active and inactive participants2018-09-01979
Number of employers contributing to the scheme2018-09-01108
2017: UNION ROOFERS HEALTH & WELFARE FUND 2017 401k membership
Total participants, beginning-of-year2017-09-01832
Total number of active participants reported on line 7a of the Form 55002017-09-01854
Number of retired or separated participants receiving benefits2017-09-0135
Total of all active and inactive participants2017-09-01889
Number of employers contributing to the scheme2017-09-01108
2016: UNION ROOFERS HEALTH & WELFARE FUND 2016 401k membership
Total participants, beginning-of-year2016-09-01812
Total number of active participants reported on line 7a of the Form 55002016-09-01832
Number of retired or separated participants receiving benefits2016-09-0135
Total of all active and inactive participants2016-09-01867
Number of employers contributing to the scheme2016-09-01101
2015: UNION ROOFERS HEALTH & WELFARE FUND 2015 401k membership
Total participants, beginning-of-year2015-09-01735
Total number of active participants reported on line 7a of the Form 55002015-09-01777
Number of retired or separated participants receiving benefits2015-09-0135
Total of all active and inactive participants2015-09-01812
Number of employers contributing to the scheme2015-09-01101
2014: UNION ROOFERS HEALTH & WELFARE FUND 2014 401k membership
Total participants, beginning-of-year2014-09-01699
Total number of active participants reported on line 7a of the Form 55002014-09-01694
Number of retired or separated participants receiving benefits2014-09-0141
Total of all active and inactive participants2014-09-01735
Number of employers contributing to the scheme2014-09-01113
2013: UNION ROOFERS HEALTH & WELFARE FUND 2013 401k membership
Total participants, beginning-of-year2013-09-01761
Total number of active participants reported on line 7a of the Form 55002013-09-01657
Number of retired or separated participants receiving benefits2013-09-0142
Total of all active and inactive participants2013-09-01699
Number of employers contributing to the scheme2013-09-0157
2012: UNION ROOFERS HEALTH & WELFARE FUND 2012 401k membership
Total participants, beginning-of-year2012-09-01759
Total number of active participants reported on line 7a of the Form 55002012-09-01716
Number of retired or separated participants receiving benefits2012-09-0145
Total of all active and inactive participants2012-09-01761
Number of employers contributing to the scheme2012-09-0160
2011: UNION ROOFERS HEALTH & WELFARE FUND 2011 401k membership
Total participants, beginning-of-year2011-09-01813
Total number of active participants reported on line 7a of the Form 55002011-09-01713
Number of retired or separated participants receiving benefits2011-09-0146
Total of all active and inactive participants2011-09-01759
Number of employers contributing to the scheme2011-09-0163
2009: UNION ROOFERS HEALTH & WELFARE FUND 2009 401k membership
Total participants, beginning-of-year2009-09-011,003
Total number of active participants reported on line 7a of the Form 55002009-09-01833
Number of retired or separated participants receiving benefits2009-09-0158
Total of all active and inactive participants2009-09-01891
Number of employers contributing to the scheme2009-09-0128

Financial Data on UNION ROOFERS HEALTH & WELFARE FUND

Measure Date Value
2023 : UNION ROOFERS HEALTH & WELFARE FUND 2023 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2023-08-31$254,138
Total unrealized appreciation/depreciation of assets2023-08-31$254,138
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-08-31$4,903,321
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-08-31$5,209,736
Total income from all sources (including contributions)2023-08-31$18,888,723
Total loss/gain on sale of assets2023-08-31$-553,457
Total of all expenses incurred2023-08-31$15,168,061
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-08-31$14,322,077
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-08-31$17,856,873
Value of total assets at end of year2023-08-31$44,077,600
Value of total assets at beginning of year2023-08-31$40,663,353
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-08-31$845,984
Total interest from all sources2023-08-31$1,327,671
Total dividends received (eg from common stock, registered investment company shares)2023-08-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-08-31No
Administrative expenses professional fees incurred2023-08-31$155,236
Was this plan covered by a fidelity bond2023-08-31Yes
Value of fidelity bond cover2023-08-31$500,000
Were there any nonexempt tranactions with any party-in-interest2023-08-31No
Contributions received from participants2023-08-31$151,822
Value of other receiveables (less allowance for doubtful accounts) at end of year2023-08-31$1,143,788
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2023-08-31$182,457
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2023-08-31$71,500
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2023-08-31$162,900
Other income not declared elsewhere2023-08-31$3,498
Administrative expenses (other) incurred2023-08-31$24,686
Liabilities. Value of operating payables at end of year2023-08-31$32,442
Liabilities. Value of operating payables at beginning of year2023-08-31$144,802
Total non interest bearing cash at end of year2023-08-31$1,802,203
Total non interest bearing cash at beginning of year2023-08-31$995,882
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-08-31No
Value of net income/loss2023-08-31$3,720,662
Value of net assets at end of year (total assets less liabilities)2023-08-31$39,174,279
Value of net assets at beginning of year (total assets less liabilities)2023-08-31$35,453,617
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-08-31No
Were any leases to which the plan was party in default or uncollectible2023-08-31No
Investment advisory and management fees2023-08-31$122,247
Income. Interest from US Government securities2023-08-31$440,508
Income. Interest from corporate debt instruments2023-08-31$840,025
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-08-31$2,585,294
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2023-08-31$2,089,064
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2023-08-31$2,089,064
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2023-08-31$47,138
Expenses. Payments to insurance carriers foe the provision of benefits2023-08-31$13,937,953
Asset value of US Government securities at end of year2023-08-31$10,425,743
Asset value of US Government securities at beginning of year2023-08-31$14,632,050
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-08-31Yes
Was there a failure to transmit to the plan any participant contributions2023-08-31No
Has the plan failed to provide any benefit when due under the plan2023-08-31No
Contributions received in cash from employer2023-08-31$17,705,051
Employer contributions (assets) at end of year2023-08-31$2,119,632
Employer contributions (assets) at beginning of year2023-08-31$1,505,117
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-08-31$384,124
Asset. Corporate debt instrument debt (other) at end of year2023-08-31$25,999,015
Asset. Corporate debt instrument debt (other) at beginning of year2023-08-31$21,256,858
Contract administrator fees2023-08-31$543,815
Liabilities. Value of benefit claims payable at end of year2023-08-31$4,799,379
Liabilities. Value of benefit claims payable at beginning of year2023-08-31$4,902,034
Assets. Value of buildings and other operty used in plan operation at end of year2023-08-31$1,925
Assets. Value of buildings and other operty used in plan operation at beginning of year2023-08-31$1,925
Did the plan have assets held for investment2023-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-08-31No
Aggregate proceeds on sale of assets2023-08-31$88,119,195
Aggregate carrying amount (costs) on sale of assets2023-08-31$88,672,652
Opinion of an independent qualified public accountant for this plan2023-08-31Unqualified
Accountancy firm name2023-08-31BALDWIN MOFFITT BEHM LLP
Accountancy firm EIN2023-08-31464370753
2022 : UNION ROOFERS HEALTH & WELFARE FUND 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-08-31$-1,127,486
Total unrealized appreciation/depreciation of assets2022-08-31$-1,127,486
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-08-31$5,209,736
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-08-31$5,146,575
Total income from all sources (including contributions)2022-08-31$15,267,724
Total loss/gain on sale of assets2022-08-31$-1,042,218
Total of all expenses incurred2022-08-31$14,650,509
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-08-31$13,803,349
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-08-31$16,820,777
Value of total assets at end of year2022-08-31$40,663,353
Value of total assets at beginning of year2022-08-31$39,982,977
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-08-31$847,160
Total interest from all sources2022-08-31$598,447
Total dividends received (eg from common stock, registered investment company shares)2022-08-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-08-31No
Administrative expenses professional fees incurred2022-08-31$157,450
Was this plan covered by a fidelity bond2022-08-31Yes
Value of fidelity bond cover2022-08-31$500,000
Were there any nonexempt tranactions with any party-in-interest2022-08-31No
Contributions received from participants2022-08-31$184,179
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-08-31$182,457
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-08-31$125,482
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-08-31$162,900
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-08-31$286,200
Other income not declared elsewhere2022-08-31$18,204
Administrative expenses (other) incurred2022-08-31$30,496
Liabilities. Value of operating payables at end of year2022-08-31$144,802
Liabilities. Value of operating payables at beginning of year2022-08-31$107,209
Total non interest bearing cash at end of year2022-08-31$995,882
