THE PRUDENTIAL INSURANCE COMPANY OF AMERICA has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan THE PRUDENTIAL WELFARE BENEFITS PLAN
| Measure | Date | Value |
|---|
| 2023 : THE PRUDENTIAL WELFARE BENEFITS PLAN 2023 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2023-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-12-31 | $0 |
| Total income from all sources (including contributions) | 2023-12-31 | $326,237,061 |
| Total loss/gain on sale of assets | 2023-12-31 | $0 |
| Total of all expenses incurred | 2023-12-31 | $330,984,142 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2023-12-31 | $318,808,042 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2023-12-31 | $312,948,416 |
| Value of total assets at end of year | 2023-12-31 | $128,562,167 |
| Value of total assets at beginning of year | 2023-12-31 | $133,309,248 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2023-12-31 | $12,176,100 |
| Total interest from all sources | 2023-12-31 | $1,251,084 |
| Total dividends received (eg from common stock, registered investment company shares) | 2023-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2023-12-31 | No |
| Was this plan covered by a fidelity bond | 2023-12-31 | Yes |
| Value of fidelity bond cover | 2023-12-31 | $100,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2023-12-31 | No |
| Contributions received from participants | 2023-12-31 | $85,215,827 |
| Other income not declared elsewhere | 2023-12-31 | $573,773 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-12-31 | No |
| Value of net income/loss | 2023-12-31 | $-4,747,081 |
| Value of net assets at end of year (total assets less liabilities) | 2023-12-31 | $128,562,167 |
| Value of net assets at beginning of year (total assets less liabilities) | 2023-12-31 | $133,309,248 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2023-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2023-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2023-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2023-12-31 | $46,751,670 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2023-12-31 | $30,118,666 |
| Value of interest in common/collective trusts at end of year | 2023-12-31 | $79,495,145 |
| Value of interest in common/collective trusts at beginning of year | 2023-12-31 | $101,530,354 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2023-12-31 | $1,251,084 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2023-12-31 | $2,315,352 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2023-12-31 | $1,660,228 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2023-12-31 | $61,580,659 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2023-12-31 | $5,458,997 |
| Net investment gain or loss from common/collective trusts | 2023-12-31 | $6,004,791 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2023-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2023-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2023-12-31 | No |
| Contributions received in cash from employer | 2023-12-31 | $227,732,589 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2023-12-31 | $257,227,383 |
| Contract administrator fees | 2023-12-31 | $12,176,100 |
| Did the plan have assets held for investment | 2023-12-31 | 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 | 2023-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2023-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2023-12-31 | Unqualified |
| Accountancy firm name | 2023-12-31 | MITCHELL & TITUS |
| Accountancy firm EIN | 2023-12-31 | 132781641 |
| Total unrealized appreciation/depreciation of assets | 2023-01-01 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-01-01 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-01-01 | $0 |
| Total income from all sources (including contributions) | 2023-01-01 | $326,237,061 |
| Total loss/gain on sale of assets | 2023-01-01 | $0 |
| Total of all expenses incurred | 2023-01-01 | $330,984,142 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2023-01-01 | $318,808,042 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2023-01-01 | $312,948,416 |
| Value of total assets at end of year | 2023-01-01 | $128,562,167 |
| Value of total assets at beginning of year | 2023-01-01 | $133,309,248 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2023-01-01 | $12,176,100 |
| Total interest from all sources | 2023-01-01 | $1,251,084 |
| Total dividends received (eg from common stock, registered investment company shares) | 2023-01-01 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2023-01-01 | No |
| Was this plan covered by a fidelity bond | 2023-01-01 | Yes |
| Value of fidelity bond cover | 2023-01-01 | $100,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2023-01-01 | No |
| Contributions received from participants | 2023-01-01 | $85,215,827 |
| Other income not declared elsewhere | 2023-01-01 | $573,773 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-01-01 | No |
| Value of net income/loss | 2023-01-01 | $-4,747,081 |
| Value of net assets at end of year (total assets less liabilities) | 2023-01-01 | $128,562,167 |
| Value of net assets at beginning of year (total assets less liabilities) | 2023-01-01 | $133,309,248 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2023-01-01 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2023-01-01 | No |
| Were any leases to which the plan was party in default or uncollectible | 2023-01-01 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2023-01-01 | $46,751,670 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2023-01-01 | $30,118,666 |
