B OF T ROOFERS UNION LOCAL 221 HEALTH & WELFARE TRUST has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan ROOFERS UNION LOCAL 221 HEALTH & WELFARE PLAN
401k plan membership statisitcs for ROOFERS UNION LOCAL 221 HEALTH & WELFARE PLAN
| Measure | Date | Value |
|---|
| 2023 : ROOFERS UNION LOCAL 221 HEALTH & WELFARE PLAN 2023 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2023-06-30 | $230,556 |
| Total unrealized appreciation/depreciation of assets | 2023-06-30 | $230,556 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-06-30 | $1,863,997 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-06-30 | $1,693,250 |
| Total income from all sources (including contributions) | 2023-06-30 | $2,997,452 |
| Total loss/gain on sale of assets | 2023-06-30 | $110,043 |
| Total of all expenses incurred | 2023-06-30 | $2,664,483 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2023-06-30 | $2,422,071 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2023-06-30 | $2,514,344 |
| Value of total assets at end of year | 2023-06-30 | $5,470,981 |
| Value of total assets at beginning of year | 2023-06-30 | $4,967,265 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2023-06-30 | $242,412 |
| Total interest from all sources | 2023-06-30 | $83,527 |
| Total dividends received (eg from common stock, registered investment company shares) | 2023-06-30 | $36,341 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2023-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2023-06-30 | $36,341 |
| Administrative expenses professional fees incurred | 2023-06-30 | $60,333 |
| Was this plan covered by a fidelity bond | 2023-06-30 | Yes |
| Value of fidelity bond cover | 2023-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2023-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2023-06-30 | No |
| Contributions received from participants | 2023-06-30 | $7,756 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2023-06-30 | $97,161 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2023-06-30 | $79,080 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2023-06-30 | $1,845,369 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2023-06-30 | $1,683,018 |
| Other income not declared elsewhere | 2023-06-30 | $37 |
| Administrative expenses (other) incurred | 2023-06-30 | $15,482 |
| Liabilities. Value of operating payables at end of year | 2023-06-30 | $18,610 |
| Liabilities. Value of operating payables at beginning of year | 2023-06-30 | $9,990 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-06-30 | No |
| Value of net income/loss | 2023-06-30 | $332,969 |
| Value of net assets at end of year (total assets less liabilities) | 2023-06-30 | $3,606,984 |
| Value of net assets at beginning of year (total assets less liabilities) | 2023-06-30 | $3,274,015 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2023-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2023-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2023-06-30 | No |
| Investment advisory and management fees | 2023-06-30 | $15,797 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2023-06-30 | $1,654,759 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2023-06-30 | $1,577,815 |
| Income. Interest from corporate debt instruments | 2023-06-30 | $49,364 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2023-06-30 | $897,588 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2023-06-30 | $853,682 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2023-06-30 | $853,682 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2023-06-30 | $34,163 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2023-06-30 | $2,419,290 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2023-06-30 | $22,604 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2023-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2023-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2023-06-30 | No |
| Contributions received in cash from employer | 2023-06-30 | $2,506,588 |
| Employer contributions (assets) at end of year | 2023-06-30 | $239,397 |
| Employer contributions (assets) at beginning of year | 2023-06-30 | $192,087 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2023-06-30 | $2,781 |
| Asset. Corporate debt instrument preferred debt at end of year | 2023-06-30 | $2,582,076 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2023-06-30 | $2,264,601 |
| Contract administrator fees | 2023-06-30 | $150,800 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2023-06-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2023-06-30 | $18 |
| Liabilities. Value of benefit claims payable at beginning of year | 2023-06-30 | $242 |
| Did the plan have assets held for investment | 2023-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2023-06-30 | No |
| Aggregate proceeds on sale of assets | 2023-06-30 | $1,538,123 |
| Aggregate carrying amount (costs) on sale of assets | 2023-06-30 | $1,428,080 |
| Opinion of an independent qualified public accountant for this plan | 2023-06-30 | Unqualified |
| Accountancy firm name | 2023-06-30 | JAMES P HASSELMAN CPA LLC |
| Accountancy firm EIN | 2023-06-30 | 205496781 |
| 2022 : ROOFERS UNION LOCAL 221 HEALTH & WELFARE PLAN 2022 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2022-06-30 | $-249,192 |
| Total unrealized appreciation/depreciation of assets | 2022-06-30 | $-249,192 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-06-30 | $1,693,250 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-06-30 | $1,855,185 |
| Total income from all sources (including contributions) | 2022-06-30 | $1,869,229 |
| Total loss/gain on sale of assets | 2022-06-30 | $23,136 |
| Total of all expenses incurred | 2022-06-30 | $2,559,336 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-06-30 | $2,311,107 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-06-30 | $2,180,924 |
| Value of total assets at end of year | 2022-06-30 | $4,967,265 |
| Value of total assets at beginning of year | 2022-06-30 | $5,819,307 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-06-30 | $248,229 |
| Total interest from all sources | 2022-06-30 | $50,475 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-06-30 | $174,898 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2022-06-30 | $174,898 |
| Administrative expenses professional fees incurred | 2022-06-30 | $63,138 |
| Was this plan covered by a fidelity bond | 2022-06-30 | Yes |
| Value of fidelity bond cover | 2022-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2022-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2022-06-30 | No |
| Contributions received from participants | 2022-06-30 | $18,174 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-06-30 | $79,080 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-06-30 | $84,458 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2022-06-30 | $1,683,018 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2022-06-30 | $1,841,132 |
| Administrative expenses (other) incurred | 2022-06-30 | $20,333 |
| Liabilities. Value of operating payables at end of year | 2022-06-30 | $9,990 |
| Liabilities. Value of operating payables at beginning of year | 2022-06-30 | $13,749 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-06-30 | No |
| Value of net income/loss | 2022-06-30 | $-690,107 |
| Value of net assets at end of year (total assets less liabilities) | 2022-06-30 | $3,274,015 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-06-30 | $3,964,122 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-06-30 | No |
| Investment advisory and management fees | 2022-06-30 | $16,914 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-06-30 | $1,577,815 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-06-30 | $2,170,179 |
| Income. Interest from corporate debt instruments | 2022-06-30 | $49,851 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-06-30 | $853,682 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-06-30 | $249,049 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-06-30 | $249,049 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-06-30 | $624 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-06-30 | $2,308,142 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-06-30 | $-311,012 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2022-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-06-30 | No |
| Contributions received in cash from employer | 2022-06-30 | $2,162,750 |
| Employer contributions (assets) at end of year | 2022-06-30 | $192,087 |
| Employer contributions (assets) at beginning of year | 2022-06-30 | $174,823 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-06-30 | $2,965 |
| Asset. Corporate debt instrument preferred debt at end of year | 2022-06-30 | $2,264,601 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2022-06-30 | $3,140,798 |
| Contract administrator fees | 2022-06-30 | $147,844 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2022-06-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2022-06-30 | $242 |
| Liabilities. Value of benefit claims payable at beginning of year | 2022-06-30 | $304 |
| Did the plan have assets held for investment | 2022-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-06-30 | No |
| Aggregate proceeds on sale of assets | 2022-06-30 | $2,665,141 |
| Aggregate carrying amount (costs) on sale of assets | 2022-06-30 | $2,642,005 |
| Opinion of an independent qualified public accountant for this plan | 2022-06-30 | Unqualified |
| Accountancy firm name | 2022-06-30 | JAMES P HASSELMAN CPA LLC |
| Accountancy firm EIN | 2022-06-30 | 205496781 |
| 2021 : ROOFERS UNION LOCAL 221 HEALTH & WELFARE PLAN 2021 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2021-06-30 | $275,067 |
| Total unrealized appreciation/depreciation of assets | 2021-06-30 | $275,067 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-06-30 | $1,855,185 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-06-30 | $1,900,845 |