Total non interest bearing cash at beginning of year2022-08-31$1,588,395
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-08-31No
Value of net income/loss2022-08-31$617,215
Value of net assets at end of year (total assets less liabilities)2022-08-31$35,453,617
Value of net assets at beginning of year (total assets less liabilities)2022-08-31$34,836,402
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-08-31No
Were any leases to which the plan was party in default or uncollectible2022-08-31No
Investment advisory and management fees2022-08-31$119,565
Income. Interest from US Government securities2022-08-31$66,105
Income. Interest from corporate debt instruments2022-08-31$527,081
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-08-31$2,089,064
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-08-31$2,277,683
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-08-31$2,277,683
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-08-31$5,261
Expenses. Payments to insurance carriers foe the provision of benefits2022-08-31$13,432,958
Asset value of US Government securities at end of year2022-08-31$14,632,050
Asset value of US Government securities at beginning of year2022-08-31$12,299,604
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-08-31Yes
Was there a failure to transmit to the plan any participant contributions2022-08-31No
Has the plan failed to provide any benefit when due under the plan2022-08-31No
Contributions received in cash from employer2022-08-31$16,636,598
Employer contributions (assets) at end of year2022-08-31$1,505,117
Employer contributions (assets) at beginning of year2022-08-31$1,428,115
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-08-31$370,391
Asset. Corporate debt instrument debt (other) at end of year2022-08-31$21,256,858
Asset. Corporate debt instrument debt (other) at beginning of year2022-08-31$22,261,773
Contract administrator fees2022-08-31$539,649
Liabilities. Value of benefit claims payable at end of year2022-08-31$4,902,034
Liabilities. Value of benefit claims payable at beginning of year2022-08-31$4,753,166
Assets. Value of buildings and other operty used in plan operation at end of year2022-08-31$1,925
Assets. Value of buildings and other operty used in plan operation at beginning of year2022-08-31$1,925
Did the plan have assets held for investment2022-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-08-31No
Aggregate proceeds on sale of assets2022-08-31$116,512,335
Aggregate carrying amount (costs) on sale of assets2022-08-31$117,554,553
Opinion of an independent qualified public accountant for this plan2022-08-31Unqualified
Accountancy firm name2022-08-31BALDWIN MOFFITT BEHM LLP
Accountancy firm EIN2022-08-31464370753
2021 : UNION ROOFERS HEALTH & WELFARE FUND 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2021-08-31$-142,846
Total unrealized appreciation/depreciation of assets2021-08-31$-142,846
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-08-31$5,128,297
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-08-31$5,664,700
Total income from all sources (including contributions)2021-08-31$18,475,921
Total loss/gain on sale of assets2021-08-31$-71,412
Total of all expenses incurred2021-08-31$15,678,199
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-08-31$14,916,923
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-08-31$18,173,788
Value of total assets at end of year2021-08-31$39,978,088
Value of total assets at beginning of year2021-08-31$37,716,769
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-08-31$761,276
Total interest from all sources2021-08-31$515,291
Total dividends received (eg from common stock, registered investment company shares)2021-08-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-08-31No
Administrative expenses professional fees incurred2021-08-31$90,396
Was this plan covered by a fidelity bond2021-08-31Yes
Value of fidelity bond cover2021-08-31$500,000
If this is an individual account plan, was there a blackout period2021-08-31No
Were there any nonexempt tranactions with any party-in-interest2021-08-31No
Contributions received from participants2021-08-31$204,304
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-08-31$122,518
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-08-31$286,482
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-08-31$286,200
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-08-31$461,200
Other income not declared elsewhere2021-08-31$1,100
Administrative expenses (other) incurred2021-08-31$35,783
Liabilities. Value of operating payables at end of year2021-08-31$88,931
Total non interest bearing cash at end of year2021-08-31$1,588,395
Total non interest bearing cash at beginning of year2021-08-31$213,378
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-08-31No
Value of net income/loss2021-08-31$2,797,722
Value of net assets at end of year (total assets less liabilities)2021-08-31$34,849,791
Value of net assets at beginning of year (total assets less liabilities)2021-08-31$32,052,069
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-08-31No
Were any leases to which the plan was party in default or uncollectible2021-08-31No
Investment advisory and management fees2021-08-31$137,164
Income. Interest from US Government securities2021-08-31$24,739
Income. Interest from corporate debt instruments2021-08-31$489,529
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-08-31$2,277,683
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-08-31$5,484,629
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-08-31$5,484,629
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-08-31$1,023
Expenses. Payments to insurance carriers foe the provision of benefits2021-08-31$14,272,299
Asset value of US Government securities at end of year2021-08-31$12,308,207
Asset value of US Government securities at beginning of year2021-08-31$8,692,164
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-08-31Yes
Was there a failure to transmit to the plan any participant contributions2021-08-31No
Has the plan failed to provide any benefit when due under the plan2021-08-31No
Contributions received in cash from employer2021-08-31$17,969,484
Employer contributions (assets) at end of year2021-08-31$1,428,115
Employer contributions (assets) at beginning of year2021-08-31$1,733,181
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-08-31$644,624
Asset. Corporate debt instrument debt (other) at end of year2021-08-31$22,253,170
Asset. Corporate debt instrument debt (other) at beginning of year2021-08-31$21,305,010
Contract administrator fees2021-08-31$497,933
Liabilities. Value of benefit claims payable at end of year2021-08-31$4,753,166
Liabilities. Value of benefit claims payable at beginning of year2021-08-31$5,203,500
Assets. Value of buildings and other operty used in plan operation at end of year2021-08-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2021-08-31$1,925
Did the plan have assets held for investment2021-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-08-31No
Aggregate proceeds on sale of assets2021-08-31$72,737,754
Aggregate carrying amount (costs) on sale of assets2021-08-31$72,809,166
Opinion of an independent qualified public accountant for this plan2021-08-31Unqualified
Accountancy firm name2021-08-31BALDWIN MOFFITT BEHM LLP
Accountancy firm EIN2021-08-31464370753
2020 : UNION ROOFERS HEALTH & WELFARE FUND 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2020-08-31$-235,775
Total unrealized appreciation/depreciation of assets2020-08-31$-235,775
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-08-31$5,345,988
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-08-31$5,087,118
Total income from all sources (including contributions)2020-08-31$20,395,575
Total loss/gain on sale of assets2020-08-31$374,107
Total of all expenses incurred2020-08-31$14,295,079
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-08-31$13,580,087
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-08-31$19,367,366
Value of total assets at end of year2020-08-31$38,807,546
Value of total assets at beginning of year2020-08-31$32,448,180
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-08-31$714,992
Total interest from all sources2020-08-31$829,277
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-08-31No
Administrative expenses professional fees incurred2020-08-31$125,381
Was this plan covered by a fidelity bond2020-08-31Yes
Value of fidelity bond cover2020-08-31$500,000
If this is an individual account plan, was there a blackout period2020-08-31No
Were there any nonexempt tranactions with any party-in-interest2020-08-31No
Contributions received from participants2020-08-31$224,083
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-08-31$314,400
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-08-31$279,086
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-08-31$135,874
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-08-31$5,106,614
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-08-31$944,544
Other income not declared elsewhere2020-08-31$60,600
Administrative expenses (other) incurred2020-08-31$14,562
Liabilities. Value of operating payables at end of year2020-08-31$12,374
Liabilities. Value of operating payables at beginning of year2020-08-31$12,374
Total non interest bearing cash at end of year2020-08-31$213,378
Total non interest bearing cash at beginning of year2020-08-31$2,001,843
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-08-31No
Value of net income/loss2020-08-31$6,100,496
Value of net assets at end of year (total assets less liabilities)2020-08-31$33,461,558
Value of net assets at beginning of year (total assets less liabilities)2020-08-31$27,361,062
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-08-31No
Were any leases to which the plan was party in default or uncollectible2020-08-31No
Investment advisory and management fees2020-08-31$74,467
Income. Interest from US Government securities2020-08-31$85,734