| Value of interest in common/collective trusts at end of year | 2023-01-01 | $79,495,145 |
| Value of interest in common/collective trusts at beginning of year | 2023-01-01 | $101,530,354 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2023-01-01 | $1,251,084 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2023-01-01 | $2,315,352 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2023-01-01 | $1,660,228 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2023-01-01 | $61,580,659 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2023-01-01 | $5,458,997 |
| Net investment gain or loss from common/collective trusts | 2023-01-01 | $6,004,791 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2023-01-01 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2023-01-01 | No |
| Has the plan failed to provide any benefit when due under the plan | 2023-01-01 | No |
| Contributions received in cash from employer | 2023-01-01 | $227,732,589 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2023-01-01 | $257,227,383 |
| Contract administrator fees | 2023-01-01 | $12,176,100 |
| Did the plan have assets held for investment | 2023-01-01 | 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 | 2023-01-01 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2023-01-01 | No |
| Opinion of an independent qualified public accountant for this plan | 2023-01-01 | 1 |
| Accountancy firm name | 2023-01-01 | MITCHELL & TITUS |
| Accountancy firm EIN | 2023-01-01 | 132781641 |
| 2022 : THE PRUDENTIAL WELFARE BENEFITS PLAN 2022 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2022-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $0 |
| Total income from all sources (including contributions) | 2022-12-31 | $240,691,333 |
| Total loss/gain on sale of assets | 2022-12-31 | $0 |
| Total of all expenses incurred | 2022-12-31 | $295,133,697 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $284,427,931 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-12-31 | $281,902,176 |
| Value of total assets at end of year | 2022-12-31 | $133,309,248 |
| Value of total assets at beginning of year | 2022-12-31 | $187,751,612 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $10,705,766 |
| Total interest from all sources | 2022-12-31 | $229,299 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-12-31 | No |
| Was this plan covered by a fidelity bond | 2022-12-31 | Yes |
| Value of fidelity bond cover | 2022-12-31 | $100,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
| Contributions received from participants | 2022-12-31 | $83,639,697 |
| Other income not declared elsewhere | 2022-12-31 | $435,867 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Value of net income/loss | 2022-12-31 | $-54,442,364 |
| Value of net assets at end of year (total assets less liabilities) | 2022-12-31 | $133,309,248 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-12-31 | $187,751,612 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-12-31 | $30,118,666 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-12-31 | $41,767,743 |
| Value of interest in common/collective trusts at end of year | 2022-12-31 | $101,530,354 |
| Value of interest in common/collective trusts at beginning of year | 2022-12-31 | $144,795,169 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-12-31 | $229,299 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2022-12-31 | $1,660,228 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2022-12-31 | $1,188,700 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-12-31 | $57,041,189 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-12-31 | $-5,911,194 |
| Net investment gain or loss from common/collective trusts | 2022-12-31 | $-35,964,815 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2022-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
| Contributions received in cash from employer | 2022-12-31 | $198,262,479 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-12-31 | $227,386,742 |
| Contract administrator fees | 2022-12-31 | $10,705,766 |
| Did the plan have assets held for investment | 2022-12-31 | 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 | 2022-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
| Accountancy firm name | 2022-12-31 | MITCHELL & TITUS |
| Accountancy firm EIN | 2022-12-31 | 132781641 |
| Total unrealized appreciation/depreciation of assets | 2022-01-01 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-01-01 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-01-01 | $0 |
| Total income from all sources (including contributions) | 2022-01-01 | $240,691,333 |
| Total loss/gain on sale of assets | 2022-01-01 | $0 |
| Total of all expenses incurred | 2022-01-01 | $295,133,697 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-01-01 | $284,427,931 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-01-01 | $281,902,176 |
| Value of total assets at end of year | 2022-01-01 | $133,309,248 |
| Value of total assets at beginning of year | 2022-01-01 | $187,751,612 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-01-01 | $10,705,766 |
| Total interest from all sources | 2022-01-01 | $229,299 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-01-01 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-01-01 | No |
| Was this plan covered by a fidelity bond | 2022-01-01 | Yes |
| Value of fidelity bond cover | 2022-01-01 | $100,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2022-01-01 | No |
| Contributions received from participants | 2022-01-01 | $83,639,697 |