| Total income from all sources (including contributions) | 2021-06-30 | $2,571,689 |
| Total loss/gain on sale of assets | 2021-06-30 | $116,909 |
| Total of all expenses incurred | 2021-06-30 | $2,780,686 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-06-30 | $2,528,618 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-06-30 | $1,854,060 |
| Value of total assets at end of year | 2021-06-30 | $5,819,307 |
| Value of total assets at beginning of year | 2021-06-30 | $6,073,964 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-06-30 | $252,068 |
| Total interest from all sources | 2021-06-30 | $59,932 |
| Total dividends received (eg from common stock, registered investment company shares) | 2021-06-30 | $92,598 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2021-06-30 | $92,598 |
| Administrative expenses professional fees incurred | 2021-06-30 | $70,485 |
| Was this plan covered by a fidelity bond | 2021-06-30 | Yes |
| Value of fidelity bond cover | 2021-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2021-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2021-06-30 | No |
| Contributions received from participants | 2021-06-30 | $2,473 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-06-30 | $84,458 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-06-30 | $103,079 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2021-06-30 | $1,841,132 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2021-06-30 | $1,877,777 |
| Administrative expenses (other) incurred | 2021-06-30 | $18,906 |
| Liabilities. Value of operating payables at end of year | 2021-06-30 | $13,749 |
| Liabilities. Value of operating payables at beginning of year | 2021-06-30 | $18,836 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-06-30 | No |
| Value of net income/loss | 2021-06-30 | $-208,997 |
| Value of net assets at end of year (total assets less liabilities) | 2021-06-30 | $3,964,122 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-06-30 | $4,173,119 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-06-30 | No |
| Investment advisory and management fees | 2021-06-30 | $17,732 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-06-30 | $2,170,179 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-06-30 | $2,441,458 |
| Income. Interest from corporate debt instruments | 2021-06-30 | $59,826 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-06-30 | $249,049 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-06-30 | $194,302 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-06-30 | $194,302 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-06-30 | $106 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-06-30 | $2,524,718 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2021-06-30 | $173,123 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2021-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-06-30 | No |
| Contributions received in cash from employer | 2021-06-30 | $1,851,587 |
| Employer contributions (assets) at end of year | 2021-06-30 | $174,823 |
| Employer contributions (assets) at beginning of year | 2021-06-30 | $285,859 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-06-30 | $3,900 |
| Asset. Corporate debt instrument preferred debt at end of year | 2021-06-30 | $3,140,798 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2021-06-30 | $3,049,266 |
| Contract administrator fees | 2021-06-30 | $144,945 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2021-06-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2021-06-30 | $304 |
| Liabilities. Value of benefit claims payable at beginning of year | 2021-06-30 | $4,232 |
| Did the plan have assets held for investment | 2021-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-06-30 | No |
| Aggregate proceeds on sale of assets | 2021-06-30 | $1,845,444 |
| Aggregate carrying amount (costs) on sale of assets | 2021-06-30 | $1,728,535 |
| Opinion of an independent qualified public accountant for this plan | 2021-06-30 | Unqualified |
| Accountancy firm name | 2021-06-30 | JAMES P HASSELMAN CPA LLC |
| Accountancy firm EIN | 2021-06-30 | 205496781 |
| 2020 : ROOFERS UNION LOCAL 221 HEALTH & WELFARE PLAN 2020 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2020-06-30 | $-31,141 |
| Total unrealized appreciation/depreciation of assets | 2020-06-30 | $-31,141 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-06-30 | $1,900,845 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-06-30 | $1,924,229 |
| Total income from all sources (including contributions) | 2020-06-30 | $2,204,815 |
| Total loss/gain on sale of assets | 2020-06-30 | $101,347 |
| Total of all expenses incurred | 2020-06-30 | $2,851,661 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-06-30 | $2,580,170 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-06-30 | $2,003,331 |
| Value of total assets at end of year | 2020-06-30 | $6,073,964 |
| Value of total assets at beginning of year | 2020-06-30 | $6,744,194 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-06-30 | $271,491 |
| Total interest from all sources | 2020-06-30 | $65,094 |
| Total dividends received (eg from common stock, registered investment company shares) | 2020-06-30 | $103,843 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2020-06-30 | $103,843 |
| Administrative expenses professional fees incurred | 2020-06-30 | $70,135 |
| Was this plan covered by a fidelity bond | 2020-06-30 | Yes |
| Value of fidelity bond cover | 2020-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2020-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-06-30 | No |
| Contributions received from participants | 2020-06-30 | $16,878 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-06-30 | $103,079 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-06-30 | $94,730 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2020-06-30 | $1,877,777 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-06-30 | $1,895,800 |
| Administrative expenses (other) incurred | 2020-06-30 | $44,827 |
| Liabilities. Value of operating payables at end of year | 2020-06-30 | $18,836 |
| Liabilities. Value of operating payables at beginning of year | 2020-06-30 | $17,795 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-06-30 | No |
| Value of net income/loss | 2020-06-30 | $-646,846 |
| Value of net assets at end of year (total assets less liabilities) | 2020-06-30 | $4,173,119 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-06-30 | $4,819,965 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-06-30 | No |
| Investment advisory and management fees | 2020-06-30 | $16,008 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-06-30 | $2,441,458 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-06-30 | $2,762,274 |
| Income. Interest from corporate debt instruments | 2020-06-30 | $60,145 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-06-30 | $194,302 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-06-30 | $226,185 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-06-30 | $226,185 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-06-30 | $4,949 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-06-30 | $2,386,771 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2020-06-30 | $-37,659 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2020-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-06-30 | No |
| Contributions received in cash from employer | 2020-06-30 | $1,986,453 |
| Employer contributions (assets) at end of year | 2020-06-30 | $285,859 |
| Employer contributions (assets) at beginning of year | 2020-06-30 | $253,429 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-06-30 | $193,399 |
| Asset. Corporate debt instrument preferred debt at end of year | 2020-06-30 | $3,049,266 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2020-06-30 | $3,407,576 |
| Contract administrator fees | 2020-06-30 | $140,521 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2020-06-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2020-06-30 | $4,232 |
| Liabilities. Value of benefit claims payable at beginning of year | 2020-06-30 | $10,634 |
| Did the plan have assets held for investment | 2020-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-06-30 | No |
| Aggregate proceeds on sale of assets | 2020-06-30 | $2,773,516 |
| Aggregate carrying amount (costs) on sale of assets | 2020-06-30 | $2,672,169 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2020-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2020-06-30 | Unqualified |
| Accountancy firm name | 2020-06-30 | JAMES P HASSELMAN CPA LLC |
| Accountancy firm EIN | 2020-06-30 | 205496781 |
| 2019 : ROOFERS UNION LOCAL 221 HEALTH & WELFARE PLAN 2019 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-06-30 | $111,735 |
| Total unrealized appreciation/depreciation of assets | 2019-06-30 | $111,735 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-06-30 | $1,924,229 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-06-30 | $1,666,279 |
| Total income from all sources (including contributions) | 2019-06-30 | $2,249,289 |
| Total loss/gain on sale of assets | 2019-06-30 | $-3,710 |
| Total of all expenses incurred | 2019-06-30 | $2,924,437 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-06-30 | $2,665,776 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-06-30 | $1,938,728 |
| Value of total assets at end of year | 2019-06-30 | $6,744,194 |
| Value of total assets at beginning of year | 2019-06-30 | $7,161,392 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-06-30 | $258,661 |
| Total interest from all sources | 2019-06-30 | $70,400 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-06-30 | $73,036 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2019-06-30 | $73,036 |
| Administrative expenses professional fees incurred | 2019-06-30 | $59,797 |
| Was this plan covered by a fidelity bond | 2019-06-30 | Yes |