Income. Interest from corporate debt instruments2020-08-31$625,052
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-08-31$5,484,634
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-08-31$454,702
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-08-31$454,702
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-08-31$118,491
Expenses. Payments to insurance carriers foe the provision of benefits2020-08-31$12,730,663
Asset value of US Government securities at end of year2020-08-31$9,390,915
Asset value of US Government securities at beginning of year2020-08-31$7,992,150
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-08-31Yes
Was there a failure to transmit to the plan any participant contributions2020-08-31No
Has the plan failed to provide any benefit when due under the plan2020-08-31No
Contributions received in cash from employer2020-08-31$19,143,283
Employer contributions (assets) at end of year2020-08-31$2,103,977
Employer contributions (assets) at beginning of year2020-08-31$2,103,977
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-08-31$535,024
Asset. Corporate debt instrument debt (other) at end of year2020-08-31$21,333,631
Asset. Corporate debt instrument debt (other) at beginning of year2020-08-31$19,757,709
Contract administrator fees2020-08-31$500,582
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-08-31No
Liabilities. Value of benefit claims payable at end of year2020-08-31$227,000
Liabilities. Value of benefit claims payable at beginning of year2020-08-31$4,130,200
Assets. Value of buildings and other operty used in plan operation at end of year2020-08-31$1,925
Assets. Value of buildings and other operty used in plan operation at beginning of year2020-08-31$1,925
Did the plan have assets held for investment2020-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-08-31No
Aggregate proceeds on sale of assets2020-08-31$85,616,768
Aggregate carrying amount (costs) on sale of assets2020-08-31$85,242,661
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-08-31No
Opinion of an independent qualified public accountant for this plan2020-08-31Unqualified
Accountancy firm name2020-08-31EIDE BAILLY LLP
Accountancy firm EIN2020-08-31450250958
2019 : UNION ROOFERS HEALTH & WELFARE FUND 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2019-08-31$390,685
Total unrealized appreciation/depreciation of assets2019-08-31$390,685
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-08-31$5,087,118
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-08-31$3,931,770
Total income from all sources (including contributions)2019-08-31$18,499,324
Total loss/gain on sale of assets2019-08-31$175,465
Total of all expenses incurred2019-08-31$13,071,616
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-08-31$12,413,367
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-08-31$17,197,818
Value of total assets at end of year2019-08-31$32,448,180
Value of total assets at beginning of year2019-08-31$25,865,124
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-08-31$658,249
Total interest from all sources2019-08-31$734,346
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-08-31No
Administrative expenses professional fees incurred2019-08-31$94,042
Was this plan covered by a fidelity bond2019-08-31Yes
Value of fidelity bond cover2019-08-31$500,000
Were there any nonexempt tranactions with any party-in-interest2019-08-31No
Contributions received from participants2019-08-31$280,851
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-08-31$135,874
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-08-31$118,685
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-08-31$944,544
Other income not declared elsewhere2019-08-31$1,010
Administrative expenses (other) incurred2019-08-31$14,327
Liabilities. Value of operating payables at end of year2019-08-31$12,374
Liabilities. Value of operating payables at beginning of year2019-08-31$20,670
Total non interest bearing cash at end of year2019-08-31$2,001,843
Total non interest bearing cash at beginning of year2019-08-31$31,190
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-08-31No
Value of net income/loss2019-08-31$5,427,708
Value of net assets at end of year (total assets less liabilities)2019-08-31$27,361,062
Value of net assets at beginning of year (total assets less liabilities)2019-08-31$21,933,354
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-08-31No
Were any leases to which the plan was party in default or uncollectible2019-08-31No
Investment advisory and management fees2019-08-31$89,933
Income. Interest from US Government securities2019-08-31$220,860
Income. Interest from corporate debt instruments2019-08-31$491,345
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-08-31$454,702
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-08-31$2,602,729
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-08-31$2,602,729
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-08-31$22,141
Expenses. Payments to insurance carriers foe the provision of benefits2019-08-31$11,751,770
Asset value of US Government securities at end of year2019-08-31$7,992,150
Asset value of US Government securities at beginning of year2019-08-31$8,452,720
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-08-31Yes
Was there a failure to transmit to the plan any participant contributions2019-08-31No
Has the plan failed to provide any benefit when due under the plan2019-08-31No
Contributions received in cash from employer2019-08-31$16,916,967
Employer contributions (assets) at end of year2019-08-31$2,103,977
Employer contributions (assets) at beginning of year2019-08-31$1,937,477
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-08-31$661,597
Asset. Corporate debt instrument debt (other) at end of year2019-08-31$19,757,709
Asset. Corporate debt instrument debt (other) at beginning of year2019-08-31$12,707,222
Contract administrator fees2019-08-31$459,947
Liabilities. Value of benefit claims payable at end of year2019-08-31$4,130,200
Liabilities. Value of benefit claims payable at beginning of year2019-08-31$3,911,100
Assets. Value of buildings and other operty used in plan operation at end of year2019-08-31$1,925
Assets. Value of buildings and other operty used in plan operation at beginning of year2019-08-31$15,101
Did the plan have assets held for investment2019-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-08-31No
Aggregate proceeds on sale of assets2019-08-31$82,076,986
Aggregate carrying amount (costs) on sale of assets2019-08-31$81,901,521
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-08-31No
Opinion of an independent qualified public accountant for this plan2019-08-31Unqualified
Accountancy firm name2019-08-31EIDE BAILLY LLP
Accountancy firm EIN2019-08-31450250958
2018 : UNION ROOFERS HEALTH & WELFARE FUND 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2018-08-31$-143,404
Total unrealized appreciation/depreciation of assets2018-08-31$-143,404
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-08-31$3,931,770
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-08-31$3,752,463
Total income from all sources (including contributions)2018-08-31$16,307,659
Total loss/gain on sale of assets2018-08-31$-160,217
Total of all expenses incurred2018-08-31$12,467,690
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-08-31$11,787,821
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-08-31$16,127,692
Value of total assets at end of year2018-08-31$25,865,124
Value of total assets at beginning of year2018-08-31$21,845,848
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-08-31$679,869
Total interest from all sources2018-08-31$481,822
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-08-31No
Administrative expenses professional fees incurred2018-08-31$131,872
Was this plan covered by a fidelity bond2018-08-31Yes
Value of fidelity bond cover2018-08-31$500,000
If this is an individual account plan, was there a blackout period2018-08-31No
Were there any nonexempt tranactions with any party-in-interest2018-08-31No
Contributions received from participants2018-08-31$244,041
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-08-31$118,685
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-08-31$59,369
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-08-31$126,260
Other income not declared elsewhere2018-08-31$1,766
Administrative expenses (other) incurred2018-08-31$17,329
Liabilities. Value of operating payables at end of year2018-08-31$20,670
Liabilities. Value of operating payables at beginning of year2018-08-31$22,103
Total non interest bearing cash at end of year2018-08-31$31,190
Total non interest bearing cash at beginning of year2018-08-31$29,231
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-08-31No
Value of net income/loss2018-08-31$3,839,969
Value of net assets at end of year (total assets less liabilities)2018-08-31$21,933,354
Value of net assets at beginning of year (total assets less liabilities)2018-08-31$18,093,385
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-08-31No
Were any leases to which the plan was party in default or uncollectible2018-08-31No
Investment advisory and management fees2018-08-31$75,005
Income. Interest from US Government securities2018-08-31$155,863
Income. Interest from corporate debt instruments2018-08-31$312,071
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-08-31$2,602,729
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-08-31$2,253,387
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-08-31$2,253,387
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-08-31$13,888
Expenses. Payments to insurance carriers foe the provision of benefits2018-08-31$11,189,989
Asset value of US Government securities at end of year2018-08-31$8,452,720
Asset value of US Government securities at beginning of year2018-08-31$7,250,580
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-08-31Yes
Was there a failure to transmit to the plan any participant contributions2018-08-31No