| Other income not declared elsewhere | 2022-01-01 | $435,867 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-01-01 | No |
| Value of net income/loss | 2022-01-01 | $-54,442,364 |
| Value of net assets at end of year (total assets less liabilities) | 2022-01-01 | $133,309,248 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-01-01 | $187,751,612 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-01-01 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-01-01 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-01-01 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-01-01 | $30,118,666 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-01-01 | $41,767,743 |
| Value of interest in common/collective trusts at end of year | 2022-01-01 | $101,530,354 |
| Value of interest in common/collective trusts at beginning of year | 2022-01-01 | $144,795,169 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-01-01 | $229,299 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2022-01-01 | $1,660,228 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2022-01-01 | $1,188,700 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-01-01 | $57,041,189 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-01-01 | $-5,911,194 |
| Net investment gain or loss from common/collective trusts | 2022-01-01 | $-35,964,815 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-01-01 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2022-01-01 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-01-01 | No |
| Contributions received in cash from employer | 2022-01-01 | $198,262,479 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-01-01 | $227,386,742 |
| Contract administrator fees | 2022-01-01 | $10,705,766 |
| Did the plan have assets held for investment | 2022-01-01 | 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 | 2022-01-01 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-01-01 | No |
| Opinion of an independent qualified public accountant for this plan | 2022-01-01 | 1 |
| Accountancy firm name | 2022-01-01 | MITCHELL & TITUS |
| Accountancy firm EIN | 2022-01-01 | 132781641 |
| 2021 : THE PRUDENTIAL WELFARE BENEFITS PLAN 2021 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2021-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $0 |
| Total income from all sources (including contributions) | 2021-12-31 | $269,984,221 |
| Total loss/gain on sale of assets | 2021-12-31 | $0 |
| Total of all expenses incurred | 2021-12-31 | $330,402,975 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $320,739,641 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-12-31 | $269,903,068 |
| Value of total assets at end of year | 2021-12-31 | $187,751,612 |
| Value of total assets at beginning of year | 2021-12-31 | $248,170,366 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $9,663,334 |
| Total interest from all sources | 2021-12-31 | $113,871 |
| Total dividends received (eg from common stock, registered investment company shares) | 2021-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-12-31 | No |
| Was this plan covered by a fidelity bond | 2021-12-31 | Yes |
| Value of fidelity bond cover | 2021-12-31 | $100,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
| Contributions received from participants | 2021-12-31 | $98,485,802 |
| Other income not declared elsewhere | 2021-12-31 | $-2,527,829 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Value of net income/loss | 2021-12-31 | $-60,418,754 |
| Value of net assets at end of year (total assets less liabilities) | 2021-12-31 | $187,751,612 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-12-31 | $248,170,366 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-12-31 | $41,767,743 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-12-31 | $39,211,995 |
| Value of interest in common/collective trusts at end of year | 2021-12-31 | $144,795,169 |
| Value of interest in common/collective trusts at beginning of year | 2021-12-31 | $205,350,090 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-12-31 | $113,871 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2021-12-31 | $1,188,700 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2021-12-31 | $3,608,281 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-12-31 | $54,097,165 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2021-12-31 | $6,270,982 |
| Net investment gain or loss from common/collective trusts | 2021-12-31 | $-3,775,871 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2021-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
| Contributions received in cash from employer | 2021-12-31 | $171,417,266 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-12-31 | $266,642,476 |
| Contract administrator fees | 2021-12-31 | $9,663,334 |
| Did the plan have assets held for investment | 2021-12-31 | 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 | 2021-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
| Accountancy firm name | 2021-12-31 | MITCHELL & TITUS |
| Accountancy firm EIN | 2021-12-31 | 132781641 |
| 2020 : THE PRUDENTIAL WELFARE BENEFITS PLAN 2020 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2020-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $0 |
| Total income from all sources (including contributions) | 2020-12-31 | $324,200,667 |
| Total loss/gain on sale of assets | 2020-12-31 | $0 |
| Total of all expenses incurred | 2020-12-31 | $309,267,974 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $299,048,593 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-12-31 | $297,408,573 |