| Value of fidelity bond cover | 2019-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2019-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-06-30 | No |
| Contributions received from participants | 2019-06-30 | $46,043 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-06-30 | $94,730 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-06-30 | $81,121 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2019-06-30 | $1,895,800 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2019-06-30 | $1,644,866 |
| Administrative expenses (other) incurred | 2019-06-30 | $44,917 |
| Liabilities. Value of operating payables at end of year | 2019-06-30 | $17,795 |
| Liabilities. Value of operating payables at beginning of year | 2019-06-30 | $12,895 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-06-30 | No |
| Value of net income/loss | 2019-06-30 | $-675,148 |
| Value of net assets at end of year (total assets less liabilities) | 2019-06-30 | $4,819,965 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-06-30 | $5,495,113 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-06-30 | No |
| Investment advisory and management fees | 2019-06-30 | $18,830 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-06-30 | $2,762,274 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-06-30 | $2,875,201 |
| Income. Interest from corporate debt instruments | 2019-06-30 | $60,853 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-06-30 | $226,185 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-06-30 | $502,463 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-06-30 | $502,463 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-06-30 | $9,547 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-06-30 | $2,538,541 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2019-06-30 | $59,100 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2019-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-06-30 | No |
| Contributions received in cash from employer | 2019-06-30 | $1,892,685 |
| Employer contributions (assets) at end of year | 2019-06-30 | $253,429 |
| Employer contributions (assets) at beginning of year | 2019-06-30 | $228,045 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-06-30 | $127,235 |
| Asset. Corporate debt instrument preferred debt at end of year | 2019-06-30 | $3,407,576 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2019-06-30 | $3,474,562 |
| Contract administrator fees | 2019-06-30 | $135,117 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2019-06-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2019-06-30 | $10,634 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-06-30 | $8,518 |
| Did the plan have assets held for investment | 2019-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-06-30 | No |
| Aggregate proceeds on sale of assets | 2019-06-30 | $1,625,012 |
| Aggregate carrying amount (costs) on sale of assets | 2019-06-30 | $1,628,722 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-06-30 | Unqualified |
| Accountancy firm name | 2019-06-30 | JAMES P HASSELMAN CPA LLC |
| Accountancy firm EIN | 2019-06-30 | 205496781 |
| 2018 : ROOFERS UNION LOCAL 221 HEALTH & WELFARE PLAN 2018 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2018-06-30 | $24,507 |
| Total unrealized appreciation/depreciation of assets | 2018-06-30 | $24,507 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-06-30 | $1,666,279 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-06-30 | $1,675,287 |
| Total income from all sources (including contributions) | 2018-06-30 | $1,933,704 |
| Total loss/gain on sale of assets | 2018-06-30 | $52,844 |
| Total of all expenses incurred | 2018-06-30 | $2,394,180 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-06-30 | $2,149,069 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-06-30 | $1,664,017 |
| Value of total assets at end of year | 2018-06-30 | $7,161,392 |
| Value of total assets at beginning of year | 2018-06-30 | $7,630,876 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-06-30 | $245,111 |
| Total interest from all sources | 2018-06-30 | $114,915 |
| Total dividends received (eg from common stock, registered investment company shares) | 2018-06-30 | $102,732 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2018-06-30 | $102,732 |
| Administrative expenses professional fees incurred | 2018-06-30 | $52,269 |
| Was this plan covered by a fidelity bond | 2018-06-30 | Yes |
| Value of fidelity bond cover | 2018-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2018-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-06-30 | No |
| Contributions received from participants | 2018-06-30 | $31,568 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-06-30 | $81,121 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-06-30 | $98,889 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2018-06-30 | $1,644,866 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2018-06-30 | $1,654,639 |
| Administrative expenses (other) incurred | 2018-06-30 | $42,534 |
| Liabilities. Value of operating payables at end of year | 2018-06-30 | $12,895 |
| Liabilities. Value of operating payables at beginning of year | 2018-06-30 | $9,826 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-06-30 | No |
| Value of net income/loss | 2018-06-30 | $-460,476 |
| Value of net assets at end of year (total assets less liabilities) | 2018-06-30 | $5,495,113 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-06-30 | $5,955,589 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-06-30 | No |
| Investment advisory and management fees | 2018-06-30 | $20,033 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2018-06-30 | $2,875,201 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2018-06-30 | $3,229,039 |
| Income. Interest from corporate debt instruments | 2018-06-30 | $111,714 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-06-30 | $502,463 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-06-30 | $431,974 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-06-30 | $431,974 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-06-30 | $3,201 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-06-30 | $2,044,425 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2018-06-30 | $-25,311 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2018-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-06-30 | No |
| Contributions received in cash from employer | 2018-06-30 | $1,632,449 |
| Employer contributions (assets) at end of year | 2018-06-30 | $228,045 |
| Employer contributions (assets) at beginning of year | 2018-06-30 | $187,301 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-06-30 | $104,644 |
| Asset. Corporate debt instrument preferred debt at end of year | 2018-06-30 | $3,474,562 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2018-06-30 | $3,683,673 |
| Contract administrator fees | 2018-06-30 | $130,275 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2018-06-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2018-06-30 | $8,518 |
| Liabilities. Value of benefit claims payable at beginning of year | 2018-06-30 | $10,822 |
| Did the plan have assets held for investment | 2018-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-06-30 | No |
| Aggregate proceeds on sale of assets | 2018-06-30 | $2,861,462 |
| Aggregate carrying amount (costs) on sale of assets | 2018-06-30 | $2,808,618 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-06-30 | Unqualified |
| Accountancy firm name | 2018-06-30 | JAMES P HASSELMAN CPA LLC |
| Accountancy firm EIN | 2018-06-30 | 205496781 |
| 2017 : ROOFERS UNION LOCAL 221 HEALTH & WELFARE PLAN 2017 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2017-06-30 | $240,473 |
| Total unrealized appreciation/depreciation of assets | 2017-06-30 | $240,473 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-06-30 | $1,675,287 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-06-30 | $1,340,945 |
| Total income from all sources (including contributions) | 2017-06-30 | $2,446,578 |
| Total loss/gain on sale of assets | 2017-06-30 | $59,585 |
| Total of all expenses incurred | 2017-06-30 | $2,513,073 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-06-30 | $2,272,978 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-06-30 | $1,846,264 |
| Value of total assets at end of year | 2017-06-30 | $7,630,876 |
| Value of total assets at beginning of year | 2017-06-30 | $7,363,029 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-06-30 | $240,095 |
| Total interest from all sources | 2017-06-30 | $71,296 |
| Total dividends received (eg from common stock, registered investment company shares) | 2017-06-30 | $124,624 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2017-06-30 | $124,624 |
| Administrative expenses professional fees incurred | 2017-06-30 | $44,095 |
| Was this plan covered by a fidelity bond | 2017-06-30 | Yes |
| Value of fidelity bond cover | 2017-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2017-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-06-30 | No |
| Contributions received from participants | 2017-06-30 | $16,073 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-06-30 | $98,889 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-06-30 | $65,512 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2017-06-30 | $1,654,639 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2017-06-30 | $1,323,802 |
| Administrative expenses (other) incurred | 2017-06-30 | $52,283 |
| Liabilities. Value of operating payables at end of year | 2017-06-30 | $9,826 |
| Liabilities. Value of operating payables at beginning of year | 2017-06-30 | $8,435 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-06-30 | No |
| Value of net income/loss | 2017-06-30 | $-66,495 |
| Value of net assets at end of year (total assets less liabilities) | 2017-06-30 | $5,955,589 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-06-30 | $6,022,084 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-06-30 | No |