Has the plan failed to provide any benefit when due under the plan2018-08-31No
Contributions received in cash from employer2018-08-31$15,883,651
Employer contributions (assets) at end of year2018-08-31$1,937,477
Employer contributions (assets) at beginning of year2018-08-31$1,736,361
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-08-31$597,832
Asset. Corporate debt instrument debt (other) at end of year2018-08-31$12,707,222
Asset. Corporate debt instrument debt (other) at beginning of year2018-08-31$10,500,760
Contract administrator fees2018-08-31$455,663
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-08-31No
Liabilities. Value of benefit claims payable at end of year2018-08-31$3,911,100
Liabilities. Value of benefit claims payable at beginning of year2018-08-31$3,604,100
Assets. Value of buildings and other operty used in plan operation at end of year2018-08-31$15,101
Assets. Value of buildings and other operty used in plan operation at beginning of year2018-08-31$16,160
Did the plan have assets held for investment2018-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-08-31No
Aggregate proceeds on sale of assets2018-08-31$38,892,282
Aggregate carrying amount (costs) on sale of assets2018-08-31$39,052,499
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-08-31No
Opinion of an independent qualified public accountant for this plan2018-08-31Unqualified
Accountancy firm name2018-08-31BERNARD KOTKIN AND COMPANY, LLP
Accountancy firm EIN2018-08-31952556670
2017 : UNION ROOFERS HEALTH & WELFARE FUND 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2017-08-31$24,618
Total unrealized appreciation/depreciation of assets2017-08-31$24,618
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-08-31$3,752,463
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-08-31$3,204,023
Total income from all sources (including contributions)2017-08-31$14,956,196
Total loss/gain on sale of assets2017-08-31$-176,698
Total of all expenses incurred2017-08-31$10,819,541
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-08-31$10,207,261
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-08-31$14,746,642
Value of total assets at end of year2017-08-31$21,845,848
Value of total assets at beginning of year2017-08-31$17,160,753
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-08-31$612,280
Total interest from all sources2017-08-31$348,172
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-08-31No
Administrative expenses professional fees incurred2017-08-31$99,440
Was this plan covered by a fidelity bond2017-08-31Yes
Value of fidelity bond cover2017-08-31$500,000
If this is an individual account plan, was there a blackout period2017-08-31No
Were there any nonexempt tranactions with any party-in-interest2017-08-31No
Contributions received from participants2017-08-31$291,734
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-08-31$59,369
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-08-31$67,017
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-08-31$126,260
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-08-31$65,941
Other income not declared elsewhere2017-08-31$13,462
Administrative expenses (other) incurred2017-08-31$16,966
Liabilities. Value of operating payables at end of year2017-08-31$22,103
Liabilities. Value of operating payables at beginning of year2017-08-31$16,882
Total non interest bearing cash at end of year2017-08-31$29,231
Total non interest bearing cash at beginning of year2017-08-31$16,786
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-08-31No
Value of net income/loss2017-08-31$4,136,655
Value of net assets at end of year (total assets less liabilities)2017-08-31$18,093,385
Value of net assets at beginning of year (total assets less liabilities)2017-08-31$13,956,730
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-08-31No
Were any leases to which the plan was party in default or uncollectible2017-08-31No
Investment advisory and management fees2017-08-31$54,665
Income. Interest from US Government securities2017-08-31$101,812
Income. Interest from corporate debt instruments2017-08-31$239,324
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-08-31$2,253,387
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-08-31$1,886,420
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-08-31$1,886,420
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-08-31$7,036
Expenses. Payments to insurance carriers foe the provision of benefits2017-08-31$9,646,766
Asset value of US Government securities at end of year2017-08-31$7,250,580
Asset value of US Government securities at beginning of year2017-08-31$4,918,315
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-08-31Yes
Was there a failure to transmit to the plan any participant contributions2017-08-31No
Has the plan failed to provide any benefit when due under the plan2017-08-31No
Contributions received in cash from employer2017-08-31$14,454,908
Employer contributions (assets) at end of year2017-08-31$1,736,361
Employer contributions (assets) at beginning of year2017-08-31$1,481,017
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-08-31$560,495
Asset. Corporate debt instrument debt (other) at end of year2017-08-31$10,500,760
Asset. Corporate debt instrument debt (other) at beginning of year2017-08-31$8,772,152
Contract administrator fees2017-08-31$441,209
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-08-31No
Liabilities. Value of benefit claims payable at end of year2017-08-31$3,604,100
Liabilities. Value of benefit claims payable at beginning of year2017-08-31$3,121,200
Assets. Value of buildings and other operty used in plan operation at end of year2017-08-31$16,160
Assets. Value of buildings and other operty used in plan operation at beginning of year2017-08-31$19,046
Did the plan have assets held for investment2017-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-08-31No
Aggregate proceeds on sale of assets2017-08-31$55,171,261
Aggregate carrying amount (costs) on sale of assets2017-08-31$55,347,959
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-08-31No
Opinion of an independent qualified public accountant for this plan2017-08-31Unqualified
Accountancy firm name2017-08-31BERNARD KOTKIN AND COMPANY, LLP
Accountancy firm EIN2017-08-31952556670
2016 : UNION ROOFERS HEALTH & WELFARE FUND 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2016-08-31$57,134
Total unrealized appreciation/depreciation of assets2016-08-31$57,134
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-08-31$3,204,023
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-08-31$2,955,987
Total income from all sources (including contributions)2016-08-31$14,292,821
Total loss/gain on sale of assets2016-08-31$-25,709
Total of all expenses incurred2016-08-31$9,819,964
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-08-31$9,271,860
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-08-31$14,004,333
Value of total assets at end of year2016-08-31$17,160,753
Value of total assets at beginning of year2016-08-31$12,439,860
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-08-31$548,104
Total interest from all sources2016-08-31$255,074
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-08-31No
Administrative expenses professional fees incurred2016-08-31$76,373
Was this plan covered by a fidelity bond2016-08-31Yes
Value of fidelity bond cover2016-08-31$500,000
If this is an individual account plan, was there a blackout period2016-08-31No
Were there any nonexempt tranactions with any party-in-interest2016-08-31No
Contributions received from participants2016-08-31$311,036
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-08-31$67,017
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-08-31$105,123
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-08-31$65,941
Other income not declared elsewhere2016-08-31$1,989
Administrative expenses (other) incurred2016-08-31$15,294
Liabilities. Value of operating payables at end of year2016-08-31$16,882
Liabilities. Value of operating payables at beginning of year2016-08-31$18,787
Total non interest bearing cash at end of year2016-08-31$16,786
Total non interest bearing cash at beginning of year2016-08-31$15,024
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-08-31No
Value of net income/loss2016-08-31$4,472,857
Value of net assets at end of year (total assets less liabilities)2016-08-31$13,956,730
Value of net assets at beginning of year (total assets less liabilities)2016-08-31$9,483,873
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-08-31No
Were any leases to which the plan was party in default or uncollectible2016-08-31No
Investment advisory and management fees2016-08-31$45,785
Income. Interest from US Government securities2016-08-31$55,236
Income. Interest from corporate debt instruments2016-08-31$197,978
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-08-31$1,886,420
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-08-31$1,430,076
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-08-31$1,430,076
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-08-31$1,860
Expenses. Payments to insurance carriers foe the provision of benefits2016-08-31$8,775,186
Asset value of US Government securities at end of year2016-08-31$4,918,315
Asset value of US Government securities at beginning of year2016-08-31$2,204,488
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-08-31Yes
Was there a failure to transmit to the plan any participant contributions2016-08-31No
Has the plan failed to provide any benefit when due under the plan2016-08-31No
Contributions received in cash from employer2016-08-31$13,693,297
Employer contributions (assets) at end of year2016-08-31$1,481,017
Employer contributions (assets) at beginning of year2016-08-31$1,379,478
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-08-31$496,674
Asset. Corporate debt instrument debt (other) at end of year2016-08-31$8,772,152
Asset. Corporate debt instrument debt (other) at beginning of year2016-08-31$7,298,151