| Value of total assets at end of year | 2020-12-31 | $248,170,366 |
| Value of total assets at beginning of year | 2020-12-31 | $233,237,673 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $10,219,381 |
| Total interest from all sources | 2020-12-31 | $96,981 |
| Total dividends received (eg from common stock, registered investment company shares) | 2020-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-12-31 | No |
| Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
| Value of fidelity bond cover | 2020-12-31 | $100,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
| Contributions received from participants | 2020-12-31 | $101,108,261 |
| Other income not declared elsewhere | 2020-12-31 | $278,629 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Value of net income/loss | 2020-12-31 | $14,932,693 |
| Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $248,170,366 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $233,237,673 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-12-31 | $39,211,995 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-12-31 | $27,626,309 |
| Value of interest in common/collective trusts at end of year | 2020-12-31 | $205,350,090 |
| Value of interest in common/collective trusts at beginning of year | 2020-12-31 | $202,378,692 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-12-31 | $96,981 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2020-12-31 | $3,608,281 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2020-12-31 | $3,232,672 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-12-31 | $59,501,288 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2020-12-31 | $789,861 |
| Net investment gain or loss from common/collective trusts | 2020-12-31 | $25,626,623 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
| Contributions received in cash from employer | 2020-12-31 | $196,300,312 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-12-31 | $239,547,305 |
| Contract administrator fees | 2020-12-31 | $10,219,381 |
| Did the plan have assets held for investment | 2020-12-31 | 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 | 2020-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Disclaimer |
| Accountancy firm name | 2020-12-31 | MITCHELL & TITUS |
| Accountancy firm EIN | 2020-12-31 | 132781641 |
| 2019 : THE PRUDENTIAL WELFARE BENEFITS PLAN 2019 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2019-12-31 | $0 |
| Total unrealized appreciation/depreciation of assets | 2019-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $0 |
| Total income from all sources (including contributions) | 2019-12-31 | $351,449,215 |
| Total income from all sources (including contributions) | 2019-12-31 | $351,449,215 |
| Total loss/gain on sale of assets | 2019-12-31 | $0 |
| Total loss/gain on sale of assets | 2019-12-31 | $0 |
| Total of all expenses incurred | 2019-12-31 | $330,776,744 |
| Total of all expenses incurred | 2019-12-31 | $330,776,744 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $321,474,124 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $321,474,124 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $320,007,860 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $320,007,860 |
| Value of total assets at end of year | 2019-12-31 | $233,237,673 |
| Value of total assets at end of year | 2019-12-31 | $233,237,673 |
| Value of total assets at beginning of year | 2019-12-31 | $212,565,202 |
| Value of total assets at beginning of year | 2019-12-31 | $212,565,202 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $9,302,620 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $9,302,620 |
| Total interest from all sources | 2019-12-31 | $135,185 |
| Total interest from all sources | 2019-12-31 | $135,185 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-12-31 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
| Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
| Value of fidelity bond cover | 2019-12-31 | $100,000,000 |
| Value of fidelity bond cover | 2019-12-31 | $100,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Contributions received from participants | 2019-12-31 | $102,787,443 |
| Contributions received from participants | 2019-12-31 | $102,787,443 |
| Other income not declared elsewhere | 2019-12-31 | $-1,408,649 |
| Other income not declared elsewhere | 2019-12-31 | $-1,408,649 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Value of net income/loss | 2019-12-31 | $20,672,471 |
| Value of net income/loss | 2019-12-31 | $20,672,471 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $233,237,673 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $233,237,673 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $212,565,202 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $212,565,202 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-12-31 | $27,626,309 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-12-31 | $27,626,309 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-12-31 | $24,761,963 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-12-31 | $24,761,963 |
| Value of interest in common/collective trusts at end of year | 2019-12-31 | $202,378,692 |
| Value of interest in common/collective trusts at end of year | 2019-12-31 | $202,378,692 |
| Value of interest in common/collective trusts at beginning of year | 2019-12-31 | $183,297,102 |