| Investment advisory and management fees | 2017-06-30 | $18,882 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2017-06-30 | $3,229,039 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2017-06-30 | $3,450,233 |
| Income. Interest from corporate debt instruments | 2017-06-30 | $70,148 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-06-30 | $431,974 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-06-30 | $283,461 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-06-30 | $283,461 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-06-30 | $1,148 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-06-30 | $2,134,023 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2017-06-30 | $104,336 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2017-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-06-30 | No |
| Contributions received in cash from employer | 2017-06-30 | $1,830,191 |
| Employer contributions (assets) at end of year | 2017-06-30 | $187,301 |
| Employer contributions (assets) at beginning of year | 2017-06-30 | $174,738 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-06-30 | $138,955 |
| Asset. Corporate debt instrument preferred debt at end of year | 2017-06-30 | $3,683,673 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2017-06-30 | $3,389,085 |
| Contract administrator fees | 2017-06-30 | $124,835 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2017-06-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2017-06-30 | $10,822 |
| Liabilities. Value of benefit claims payable at beginning of year | 2017-06-30 | $8,708 |
| Did the plan have assets held for investment | 2017-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-06-30 | No |
| Aggregate proceeds on sale of assets | 2017-06-30 | $1,380,470 |
| Aggregate carrying amount (costs) on sale of assets | 2017-06-30 | $1,320,885 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-06-30 | Unqualified |
| Accountancy firm name | 2017-06-30 | JAMES P HASSELMAN CPA LLC |
| Accountancy firm EIN | 2017-06-30 | 205496781 |
| 2016 : ROOFERS UNION LOCAL 221 HEALTH & WELFARE PLAN 2016 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2016-06-30 | $30,734 |
| Total unrealized appreciation/depreciation of assets | 2016-06-30 | $30,734 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-06-30 | $1,340,945 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-06-30 | $1,024,683 |
| Total income from all sources (including contributions) | 2016-06-30 | $1,924,040 |
| Total loss/gain on sale of assets | 2016-06-30 | $-36,789 |
| Total of all expenses incurred | 2016-06-30 | $2,203,669 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-06-30 | $1,978,854 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-06-30 | $1,756,829 |
| Value of total assets at end of year | 2016-06-30 | $7,363,029 |
| Value of total assets at beginning of year | 2016-06-30 | $7,326,396 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-06-30 | $224,815 |
| Total interest from all sources | 2016-06-30 | $122,185 |
| Total dividends received (eg from common stock, registered investment company shares) | 2016-06-30 | $133,364 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2016-06-30 | $133,364 |
| Administrative expenses professional fees incurred | 2016-06-30 | $44,738 |
| Was this plan covered by a fidelity bond | 2016-06-30 | Yes |
| Value of fidelity bond cover | 2016-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2016-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-06-30 | No |
| Contributions received from participants | 2016-06-30 | $21,930 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-06-30 | $65,512 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-06-30 | $12,260 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2016-06-30 | $1,323,802 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2016-06-30 | $1,009,802 |
| Administrative expenses (other) incurred | 2016-06-30 | $44,079 |
| Liabilities. Value of operating payables at end of year | 2016-06-30 | $8,435 |
| Liabilities. Value of operating payables at beginning of year | 2016-06-30 | $7,551 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-06-30 | No |
| Value of net income/loss | 2016-06-30 | $-279,629 |
| Value of net assets at end of year (total assets less liabilities) | 2016-06-30 | $6,022,084 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-06-30 | $6,301,713 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-06-30 | No |
| Investment advisory and management fees | 2016-06-30 | $15,701 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2016-06-30 | $3,450,233 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2016-06-30 | $3,615,365 |
| Income. Interest from corporate debt instruments | 2016-06-30 | $121,221 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-06-30 | $283,461 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-06-30 | $298,553 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-06-30 | $298,553 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-06-30 | $964 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-06-30 | $1,869,004 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2016-06-30 | $-82,283 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2016-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-06-30 | No |
| Contributions received in cash from employer | 2016-06-30 | $1,734,899 |
| Employer contributions (assets) at end of year | 2016-06-30 | $174,738 |
| Employer contributions (assets) at beginning of year | 2016-06-30 | $155,078 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-06-30 | $109,850 |
| Asset. Corporate debt instrument preferred debt at end of year | 2016-06-30 | $3,389,085 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2016-06-30 | $3,245,140 |
| Contract administrator fees | 2016-06-30 | $120,297 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2016-06-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2016-06-30 | $8,708 |
| Liabilities. Value of benefit claims payable at beginning of year | 2016-06-30 | $7,330 |
| Did the plan have assets held for investment | 2016-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-06-30 | No |
| Aggregate proceeds on sale of assets | 2016-06-30 | $2,950,000 |
| Aggregate carrying amount (costs) on sale of assets | 2016-06-30 | $2,986,789 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-06-30 | Unqualified |
| Accountancy firm name | 2016-06-30 | JAMES P HASSELMAN CPA LLC |
| Accountancy firm EIN | 2016-06-30 | 205496781 |
| 2015 : ROOFERS UNION LOCAL 221 HEALTH & WELFARE PLAN 2015 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2015-06-30 | $40,340 |
| Total unrealized appreciation/depreciation of assets | 2015-06-30 | $40,340 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-06-30 | $1,024,683 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-06-30 | $851,075 |
| Total income from all sources (including contributions) | 2015-06-30 | $1,643,421 |
| Total loss/gain on sale of assets | 2015-06-30 | $-4,780 |
| Total of all expenses incurred | 2015-06-30 | $1,839,561 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-06-30 | $1,628,835 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-06-30 | $1,487,204 |
| Value of total assets at end of year | 2015-06-30 | $7,326,396 |
| Value of total assets at beginning of year | 2015-06-30 | $7,348,928 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-06-30 | $210,726 |
| Total interest from all sources | 2015-06-30 | $116,456 |
| Total dividends received (eg from common stock, registered investment company shares) | 2015-06-30 | $144,287 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2015-06-30 | $144,287 |
| Administrative expenses professional fees incurred | 2015-06-30 | $43,042 |
| Was this plan covered by a fidelity bond | 2015-06-30 | Yes |
| Value of fidelity bond cover | 2015-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2015-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-06-30 | No |
| Contributions received from participants | 2015-06-30 | $25,236 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-06-30 | $12,260 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-06-30 | $12,205 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2015-06-30 | $1,009,802 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2015-06-30 | $833,460 |
| Other income not declared elsewhere | 2015-06-30 | $3,332 |
| Administrative expenses (other) incurred | 2015-06-30 | $44,716 |
| Liabilities. Value of operating payables at end of year | 2015-06-30 | $7,551 |
| Liabilities. Value of operating payables at beginning of year | 2015-06-30 | $9,173 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-06-30 | No |
| Value of net income/loss | 2015-06-30 | $-196,140 |
| Value of net assets at end of year (total assets less liabilities) | 2015-06-30 | $6,301,713 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-06-30 | $6,497,853 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-06-30 | No |
| Investment advisory and management fees | 2015-06-30 | $10,160 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2015-06-30 | $3,615,365 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2015-06-30 | $3,878,830 |
| Income. Interest from corporate debt instruments | 2015-06-30 | $116,303 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-06-30 | $298,553 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-06-30 | $482,107 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-06-30 | $482,107 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-06-30 | $153 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-06-30 | $1,535,280 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2015-06-30 | $-143,418 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2015-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-06-30 | No |