Contract administrator fees2016-08-31$410,652
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-08-31No
Liabilities. Value of benefit claims payable at end of year2016-08-31$3,121,200
Liabilities. Value of benefit claims payable at beginning of year2016-08-31$2,937,200
Assets. Value of buildings and other operty used in plan operation at end of year2016-08-31$19,046
Assets. Value of buildings and other operty used in plan operation at beginning of year2016-08-31$7,520
Did the plan have assets held for investment2016-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-08-31No
Aggregate proceeds on sale of assets2016-08-31$59,303,458
Aggregate carrying amount (costs) on sale of assets2016-08-31$59,329,167
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-08-31No
Opinion of an independent qualified public accountant for this plan2016-08-31Unqualified
Accountancy firm name2016-08-31BERNARD KOTKIN AND COMPANY, LLP
Accountancy firm EIN2016-08-31952556670
2015 : UNION ROOFERS HEALTH & WELFARE FUND 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2015-08-31$-59,459
Total unrealized appreciation/depreciation of assets2015-08-31$-59,459
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-08-31$2,955,987
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-08-31$2,565,751
Total income from all sources (including contributions)2015-08-31$11,672,974
Total loss/gain on sale of assets2015-08-31$-42,887
Total of all expenses incurred2015-08-31$9,131,313
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-08-31$8,606,254
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-08-31$11,583,256
Value of total assets at end of year2015-08-31$12,439,860
Value of total assets at beginning of year2015-08-31$9,507,963
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-08-31$525,059
Total interest from all sources2015-08-31$186,398
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-08-31No
Administrative expenses professional fees incurred2015-08-31$70,145
Was this plan covered by a fidelity bond2015-08-31Yes
Value of fidelity bond cover2015-08-31$500,000
If this is an individual account plan, was there a blackout period2015-08-31No
Were there any nonexempt tranactions with any party-in-interest2015-08-31No
Contributions received from participants2015-08-31$330,657
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-08-31$105,123
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-08-31$27,982
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-08-31$2,981
Other income not declared elsewhere2015-08-31$5,666
Administrative expenses (other) incurred2015-08-31$15,319
Liabilities. Value of operating payables at end of year2015-08-31$18,787
Liabilities. Value of operating payables at beginning of year2015-08-31$13,470
Total non interest bearing cash at end of year2015-08-31$15,024
Total non interest bearing cash at beginning of year2015-08-31$6,503
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-08-31No
Value of net income/loss2015-08-31$2,541,661
Value of net assets at end of year (total assets less liabilities)2015-08-31$9,483,873
Value of net assets at beginning of year (total assets less liabilities)2015-08-31$6,942,212
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-08-31No
Were any leases to which the plan was party in default or uncollectible2015-08-31No
Investment advisory and management fees2015-08-31$30,513
Income. Interest from US Government securities2015-08-31$13,647
Income. Interest from corporate debt instruments2015-08-31$172,510
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-08-31$1,430,076
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-08-31$1,012,598
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-08-31$1,012,598
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-08-31$241
Expenses. Payments to insurance carriers foe the provision of benefits2015-08-31$7,893,034
Asset value of US Government securities at end of year2015-08-31$2,204,488
Asset value of US Government securities at beginning of year2015-08-31$1,532,559
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-08-31Yes
Was there a failure to transmit to the plan any participant contributions2015-08-31No
Has the plan failed to provide any benefit when due under the plan2015-08-31No
Contributions received in cash from employer2015-08-31$11,252,599
Employer contributions (assets) at end of year2015-08-31$1,379,478
Employer contributions (assets) at beginning of year2015-08-31$1,009,761
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-08-31$713,220
Asset. Corporate debt instrument debt (other) at end of year2015-08-31$7,298,151
Asset. Corporate debt instrument debt (other) at beginning of year2015-08-31$5,911,144
Contract administrator fees2015-08-31$409,082
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-08-31No
Liabilities. Value of benefit claims payable at end of year2015-08-31$2,937,200
Liabilities. Value of benefit claims payable at beginning of year2015-08-31$2,549,300
Assets. Value of buildings and other operty used in plan operation at end of year2015-08-31$7,520
Assets. Value of buildings and other operty used in plan operation at beginning of year2015-08-31$7,416
Did the plan have assets held for investment2015-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-08-31No
Aggregate proceeds on sale of assets2015-08-31$41,357,078
Aggregate carrying amount (costs) on sale of assets2015-08-31$41,399,965
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-08-31No
Opinion of an independent qualified public accountant for this plan2015-08-31Unqualified
Accountancy firm name2015-08-31BERNARD KOTKIN AND COMPANY, LLP
Accountancy firm EIN2015-08-31952556670
2014 : UNION ROOFERS HEALTH & WELFARE FUND 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-08-31$61,443
Total unrealized appreciation/depreciation of assets2014-08-31$61,443
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-08-31$2,565,751
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-08-31$2,503,469
Total income from all sources (including contributions)2014-08-31$9,168,980
Total loss/gain on sale of assets2014-08-31$-55,838
Total of all expenses incurred2014-08-31$7,959,635
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-08-31$7,442,223
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-08-31$9,020,232
Value of total assets at end of year2014-08-31$9,507,963
Value of total assets at beginning of year2014-08-31$8,236,336
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-08-31$517,412
Total interest from all sources2014-08-31$131,328
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-08-31No
Administrative expenses professional fees incurred2014-08-31$75,022
Was this plan covered by a fidelity bond2014-08-31Yes
Value of fidelity bond cover2014-08-31$500,000
If this is an individual account plan, was there a blackout period2014-08-31No
Were there any nonexempt tranactions with any party-in-interest2014-08-31No
Contributions received from participants2014-08-31$277,882
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-08-31$27,982
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-08-31$42,561
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-08-31$2,981
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-08-31$1,067
Other income not declared elsewhere2014-08-31$11,815
Administrative expenses (other) incurred2014-08-31$14,975
Liabilities. Value of operating payables at end of year2014-08-31$13,470
Liabilities. Value of operating payables at beginning of year2014-08-31$10,002
Total non interest bearing cash at end of year2014-08-31$6,503
Total non interest bearing cash at beginning of year2014-08-31$16,309
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-08-31No
Value of net income/loss2014-08-31$1,209,345
Value of net assets at end of year (total assets less liabilities)2014-08-31$6,942,212
Value of net assets at beginning of year (total assets less liabilities)2014-08-31$5,732,867
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-08-31No
Were any leases to which the plan was party in default or uncollectible2014-08-31No
Investment advisory and management fees2014-08-31$27,305
Income. Interest from US Government securities2014-08-31$13,609
Income. Interest from corporate debt instruments2014-08-31$117,417
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-08-31$1,012,598
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-08-31$733,705
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-08-31$733,705
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-08-31$302
Expenses. Payments to insurance carriers foe the provision of benefits2014-08-31$7,046,569
Asset value of US Government securities at end of year2014-08-31$1,532,559
Asset value of US Government securities at beginning of year2014-08-31$3,293,022
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-08-31Yes
Was there a failure to transmit to the plan any participant contributions2014-08-31No
Has the plan failed to provide any benefit when due under the plan2014-08-31No
Contributions received in cash from employer2014-08-31$8,742,350
Employer contributions (assets) at end of year2014-08-31$1,009,761
Employer contributions (assets) at beginning of year2014-08-31$984,006
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-08-31$395,654
Asset. Corporate debt instrument debt (other) at end of year2014-08-31$5,911,144
Asset. Corporate debt instrument debt (other) at beginning of year2014-08-31$3,160,926
Contract administrator fees2014-08-31$400,110
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-08-31No
Liabilities. Value of benefit claims payable at end of year2014-08-31$2,549,300
Liabilities. Value of benefit claims payable at beginning of year2014-08-31$2,492,400
Assets. Value of buildings and other operty used in plan operation at end of year2014-08-31$7,416
Assets. Value of buildings and other operty used in plan operation at beginning of year2014-08-31$5,807