| Value of interest in common/collective trusts at beginning of year | 2019-12-31 | $183,297,102 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-12-31 | $135,185 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-12-31 | $135,185 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2019-12-31 | $3,232,672 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2019-12-31 | $3,232,672 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2019-12-31 | $4,506,137 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2019-12-31 | $4,506,137 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $49,082,348 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $49,082,348 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2019-12-31 | $533,230 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2019-12-31 | $533,230 |
| Net investment gain or loss from common/collective trusts | 2019-12-31 | $32,181,589 |
| Net investment gain or loss from common/collective trusts | 2019-12-31 | $32,181,589 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | Yes |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Contributions received in cash from employer | 2019-12-31 | $217,220,417 |
| Contributions received in cash from employer | 2019-12-31 | $217,220,417 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $272,391,776 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $272,391,776 |
| Contract administrator fees | 2019-12-31 | $9,302,620 |
| Contract administrator fees | 2019-12-31 | $9,302,620 |
| Did the plan have assets held for investment | 2019-12-31 | Yes |
| Did the plan have assets held for investment | 2019-12-31 | 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 | 2019-12-31 | No |
| 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 | 2019-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | Yes |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Disclaimer |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Disclaimer |
| Accountancy firm name | 2019-12-31 | MITCHELL & TITUS |
| Accountancy firm name | 2019-12-31 | MITCHELL & TITUS |
| Accountancy firm EIN | 2019-12-31 | 132781641 |
| Accountancy firm EIN | 2019-12-31 | 132781641 |
| 2018 : THE PRUDENTIAL WELFARE BENEFITS PLAN 2018 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2018-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $0 |
| Total income from all sources (including contributions) | 2018-12-31 | $281,720,786 |
| Total loss/gain on sale of assets | 2018-12-31 | $0 |
| Total of all expenses incurred | 2018-12-31 | $327,338,295 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $318,608,566 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $286,370,123 |
| Value of total assets at end of year | 2018-12-31 | $212,565,202 |
| Value of total assets at beginning of year | 2018-12-31 | $258,182,711 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $8,729,729 |
| Total interest from all sources | 2018-12-31 | $183,010 |
| Total dividends received (eg from common stock, registered investment company shares) | 2018-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-12-31 | No |
| Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
| Value of fidelity bond cover | 2018-12-31 | $100,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
| Contributions received from participants | 2018-12-31 | $99,508,535 |
| Other income not declared elsewhere | 2018-12-31 | $-751,342 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Value of net income/loss | 2018-12-31 | $-45,617,509 |
| Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $212,565,202 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $258,182,711 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2018-12-31 | $24,761,963 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2018-12-31 | $56,741,781 |
| Value of interest in common/collective trusts at end of year | 2018-12-31 | $183,297,102 |
| Value of interest in common/collective trusts at beginning of year | 2018-12-31 | $195,340,594 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-12-31 | $183,010 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2018-12-31 | $4,506,137 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2018-12-31 | $6,100,336 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $47,230,672 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2018-12-31 | $995,321 |
| Net investment gain or loss from common/collective trusts | 2018-12-31 | $-5,076,326 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2018-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
| Contributions received in cash from employer | 2018-12-31 | $186,861,588 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-12-31 | $271,377,894 |
| Contract administrator fees | 2018-12-31 | $8,729,729 |
| Did the plan have assets held for investment | 2018-12-31 | 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 | 2018-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Disclaimer |
| Accountancy firm name | 2018-12-31 | SB AND COMPANY |
| Accountancy firm EIN | 2018-12-31 | 202153727 |
| 2017 : THE PRUDENTIAL WELFARE BENEFITS PLAN 2017 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2017-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $0 |
| Total income from all sources (including contributions) | 2017-12-31 | $322,708,857 |
| Total loss/gain on sale of assets | 2017-12-31 | $0 |
| Total of all expenses incurred | 2017-12-31 | $303,002,524 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $295,162,798 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $296,080,367 |
| Value of total assets at end of year | 2017-12-31 | $258,182,711 |
| Value of total assets at beginning of year | 2017-12-31 | $238,476,378 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $7,839,726 |