| Contributions received in cash from employer | 2015-06-30 | $1,461,968 |
| Employer contributions (assets) at end of year | 2015-06-30 | $155,078 |
| Employer contributions (assets) at beginning of year | 2015-06-30 | $116,206 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-06-30 | $93,555 |
| Asset. Corporate debt instrument preferred debt at end of year | 2015-06-30 | $3,245,140 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2015-06-30 | $2,859,580 |
| Contract administrator fees | 2015-06-30 | $112,808 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2015-06-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2015-06-30 | $7,330 |
| Liabilities. Value of benefit claims payable at beginning of year | 2015-06-30 | $8,442 |
| Did the plan have assets held for investment | 2015-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-06-30 | No |
| Aggregate proceeds on sale of assets | 2015-06-30 | $2,100,000 |
| Aggregate carrying amount (costs) on sale of assets | 2015-06-30 | $2,104,780 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-06-30 | Unqualified |
| Accountancy firm name | 2015-06-30 | JAMES P HASSELMAN CPA LLC |
| Accountancy firm EIN | 2015-06-30 | 205496781 |
| 2014 : ROOFERS UNION LOCAL 221 HEALTH & WELFARE PLAN 2014 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2014-06-30 | $10,130 |
| Total unrealized appreciation/depreciation of assets | 2014-06-30 | $10,130 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-06-30 | $851,075 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-06-30 | $773,623 |
| Total income from all sources (including contributions) | 2014-06-30 | $1,483,294 |
| Total loss/gain on sale of assets | 2014-06-30 | $-3,921 |
| Total of all expenses incurred | 2014-06-30 | $1,561,295 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-06-30 | $1,366,166 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-06-30 | $1,186,336 |
| Value of total assets at end of year | 2014-06-30 | $7,348,928 |
| Value of total assets at beginning of year | 2014-06-30 | $7,349,477 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-06-30 | $195,129 |
| Total interest from all sources | 2014-06-30 | $81,068 |
| Total dividends received (eg from common stock, registered investment company shares) | 2014-06-30 | $157,651 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2014-06-30 | $157,651 |
| Administrative expenses professional fees incurred | 2014-06-30 | $52,127 |
| Was this plan covered by a fidelity bond | 2014-06-30 | Yes |
| Value of fidelity bond cover | 2014-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2014-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-06-30 | No |
| Contributions received from participants | 2014-06-30 | $44,164 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-06-30 | $12,205 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-06-30 | $35,361 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2014-06-30 | $833,460 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2014-06-30 | $755,813 |
| Administrative expenses (other) incurred | 2014-06-30 | $20,504 |
| Liabilities. Value of operating payables at end of year | 2014-06-30 | $9,173 |
| Liabilities. Value of operating payables at beginning of year | 2014-06-30 | $4,172 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-06-30 | No |
| Value of net income/loss | 2014-06-30 | $-78,001 |
| Value of net assets at end of year (total assets less liabilities) | 2014-06-30 | $6,497,853 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-06-30 | $6,575,854 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-06-30 | No |
| Investment advisory and management fees | 2014-06-30 | $13,691 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2014-06-30 | $3,878,830 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2014-06-30 | $3,553,333 |
| Interest earned on other investments | 2014-06-30 | $11,613 |
| Income. Interest from US Government securities | 2014-06-30 | $5,683 |
| Income. Interest from corporate debt instruments | 2014-06-30 | $62,811 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-06-30 | $482,107 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-06-30 | $2,351,456 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-06-30 | $2,351,456 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-06-30 | $961 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-06-30 | $1,265,942 |
| Asset value of US Government securities at end of year | 2014-06-30 | $0 |
| Asset value of US Government securities at beginning of year | 2014-06-30 | $530,334 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2014-06-30 | $52,030 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2014-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-06-30 | No |
| Contributions received in cash from employer | 2014-06-30 | $1,142,172 |
| Employer contributions (assets) at end of year | 2014-06-30 | $116,206 |
| Employer contributions (assets) at beginning of year | 2014-06-30 | $176,112 |
| Income. Dividends from preferred stock | 2014-06-30 | $0 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-06-30 | $100,224 |
| Asset. Corporate debt instrument preferred debt at end of year | 2014-06-30 | $2,859,580 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2014-06-30 | $702,881 |
| Contract administrator fees | 2014-06-30 | $108,807 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2014-06-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2014-06-30 | $8,442 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-06-30 | $13,638 |
| Did the plan have assets held for investment | 2014-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-06-30 | No |
| Aggregate proceeds on sale of assets | 2014-06-30 | $2,554,606 |
| Aggregate carrying amount (costs) on sale of assets | 2014-06-30 | $2,558,527 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-06-30 | Unqualified |
| Accountancy firm name | 2014-06-30 | JAMES P HASSELMAN CPA LLC |
| Accountancy firm EIN | 2014-06-30 | 205496781 |
| 2013 : ROOFERS UNION LOCAL 221 HEALTH & WELFARE PLAN 2013 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2013-06-30 | $-21,084 |
| Total unrealized appreciation/depreciation of assets | 2013-06-30 | $-21,084 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-06-30 | $773,623 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-06-30 | $1,042,668 |
| Total income from all sources (including contributions) | 2013-06-30 | $1,336,862 |
| Total loss/gain on sale of assets | 2013-06-30 | $4,609 |
| Total of all expenses incurred | 2013-06-30 | $1,329,648 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-06-30 | $1,156,542 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-06-30 | $1,129,975 |
| Value of total assets at end of year | 2013-06-30 | $7,349,477 |
| Value of total assets at beginning of year | 2013-06-30 | $7,611,308 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-06-30 | $173,106 |
| Total interest from all sources | 2013-06-30 | $139,064 |
| Total dividends received (eg from common stock, registered investment company shares) | 2013-06-30 | $125,479 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-06-30 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2013-06-30 | $103,312 |
| Administrative expenses professional fees incurred | 2013-06-30 | $40,628 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2013-06-30 | $0 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2013-06-30 | $496,906 |
| Was this plan covered by a fidelity bond | 2013-06-30 | Yes |
| Value of fidelity bond cover | 2013-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2013-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-06-30 | No |
| Contributions received from participants | 2013-06-30 | $46,787 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-06-30 | $35,361 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-06-30 | $19,526 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2013-06-30 | $755,813 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2013-06-30 | $1,027,316 |
| Administrative expenses (other) incurred | 2013-06-30 | $17,198 |
| Liabilities. Value of operating payables at end of year | 2013-06-30 | $4,172 |
| Liabilities. Value of operating payables at beginning of year | 2013-06-30 | $2,788 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-06-30 | No |
| Value of net income/loss | 2013-06-30 | $7,214 |
| Value of net assets at end of year (total assets less liabilities) | 2013-06-30 | $6,575,854 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-06-30 | $6,568,640 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-06-30 | No |
| Investment advisory and management fees | 2013-06-30 | $9,926 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2013-06-30 | $3,553,333 |
| Interest earned on other investments | 2013-06-30 | $12,800 |
| Income. Interest from US Government securities | 2013-06-30 | $13,948 |
| Income. Interest from corporate debt instruments | 2013-06-30 | $109,967 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-06-30 | $2,351,456 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-06-30 | $3,797,820 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-06-30 | $3,797,820 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-06-30 | $2,349 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-06-30 | $985,169 |
| Asset value of US Government securities at end of year | 2013-06-30 | $530,334 |
| Asset value of US Government securities at beginning of year | 2013-06-30 | $935,655 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2013-06-30 | $-41,181 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2013-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-06-30 | No |
| Contributions received in cash from employer | 2013-06-30 | $1,083,188 |
| Employer contributions (assets) at end of year | 2013-06-30 | $176,112 |
| Employer contributions (assets) at beginning of year | 2013-06-30 | $99,537 |