Did the plan have assets held for investment2014-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-08-31No
Aggregate proceeds on sale of assets2014-08-31$42,883,711
Aggregate carrying amount (costs) on sale of assets2014-08-31$42,939,549
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-08-31No
Opinion of an independent qualified public accountant for this plan2014-08-31Unqualified
Accountancy firm name2014-08-31BERNARD KOTKIN AND COMPANY, LLP
Accountancy firm EIN2014-08-31952556670
2013 : UNION ROOFERS HEALTH & WELFARE FUND 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-08-31$-119,287
Total unrealized appreciation/depreciation of assets2013-08-31$-119,287
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-08-31$2,503,469
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-08-31$2,678,701
Total income from all sources (including contributions)2013-08-31$7,681,114
Total loss/gain on sale of assets2013-08-31$-3,732
Total of all expenses incurred2013-08-31$7,575,429
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-08-31$7,057,968
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-08-31$7,649,493
Value of total assets at end of year2013-08-31$8,236,336
Value of total assets at beginning of year2013-08-31$8,305,883
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-08-31$517,461
Total interest from all sources2013-08-31$154,640
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-08-31No
Administrative expenses professional fees incurred2013-08-31$67,630
Was this plan covered by a fidelity bond2013-08-31Yes
Value of fidelity bond cover2013-08-31$500,000
If this is an individual account plan, was there a blackout period2013-08-31No
Were there any nonexempt tranactions with any party-in-interest2013-08-31No
Contributions received from participants2013-08-31$332,699
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-08-31$42,561
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-08-31$46,009
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-08-31$1,067
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-08-31$821
Administrative expenses (other) incurred2013-08-31$16,093
Liabilities. Value of operating payables at end of year2013-08-31$10,002
Liabilities. Value of operating payables at beginning of year2013-08-31$4,880
Total non interest bearing cash at end of year2013-08-31$16,309
Total non interest bearing cash at beginning of year2013-08-31$9,093
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-08-31No
Value of net income/loss2013-08-31$105,685
Value of net assets at end of year (total assets less liabilities)2013-08-31$5,732,867
Value of net assets at beginning of year (total assets less liabilities)2013-08-31$5,627,182
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-08-31No
Were any leases to which the plan was party in default or uncollectible2013-08-31No
Investment advisory and management fees2013-08-31$24,428
Income. Interest from US Government securities2013-08-31$32,387
Income. Interest from corporate debt instruments2013-08-31$121,934
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-08-31$733,705
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-08-31$614,354
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-08-31$614,354
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-08-31$319
Expenses. Payments to insurance carriers foe the provision of benefits2013-08-31$6,185,337
Asset value of US Government securities at end of year2013-08-31$3,293,022
Asset value of US Government securities at beginning of year2013-08-31$3,442,751
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-08-31Yes
Was there a failure to transmit to the plan any participant contributions2013-08-31No
Has the plan failed to provide any benefit when due under the plan2013-08-31No
Contributions received in cash from employer2013-08-31$7,316,794
Employer contributions (assets) at end of year2013-08-31$984,006
Employer contributions (assets) at beginning of year2013-08-31$845,415
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-08-31$872,631
Asset. Corporate debt instrument debt (other) at end of year2013-08-31$3,160,926
Asset. Corporate debt instrument debt (other) at beginning of year2013-08-31$3,342,242
Contract administrator fees2013-08-31$409,310
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-08-31No
Liabilities. Value of benefit claims payable at end of year2013-08-31$2,492,400
Liabilities. Value of benefit claims payable at beginning of year2013-08-31$2,673,000
Assets. Value of buildings and other operty used in plan operation at end of year2013-08-31$5,807
Assets. Value of buildings and other operty used in plan operation at beginning of year2013-08-31$6,019
Did the plan have assets held for investment2013-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-08-31No
Aggregate proceeds on sale of assets2013-08-31$12,736,190
Aggregate carrying amount (costs) on sale of assets2013-08-31$12,739,922
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-08-31No
Opinion of an independent qualified public accountant for this plan2013-08-31Unqualified
Accountancy firm name2013-08-31BERNARD KOTKIN AND COMPANY, LLP
Accountancy firm EIN2013-08-31952556670
2012 : UNION ROOFERS HEALTH & WELFARE FUND 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-08-31$117,497
Total unrealized appreciation/depreciation of assets2012-08-31$117,497
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-08-31$2,678,701
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-08-31$2,983,832
Total income from all sources (including contributions)2012-08-31$8,495,010
Total loss/gain on sale of assets2012-08-31$-169,599
Total of all expenses incurred2012-08-31$8,266,596
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-08-31$7,747,541
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-08-31$8,359,158
Value of total assets at end of year2012-08-31$8,305,883
Value of total assets at beginning of year2012-08-31$8,382,600
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-08-31$519,055
Total interest from all sources2012-08-31$187,954
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-08-31No
Administrative expenses professional fees incurred2012-08-31$84,526
Was this plan covered by a fidelity bond2012-08-31Yes
Value of fidelity bond cover2012-08-31$500,000
If this is an individual account plan, was there a blackout period2012-08-31No
Were there any nonexempt tranactions with any party-in-interest2012-08-31No
Contributions received from participants2012-08-31$335,276
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-08-31$46,009
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-08-31$54,408
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-08-31$821
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-08-31$2,648
Administrative expenses (other) incurred2012-08-31$18,086
Liabilities. Value of operating payables at end of year2012-08-31$4,880
Liabilities. Value of operating payables at beginning of year2012-08-31$17,184
Total non interest bearing cash at end of year2012-08-31$9,093
Total non interest bearing cash at beginning of year2012-08-31$35,849
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-08-31No
Value of net income/loss2012-08-31$228,414
Value of net assets at end of year (total assets less liabilities)2012-08-31$5,627,182
Value of net assets at beginning of year (total assets less liabilities)2012-08-31$5,398,768
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-08-31No
Were any leases to which the plan was party in default or uncollectible2012-08-31No
Investment advisory and management fees2012-08-31$25,519
Income. Interest from US Government securities2012-08-31$51,659
Income. Interest from corporate debt instruments2012-08-31$136,099
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-08-31$614,354
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-08-31$746,891
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-08-31$746,891
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-08-31$196
Expenses. Payments to insurance carriers foe the provision of benefits2012-08-31$6,569,215
Asset value of US Government securities at end of year2012-08-31$3,442,751
Asset value of US Government securities at beginning of year2012-08-31$3,329,889
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-08-31Yes
Was there a failure to transmit to the plan any participant contributions2012-08-31No
Has the plan failed to provide any benefit when due under the plan2012-08-31No
Contributions received in cash from employer2012-08-31$8,023,882
Employer contributions (assets) at end of year2012-08-31$845,415
Employer contributions (assets) at beginning of year2012-08-31$863,637
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-08-31$1,178,326
Asset. Corporate debt instrument debt (other) at end of year2012-08-31$3,342,242
Asset. Corporate debt instrument debt (other) at beginning of year2012-08-31$3,345,819
Contract administrator fees2012-08-31$390,924
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-08-31No
Liabilities. Value of benefit claims payable at end of year2012-08-31$2,673,000
Liabilities. Value of benefit claims payable at beginning of year2012-08-31$2,964,000
Assets. Value of buildings and other operty used in plan operation at end of year2012-08-31$6,019
Assets. Value of buildings and other operty used in plan operation at beginning of year2012-08-31$6,107
Did the plan have assets held for investment2012-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-08-31No
Aggregate proceeds on sale of assets2012-08-31$7,078,512
Aggregate carrying amount (costs) on sale of assets2012-08-31$7,248,111
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-08-31No
Opinion of an independent qualified public accountant for this plan2012-08-31Unqualified
Accountancy firm name2012-08-31BERNARD KOTKIN AND COMPANY LLP
Accountancy firm EIN2012-08-31952556670
2011 : UNION ROOFERS HEALTH & WELFARE FUND 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-08-31$-31,749
Total unrealized appreciation/depreciation of assets2011-08-31$-31,749