| Income. Dividends from preferred stock | 2013-06-30 | $22,167 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-06-30 | $171,373 |
| Asset. Corporate debt instrument preferred debt at end of year | 2013-06-30 | $702,881 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2013-06-30 | $2,261,864 |
| Contract administrator fees | 2013-06-30 | $105,354 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2013-06-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2013-06-30 | $13,638 |
| Liabilities. Value of benefit claims payable at beginning of year | 2013-06-30 | $12,564 |
| Did the plan have assets held for investment | 2013-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-06-30 | No |
| Aggregate proceeds on sale of assets | 2013-06-30 | $3,541,687 |
| Aggregate carrying amount (costs) on sale of assets | 2013-06-30 | $3,537,078 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-06-30 | Unqualified |
| Accountancy firm name | 2013-06-30 | JAMES P HASSELMAN CPA LLC |
| Accountancy firm EIN | 2013-06-30 | 205496781 |
| 2012 : ROOFERS UNION LOCAL 221 HEALTH & WELFARE PLAN 2012 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2012-06-30 | $-37,783 |
| Total unrealized appreciation/depreciation of assets | 2012-06-30 | $-37,783 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-06-30 | $1,042,668 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-06-30 | $853,234 |
| Total income from all sources (including contributions) | 2012-06-30 | $1,650,842 |
| Total loss/gain on sale of assets | 2012-06-30 | $-66,204 |
| Total of all expenses incurred | 2012-06-30 | $1,707,265 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-06-30 | $1,525,849 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-06-30 | $1,579,902 |
| Value of total assets at end of year | 2012-06-30 | $7,611,308 |
| Value of total assets at beginning of year | 2012-06-30 | $7,478,297 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-06-30 | $181,416 |
| Total interest from all sources | 2012-06-30 | $163,843 |
| Total dividends received (eg from common stock, registered investment company shares) | 2012-06-30 | $11,082 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-06-30 | No |
| Administrative expenses professional fees incurred | 2012-06-30 | $43,740 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2012-06-30 | $496,906 |
| Was this plan covered by a fidelity bond | 2012-06-30 | Yes |
| Value of fidelity bond cover | 2012-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2012-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-06-30 | No |
| Contributions received from participants | 2012-06-30 | $27,523 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2012-06-30 | $1,989 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-06-30 | $19,526 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-06-30 | $54,067 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2012-06-30 | $1,027,316 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2012-06-30 | $841,695 |
| Other income not declared elsewhere | 2012-06-30 | $2 |
| Administrative expenses (other) incurred | 2012-06-30 | $19,105 |
| Liabilities. Value of operating payables at end of year | 2012-06-30 | $2,788 |
| Liabilities. Value of operating payables at beginning of year | 2012-06-30 | $1,437 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-06-30 | No |
| Value of net income/loss | 2012-06-30 | $-56,423 |
| Value of net assets at end of year (total assets less liabilities) | 2012-06-30 | $6,568,640 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-06-30 | $6,625,063 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-06-30 | No |
| Investment advisory and management fees | 2012-06-30 | $17,244 |
| Interest earned on other investments | 2012-06-30 | $6,924 |
| Income. Interest from US Government securities | 2012-06-30 | $52,103 |
| Income. Interest from corporate debt instruments | 2012-06-30 | $102,145 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-06-30 | $3,797,820 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-06-30 | $1,398,567 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-06-30 | $1,398,567 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-06-30 | $2,671 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-06-30 | $1,366,343 |
| Asset value of US Government securities at end of year | 2012-06-30 | $935,655 |
| Asset value of US Government securities at beginning of year | 2012-06-30 | $2,557,075 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2012-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-06-30 | No |
| Contributions received in cash from employer | 2012-06-30 | $1,550,390 |
| Employer contributions (assets) at end of year | 2012-06-30 | $99,537 |
| Employer contributions (assets) at beginning of year | 2012-06-30 | $101,168 |
| Income. Dividends from preferred stock | 2012-06-30 | $11,082 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-06-30 | $159,506 |
| Asset. Corporate debt instrument preferred debt at end of year | 2012-06-30 | $2,261,864 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2012-06-30 | $3,367,420 |
| Contract administrator fees | 2012-06-30 | $101,327 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2012-06-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2012-06-30 | $12,564 |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-06-30 | $10,102 |
| Did the plan have assets held for investment | 2012-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-06-30 | No |
| Aggregate proceeds on sale of assets | 2012-06-30 | $7,382,793 |
| Aggregate carrying amount (costs) on sale of assets | 2012-06-30 | $7,448,997 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-06-30 | Unqualified |
| Accountancy firm name | 2012-06-30 | JAMES P HASSELMAN CPA LLC |
| Accountancy firm EIN | 2012-06-30 | 205496781 |
| 2011 : ROOFERS UNION LOCAL 221 HEALTH & WELFARE PLAN 2011 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2011-06-30 | $-57,473 |
| Total unrealized appreciation/depreciation of assets | 2011-06-30 | $-57,473 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-06-30 | $853,234 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-06-30 | $762,498 |
| Total income from all sources (including contributions) | 2011-06-30 | $1,477,176 |
| Total loss/gain on sale of assets | 2011-06-30 | $-26,269 |
| Total of all expenses incurred | 2011-06-30 | $1,433,961 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-06-30 | $1,257,250 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-06-30 | $1,380,996 |
| Value of total assets at end of year | 2011-06-30 | $7,478,297 |
| Value of total assets at beginning of year | 2011-06-30 | $7,344,346 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-06-30 | $176,711 |
| Total interest from all sources | 2011-06-30 | $179,912 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-06-30 | No |
| Administrative expenses professional fees incurred | 2011-06-30 | $48,181 |
| Was this plan covered by a fidelity bond | 2011-06-30 | Yes |
| Value of fidelity bond cover | 2011-06-30 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2011-06-30 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-06-30 | No |
| Contributions received from participants | 2011-06-30 | $35,049 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2011-06-30 | $3,540 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-06-30 | $54,067 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-06-30 | $30,591 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2011-06-30 | $841,695 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2011-06-30 | $728,722 |
| Other income not declared elsewhere | 2011-06-30 | $10 |
| Administrative expenses (other) incurred | 2011-06-30 | $18,480 |
| Liabilities. Value of operating payables at end of year | 2011-06-30 | $1,437 |
| Liabilities. Value of operating payables at beginning of year | 2011-06-30 | $2,753 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-06-30 | No |
| Value of net income/loss | 2011-06-30 | $43,215 |
| Value of net assets at end of year (total assets less liabilities) | 2011-06-30 | $6,625,063 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-06-30 | $6,581,848 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-06-30 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-06-30 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-06-30 | No |
| Investment advisory and management fees | 2011-06-30 | $13,414 |
| Interest earned on other investments | 2011-06-30 | $7,579 |
| Income. Interest from US Government securities | 2011-06-30 | $58,719 |
| Income. Interest from corporate debt instruments | 2011-06-30 | $107,873 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-06-30 | $1,398,567 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-06-30 | $4,161,649 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-06-30 | $4,161,649 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-06-30 | $5,741 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-06-30 | $1,128,403 |
| Asset value of US Government securities at end of year | 2011-06-30 | $2,557,075 |
| Asset value of US Government securities at beginning of year | 2011-06-30 | $921,028 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-06-30 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2011-06-30 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-06-30 | No |
| Contributions received in cash from employer | 2011-06-30 | $1,342,407 |
| Employer contributions (assets) at end of year | 2011-06-30 | $101,168 |
| Employer contributions (assets) at beginning of year | 2011-06-30 | $111,176 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-06-30 | $128,847 |
| Asset. Corporate debt instrument preferred debt at end of year | 2011-06-30 | $3,367,420 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2011-06-30 | $2,119,902 |
| Contract administrator fees | 2011-06-30 | $96,636 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2011-06-30 | No |
| Liabilities. Value of benefit claims payable at end of year | 2011-06-30 | $10,102 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-06-30 | $31,023 |
| Did the plan have assets held for investment | 2011-06-30 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-06-30 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-06-30 | No |
| Aggregate proceeds on sale of assets | 2011-06-30 | $4,503,990 |
| Aggregate carrying amount (costs) on sale of assets | 2011-06-30 | $4,530,259 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-06-30 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-06-30 | Unqualified |
| Accountancy firm name | 2011-06-30 | JAMES P HASSELMAN CPA LLC |
| Accountancy firm EIN | 2011-06-30 | 205496781 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | SGM605158 |
| Policy instance | 4 |
| Insurance contract or identification number | SGM605158 | | Number of Individuals Covered | 188 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $3,533 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $21,727 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,533 |
|
| HAWAII MEDICAL ASSURANCE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 48330 ) |
| Policy contract number | 56200 |
| Policy instance | 3 |
| Insurance contract or identification number | 56200 | | Number of Individuals Covered | 312 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $15,330 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $506,118 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,330 |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 145 |
| Policy instance | 2 |
| Insurance contract or identification number | 145 | | Number of Individuals Covered | 181 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $926,987 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 99 |
| Policy instance | 1 |
| Insurance contract or identification number | 99 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $1,426 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,426 | | Insurance broker organization code? | 3 |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 145 |
| Policy instance | 2 |
| Insurance contract or identification number | 145 | | Number of Individuals Covered | 197 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $906,783 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 99 |
| Policy instance | 1 |
| Insurance contract or identification number | 99 | | Number of Individuals Covered | 478 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $1,446 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,446 | | Insurance broker organization code? | 3 |
|
| HAWAII MEDICAL ASSURANCE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 48330 ) |
| Policy contract number | 56200 |
| Policy instance | 3 |
| Insurance contract or identification number | 56200 | | Number of Individuals Covered | 317 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $41,043 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,372,913 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $41,043 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | SGM605158 |
| Policy instance | 4 |
| Insurance contract or identification number | SGM605158 | | Number of Individuals Covered | 199 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $3,025 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $21,994 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,025 |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 145 |
| Policy instance | 2 |
| Insurance contract or identification number | 145 | | Number of Individuals Covered | 187 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $860,677 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 99 |
| Policy instance | 1 |
| Insurance contract or identification number | 99 | | Number of Individuals Covered | 512 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $1,531 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,271 | | Insurance broker organization code? | 3 |
|
| HAWAII MEDICAL ASSURANCE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 48330 ) |
| Policy contract number | 56200 |
| Policy instance | 3 |
| Insurance contract or identification number | 56200 | | Number of Individuals Covered | 343 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $43,923 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,502,457 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $43,923 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | SGM605158 |
| Policy instance | 4 |
| Insurance contract or identification number | SGM605158 | | Number of Individuals Covered | 218 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $730 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $23,649 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $730 |
|
| HAWAII MEDICAL ASSURANCE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 48330 ) |
| Policy contract number | 56200 |
| Policy instance | 4 |
| Insurance contract or identification number | 56200 | | Number of Individuals Covered | 382 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $41,737 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,382,249 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $41,737 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | SGM605158 |
| Policy instance | 5 |
| Insurance contract or identification number | SGM605158 | | Number of Individuals Covered | 221 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $6,234 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $25,459 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,546 |
|
| GENTLE DENTAL (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 0000 |
| Policy instance | 3 |
| Insurance contract or identification number | 0000 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $683 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 145 |
| Policy instance | 2 |
| Insurance contract or identification number | 145 | | Number of Individuals Covered | 177 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $814,117 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 99 |
| Policy instance | 1 |
| Insurance contract or identification number | 99 | | Number of Individuals Covered | 547 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $1,666 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,666 | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | |
| Policy instance | 5 |
| Number of Individuals Covered | 245 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $3,829 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $25,685 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,829 |
|
| HAWAII MEDICAL ASSURANCE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 48330 ) |
| Policy contract number | 56200 |
| Policy instance | 4 |
| Insurance contract or identification number | 56200 | | Number of Individuals Covered | 433 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $37,095 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,269,948 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $37,095 |
|
| GENTLE DENTAL (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 0000 |
| Policy instance | 3 |
| Insurance contract or identification number | 0000 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $866 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 145 |
| Policy instance | 2 |
| Insurance contract or identification number | 145 | | Number of Individuals Covered | 209 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $797,115 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 99 |
| Policy instance | 1 |
| Insurance contract or identification number | 99 | | Number of Individuals Covered | 627 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $1,689 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,689 | | Insurance broker organization code? | 3 |
|
| HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 99 |
| Policy instance | 1 |
| Insurance contract or identification number | 99 | | Number of Individuals Covered | 577 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $1,527 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $829 | | Insurance broker organization code? | 3 | | Insurance broker name | ATLAS INSURANCE AGENCY, INC. |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | |
| Policy instance | 5 |
| Number of Individuals Covered | 221 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $3,193 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $23,368 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,193 | | Insurance broker name | ATLAS INSURANCE AGENCY, INC. |
|
| GENTLE DENTAL (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 0000 |
| Policy instance | 3 |
| Insurance contract or identification number | 0000 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $547 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | NONE |
|
| HAWAII MEDICAL ASSURANCE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 48330 ) |
| Policy contract number | 56200 |
| Policy instance | 4 |
| Insurance contract or identification number | 56200 | | Number of Individuals Covered | 405 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $32,047 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,074,208 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $32,047 | | Insurance broker name | BTP HEALTH LLC |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 145 |
| Policy instance | 2 |
| Insurance contract or identification number | 145 | | Number of Individuals Covered | 174 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $745,121 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | |
| Policy instance | 5 |
| Number of Individuals Covered | 213 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $3,086 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $20,775 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,086 | | Additional information about fees paid to insurance broker | SALES AND SERVICE. | | Insurance broker name | ATLAS INSURANCE AGENCY, INC. |