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-08-31$2,983,832
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-08-31$3,132,393
Total income from all sources (including contributions)2011-08-31$7,970,961
Total loss/gain on sale of assets2011-08-31$33,053
Total of all expenses incurred2011-08-31$8,324,011
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-08-31$7,820,744
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-08-31$7,720,173
Value of total assets at end of year2011-08-31$8,382,600
Value of total assets at beginning of year2011-08-31$8,884,211
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-08-31$503,267
Total interest from all sources2011-08-31$236,837
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-08-31No
Administrative expenses professional fees incurred2011-08-31$75,764
Was this plan covered by a fidelity bond2011-08-31Yes
Value of fidelity bond cover2011-08-31$500,000
If this is an individual account plan, was there a blackout period2011-08-31No
Were there any nonexempt tranactions with any party-in-interest2011-08-31No
Contributions received from participants2011-08-31$359,509
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-08-31$54,408
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-08-31$66,697
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-08-31$2,648
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-08-31$6,655
Other income not declared elsewhere2011-08-31$12,647
Administrative expenses (other) incurred2011-08-31$18,939
Liabilities. Value of operating payables at end of year2011-08-31$17,184
Liabilities. Value of operating payables at beginning of year2011-08-31$7,738
Total non interest bearing cash at end of year2011-08-31$35,849
Total non interest bearing cash at beginning of year2011-08-31$340,404
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-08-31No
Value of net income/loss2011-08-31$-353,050
Value of net assets at end of year (total assets less liabilities)2011-08-31$5,398,768
Value of net assets at beginning of year (total assets less liabilities)2011-08-31$5,751,818
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-08-31No
Were any leases to which the plan was party in default or uncollectible2011-08-31No
Investment advisory and management fees2011-08-31$26,278
Income. Interest from US Government securities2011-08-31$49,221
Income. Interest from corporate debt instruments2011-08-31$184,373
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-08-31$746,891
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-08-31$590,595
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-08-31$590,595
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-08-31$3,243
Expenses. Payments to insurance carriers foe the provision of benefits2011-08-31$6,507,715
Asset value of US Government securities at end of year2011-08-31$3,329,889
Asset value of US Government securities at beginning of year2011-08-31$2,820,356
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-08-31Yes
Was there a failure to transmit to the plan any participant contributions2011-08-31No
Has the plan failed to provide any benefit when due under the plan2011-08-31No
Contributions received in cash from employer2011-08-31$7,360,664
Employer contributions (assets) at end of year2011-08-31$863,637
Employer contributions (assets) at beginning of year2011-08-31$728,006
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-08-31$1,313,029
Asset. Corporate debt instrument debt (other) at end of year2011-08-31$3,345,819
Asset. Corporate debt instrument debt (other) at beginning of year2011-08-31$4,330,578
Contract administrator fees2011-08-31$382,286
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-08-31No
Liabilities. Value of benefit claims payable at end of year2011-08-31$2,964,000
Liabilities. Value of benefit claims payable at beginning of year2011-08-31$3,118,000
Assets. Value of buildings and other operty used in plan operation at end of year2011-08-31$6,107
Assets. Value of buildings and other operty used in plan operation at beginning of year2011-08-31$7,575
Did the plan have assets held for investment2011-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-08-31No
Aggregate proceeds on sale of assets2011-08-31$3,153,109
Aggregate carrying amount (costs) on sale of assets2011-08-31$3,120,056
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-08-31No
Opinion of an independent qualified public accountant for this plan2011-08-31Unqualified
Accountancy firm name2011-08-31BERNARD KOTKIN AND CO LLP
Accountancy firm EIN2011-08-31952556670

Form 5500 Responses for UNION ROOFERS HEALTH & WELFARE FUND

2022: UNION ROOFERS HEALTH & WELFARE FUND 2022 form 5500 responses
2022-09-01Type of plan entityMulti-employer plan
2022-09-01Submission has been amendedNo
2022-09-01This submission is the final filingNo
2022-09-01This return/report is a short plan year return/report (less than 12 months)No
2022-09-01Plan is a collectively bargained planYes
2022-09-01Plan funding arrangement – TrustYes
2022-09-01Plan benefit arrangement – InsuranceYes
2022-09-01Plan benefit arrangement - TrustYes
2021: UNION ROOFERS HEALTH & WELFARE FUND 2021 form 5500 responses
2021-09-01Type of plan entityMulti-employer plan
2021-09-01Submission has been amendedNo
2021-09-01This submission is the final filingNo
2021-09-01This return/report is a short plan year return/report (less than 12 months)No
2021-09-01Plan is a collectively bargained planYes
2021-09-01Plan funding arrangement – TrustYes
2021-09-01Plan benefit arrangement – InsuranceYes
2021-09-01Plan benefit arrangement - TrustYes
2020: UNION ROOFERS HEALTH & WELFARE FUND 2020 form 5500 responses
2020-09-01Type of plan entityMulti-employer plan
2020-09-01Submission has been amendedNo
2020-09-01This submission is the final filingNo
2020-09-01This return/report is a short plan year return/report (less than 12 months)No
2020-09-01Plan is a collectively bargained planYes
2020-09-01Plan funding arrangement – TrustYes
2020-09-01Plan benefit arrangement – InsuranceYes
2020-09-01Plan benefit arrangement - TrustYes
2019: UNION ROOFERS HEALTH & WELFARE FUND 2019 form 5500 responses
2019-09-01Type of plan entityMulti-employer plan
2019-09-01Submission has been amendedYes
2019-09-01Plan is a collectively bargained planYes
2019-09-01Plan funding arrangement – TrustYes
2019-09-01Plan benefit arrangement – InsuranceYes
2019-09-01Plan benefit arrangement - TrustYes
2018: UNION ROOFERS HEALTH & WELFARE FUND 2018 form 5500 responses
2018-09-01Type of plan entityMulti-employer plan
2018-09-01Plan is a collectively bargained planYes
2018-09-01Plan funding arrangement – TrustYes
2018-09-01Plan benefit arrangement – InsuranceYes
2018-09-01Plan benefit arrangement - TrustYes
2017: UNION ROOFERS HEALTH & WELFARE FUND 2017 form 5500 responses
2017-09-01Type of plan entityMulti-employer plan
2017-09-01Plan is a collectively bargained planYes
2017-09-01Plan funding arrangement – TrustYes
2017-09-01Plan benefit arrangement – InsuranceYes
2017-09-01Plan benefit arrangement - TrustYes
2016: UNION ROOFERS HEALTH & WELFARE FUND 2016 form 5500 responses
2016-09-01Type of plan entityMulti-employer plan
2016-09-01Plan is a collectively bargained planYes
2016-09-01Plan funding arrangement – TrustYes
2016-09-01Plan benefit arrangement – InsuranceYes
2016-09-01Plan benefit arrangement - TrustYes
2015: UNION ROOFERS HEALTH & WELFARE FUND 2015 form 5500 responses
2015-09-01Type of plan entityMulti-employer plan
2015-09-01Plan is a collectively bargained planYes
2015-09-01Plan funding arrangement – TrustYes
2015-09-01Plan benefit arrangement – InsuranceYes
2015-09-01Plan benefit arrangement - TrustYes
2014: UNION ROOFERS HEALTH & WELFARE FUND 2014 form 5500 responses
2014-09-01Type of plan entityMulti-employer plan
2014-09-01Plan is a collectively bargained planYes
2014-09-01Plan funding arrangement – TrustYes
2014-09-01Plan benefit arrangement – InsuranceYes
2014-09-01Plan benefit arrangement - TrustYes
2013: UNION ROOFERS HEALTH & WELFARE FUND 2013 form 5500 responses
2013-09-01Type of plan entityMulti-employer plan
2013-09-01Plan is a collectively bargained planYes
2013-09-01Plan funding arrangement – TrustYes
2013-09-01Plan benefit arrangement – InsuranceYes
2013-09-01Plan benefit arrangement - TrustYes
2012: UNION ROOFERS HEALTH & WELFARE FUND 2012 form 5500 responses
2012-09-01Type of plan entityMulti-employer plan
2012-09-01Plan is a collectively bargained planYes
2012-09-01Plan funding arrangement – TrustYes
2012-09-01Plan benefit arrangement – InsuranceYes
2012-09-01Plan benefit arrangement - TrustYes
2011: UNION ROOFERS HEALTH & WELFARE FUND 2011 form 5500 responses
2011-09-01Type of plan entityMulti-employer plan
2011-09-01Plan is a collectively bargained planYes
2011-09-01Plan funding arrangement – TrustYes
2011-09-01Plan benefit arrangement – InsuranceYes
2011-09-01Plan benefit arrangement - TrustYes
2009: UNION ROOFERS HEALTH & WELFARE FUND 2009 form 5500 responses
2009-09-01Type of plan entityMulti-employer plan
2009-09-01This submission is the final filingNo
2009-09-01Plan is a collectively bargained planYes
2009-09-01Plan funding arrangement – TrustYes
2009-09-01Plan benefit arrangement – InsuranceYes
2009-09-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number409901
Policy instance 7
Insurance contract or identification number409901
Number of Individuals Covered981
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedDISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00716000
Policy instance 1
Insurance contract or identification number00716000
Number of Individuals Covered695
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number76855
Policy instance 2
Insurance contract or identification number76855
Number of Individuals Covered105
Insurance policy start date2022-08-01
Insurance policy end date2023-07-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,302,712
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 number19964
Policy instance 3
Insurance contract or identification number19964
Number of Individuals Covered426
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $206,509
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 number76243
Policy instance 4
Insurance contract or identification number76243
Number of Individuals Covered103
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $149,907
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 numberHCL31230
Policy instance 5
Insurance contract or identification numberHCL31230
Number of Individuals Covered1004
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $311,495
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 number107370
Policy instance 6
Insurance contract or identification number107370
Number of Individuals Covered2128
Insurance policy start date2022-08-01
Insurance policy end date2023-07-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $12,068,587
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 number00716000
Policy instance 1
Insurance contract or identification number00716000
Number of Individuals Covered594
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number76855
Policy instance 2
Insurance contract or identification number76855
Number of Individuals Covered89
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,395,565
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 number76243
Policy instance 3
Insurance contract or identification number76243
Number of Individuals Covered453
Insurance policy start date2021-09-01
Insurance policy end date2022-09-01
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $182,665
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 number19964
Policy instance 4
Insurance contract or identification number19964
Number of Individuals Covered111
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $139,158
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 numberHCL31230
Policy instance 5
Insurance contract or identification numberHCL31230
Number of Individuals Covered1004
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $299,258
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 number107370
Policy instance 6
Insurance contract or identification number107370
Number of Individuals Covered758
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $11,355,060
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number409901
Policy instance 7
Insurance contract or identification number409901
Number of Individuals Covered189
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedDISABILITY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $16,484
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 number19964
Policy instance 6
Insurance contract or identification number19964
Number of Individuals Covered464
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $107,073
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 number00716000
Policy instance 1
Insurance contract or identification number00716000
Number of Individuals Covered677
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number76855
Policy instance 2
Insurance contract or identification number76855
Number of Individuals Covered128
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $19,719
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,484,248
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,719
Insurance broker organization code?4
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number76243
Policy instance 3
Insurance contract or identification number76243
Number of Individuals Covered1284
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $230,837
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 number107370
Policy instance 6
Insurance contract or identification number107370
Number of Individuals Covered2402
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $12,712,934
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number409901
Policy instance 7
Insurance contract or identification number409901
Number of Individuals Covered189
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedDISABILITY INSURANCE
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $25,727
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 numberHCL31230
Policy instance 5
Insurance contract or identification numberHCL31230
Number of Individuals Covered1123
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $288,540
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 number76243
Policy instance 4
Insurance contract or identification number69312-0
Number of Individuals Covered556
Insurance policy start date2020-02-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $18,637
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $359,601
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,378
Insurance broker organization code?3
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number76855
Policy instance 3
Insurance contract or identification number76855
Number of Individuals Covered128
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $197,019
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,484,248
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,719
Insurance broker organization code?4
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00716000
Policy instance 2
Insurance contract or identification number00716000
Number of Individuals Covered677
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $79,134
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 number107370
Policy instance 1
Insurance contract or identification number107370
Number of Individuals Covered2402
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $12,780,183
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 number19964
Policy instance 4
Insurance contract or identification number19964
Number of Individuals Covered464
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $107,073
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number409901
Policy instance 1
Insurance contract or identification number409901
Number of Individuals Covered1100
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedDISABILITY INSURANCE
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 number107370
Policy instance 2
Insurance contract or identification number107370
Number of Individuals Covered2326
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $10,563,836
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 number00716000
Policy instance 3
Insurance contract or identification number00716000
Number of Individuals Covered691
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $67,322
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number76855
Policy instance 4
Insurance contract or identification number76855
Number of Individuals Covered118
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $19,365
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,307,680
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,365
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL31230
Policy instance 6
Insurance contract or identification numberHCL31230
Number of Individuals Covered1123
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $315,781
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 number76243
Policy instance 5
Insurance contract or identification number76243
Number of Individuals Covered529
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $241,219
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 number107370
Policy instance 2
Insurance contract or identification number107370
Number of Individuals Covered2536
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $9,339,718
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number409901
Policy instance 1
Insurance contract or identification number409901
Number of Individuals Covered978
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedDISABILITY INSURANCE
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 number00716000
Policy instance 3
Insurance contract or identification number00716000
Number of Individuals Covered586
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $78,309
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number76855
Policy instance 4
Insurance contract or identification number76855
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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 number76243
Policy instance 5
Insurance contract or identification number76243
Insurance policy start date2018-07-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL31230
Policy instance 6
Insurance contract or identification numberHCL31230
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL31230
Policy instance 6
Insurance contract or identification numberHCL31230
Number of Individuals Covered1014
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $272,408
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 number76243
Policy instance 5
Insurance contract or identification number76243
Number of Individuals Covered584
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number107370
Policy instance 4
Insurance contract or identification number107370
Number of Individuals Covered2249
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,579,810
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number409901
Policy instance 2
Insurance contract or identification number409901
Number of Individuals Covered988
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedDISABILITY INSURANCE
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 number00716000
Policy instance 3
Insurance contract or identification number00716000
Number of Individuals Covered673
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number76855
Policy instance 1
Insurance contract or identification number76855
Number of Individuals Covered123
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $18,615
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,786,025
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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