|
| HAWAII MEDICAL ASSURANCE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 48330 ) |
| Policy contract number | 56200 |
| Policy instance | 4 |
| Insurance contract or identification number | 56200 | | Number of Individuals Covered | 392 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $830,225 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GENTLE DENTAL (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 0000 |
| Policy instance | 3 |
| Insurance contract or identification number | 0000 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,093 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | NONE |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 145 |
| Policy instance | 2 |
| Insurance contract or identification number | 145 | | Number of Individuals Covered | 178 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $579,000 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | NONE |
|
| HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 99 |
| Policy instance | 1 |
| Insurance contract or identification number | 99 | | Number of Individuals Covered | 551 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $1,646 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,646 | | Insurance broker organization code? | 3 | | Insurance broker name | ATLAS INSURANCE AGENCY, INC. |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 032229G |
| Policy instance | 2 |
| Insurance contract or identification number | 032229G | | Number of Individuals Covered | 0 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $1,727 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Insurance broker name | ATLAS INSURANCE AGENCY, INC. |
|
| HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 99 |
| Policy instance | 1 |
| Insurance contract or identification number | 99 | | Number of Individuals Covered | 486 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $1,431 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,431 | | Insurance broker organization code? | 3 | | Insurance broker name | ATLAS INSURANCE AGENCY, INC. |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 145 |
| Policy instance | 3 |
| Insurance contract or identification number | 145 | | Number of Individuals Covered | 160 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $468,650 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | NONE |
|
| HAWAII MEDICAL ASSURANCE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 48330 ) |
| Policy contract number | 56200 |
| Policy instance | 5 |
| Insurance contract or identification number | 56200 | | Number of Individuals Covered | 358 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $9,979 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $722,095 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,979 | | Insurance broker name | BTP HEALTH LLC |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | |
| Policy instance | 6 |
| Number of Individuals Covered | 189 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $2,638 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,638 | | Insurance broker name | ATLAS INSURANCE AGENCY, INC. |
|
| GENTLE DENTAL (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 0000 |
| Policy instance | 4 |
| Insurance contract or identification number | 0000 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,230 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | NONE |
|
| HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) |
| Policy contract number | M333 |
| Policy instance | 5 |
| Insurance contract or identification number | M333 | | Number of Individuals Covered | 124 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $569,438 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GENTLE DENTAL (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 0000 |
| Policy instance | 4 |
| Insurance contract or identification number | 0000 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,232 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | NONE |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 032229G |
| Policy instance | 2 |
| Insurance contract or identification number | 032229G | | Number of Individuals Covered | 195 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $22,016 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | ATLAS INSURANCE AGENCY, INC. |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 145 |
| Policy instance | 3 |
| Insurance contract or identification number | 145 | | Number of Individuals Covered | 143 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $470,569 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | NONE |
|
| HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 99 |
| Policy instance | 1 |
| Insurance contract or identification number | 99 | | Number of Individuals Covered | 468 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $1,249 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,249 | | Insurance broker organization code? | 3 | | Insurance broker name | ATLAS INSURANCE AGENCY, INC. |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 032229G |
| Policy instance | 2 |
| Insurance contract or identification number | 032229G | | Number of Individuals Covered | 154 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $24,104 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 | | Insurance broker name | ATLAS INSURANCE AGENCY, INC. |
|
| HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) |
| Policy contract number | M333 |
| Policy instance | 6 |
| Insurance contract or identification number | M333 | | Number of Individuals Covered | 112 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $571,396 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 ) |
| Policy contract number | 8584 |
| Policy instance | 5 |
| Insurance contract or identification number | 8584 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GENTLE DENTAL (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 0000 |
| Policy instance | 4 |
| Insurance contract or identification number | 0000 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,554 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | NONE |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 145 |
| Policy instance | 3 |
| Insurance contract or identification number | 145 | | Number of Individuals Covered | 140 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $418,352 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker name | NONE |
|
| HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 99 |
| Policy instance | 1 |
| Insurance contract or identification number | 99 | | Number of Individuals Covered | 418 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $1,382 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,382 | | Insurance broker name | ATLAS INSURANCE AGENCY, INC. |
|
| UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 ) |
| Policy contract number | 8584 |
| Policy instance | 5 |
| Insurance contract or identification number | 8584 | | Number of Individuals Covered | 429 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GENTLE DENTAL (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 0000 |
| Policy instance | 4 |
| Insurance contract or identification number | 0000 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,237 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 145 |
| Policy instance | 3 |
| Insurance contract or identification number | 145 | | Number of Individuals Covered | 162 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $410,319 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 032229G |
| Policy instance | 2 |
| Insurance contract or identification number | 032229G | | Number of Individuals Covered | 217 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $34,438 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 99 |
| Policy instance | 1 |
| Insurance contract or identification number | 99 | | Number of Individuals Covered | 553 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $1,433 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 99 |
| Policy instance | 1 |
| Insurance contract or identification number | 99 | | Number of Individuals Covered | 516 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $1,407 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HAWAII MEDICAL SERVICE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 95804 ) |
| Policy contract number | |
| Policy instance | 6 |
| Number of Individuals Covered | 590 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2010-09-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $116,734 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNIVERSITY HEALTH ALLIANCE (National Association of Insurance Commissioners NAIC id number: 47953 ) |
| Policy contract number | 8584 |
| Policy instance | 5 |
| Insurance contract or identification number | 8584 | | Number of Individuals Covered | 398 | | Insurance policy start date | 2010-10-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GENTLE DENTAL (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 0000 |
| Policy instance | 4 |
| Insurance contract or identification number | 0000 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,417 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 145 |
| Policy instance | 3 |
| Insurance contract or identification number | 145 | | Number of Individuals Covered | 168 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $327,914 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 032229G |
| Policy instance | 2 |
| Insurance contract or identification number | 032229G | | Number of Individuals Covered | 206 | | Insurance policy start date | 2010-10-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $441 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $25,335 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