| Total interest from all sources | 2017-12-31 | $222,031 |
| Total dividends received (eg from common stock, registered investment company shares) | 2017-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-12-31 | No |
| Was this plan covered by a fidelity bond | 2017-12-31 | Yes |
| Value of fidelity bond cover | 2017-12-31 | $100,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
| Contributions received from participants | 2017-12-31 | $92,977,291 |
| Other income not declared elsewhere | 2017-12-31 | $-1,522,728 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Value of net income/loss | 2017-12-31 | $19,706,333 |
| Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $258,182,711 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $238,476,378 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2017-12-31 | $56,741,781 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2017-12-31 | $47,240,111 |
| Value of interest in common/collective trusts at end of year | 2017-12-31 | $195,340,594 |
| Value of interest in common/collective trusts at beginning of year | 2017-12-31 | $183,835,234 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-12-31 | $222,031 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2017-12-31 | $6,100,336 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2017-12-31 | $7,401,033 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $44,447,336 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2017-12-31 | $495,003 |
| Net investment gain or loss from common/collective trusts | 2017-12-31 | $27,434,184 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2017-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
| Contributions received in cash from employer | 2017-12-31 | $203,103,076 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-12-31 | $250,715,462 |
| Contract administrator fees | 2017-12-31 | $7,839,726 |
| Did the plan have assets held for investment | 2017-12-31 | 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 | 2017-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Disclaimer |
| Accountancy firm name | 2017-12-31 | SB AND COMPANY |
| Accountancy firm EIN | 2017-12-31 | 202153727 |
| 2016 : THE PRUDENTIAL WELFARE BENEFITS PLAN 2016 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2016-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $0 |
| Total income from all sources (including contributions) | 2016-12-31 | $310,556,498 |
| Total loss/gain on sale of assets | 2016-12-31 | $0 |
| Total of all expenses incurred | 2016-12-31 | $310,003,986 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $297,236,856 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $299,591,517 |
| Value of total assets at end of year | 2016-12-31 | $238,476,378 |
| Value of total assets at beginning of year | 2016-12-31 | $237,923,866 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $12,767,130 |
| Total interest from all sources | 2016-12-31 | $1,259,946 |
| Total dividends received (eg from common stock, registered investment company shares) | 2016-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
| Was this plan covered by a fidelity bond | 2016-12-31 | Yes |
| Value of fidelity bond cover | 2016-12-31 | $100,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
| Contributions received from participants | 2016-12-31 | $99,850,043 |
| Other income not declared elsewhere | 2016-12-31 | $-3,107,303 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Value of net income/loss | 2016-12-31 | $552,512 |
| Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $238,476,378 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $237,923,866 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
| Investment advisory and management fees | 2016-12-31 | $0 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2016-12-31 | $47,240,111 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2016-12-31 | $12,061,499 |
| Value of interest in common/collective trusts at end of year | 2016-12-31 | $183,835,234 |
| Value of interest in common/collective trusts at beginning of year | 2016-12-31 | $182,109,812 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-12-31 | $0 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-12-31 | $159,048 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-12-31 | $159,048 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-12-31 | $1,259,946 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2016-12-31 | $7,401,033 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2016-12-31 | $43,593,507 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $50,329,559 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2016-12-31 | $60,743 |
| Net investment gain or loss from common/collective trusts | 2016-12-31 | $12,751,595 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
| Contributions received in cash from employer | 2016-12-31 | $199,741,474 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-12-31 | $246,907,297 |
| Contract administrator fees | 2016-12-31 | $12,767,130 |
| Did the plan have assets held for investment | 2016-12-31 | 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 | 2016-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Disclaimer |
| Accountancy firm name | 2016-12-31 | SB AND COMPANY |
| Accountancy firm EIN | 2016-12-31 | 202153727 |
| 2015 : THE PRUDENTIAL WELFARE BENEFITS PLAN 2015 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 2015-12-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $0 |
| Total income from all sources (including contributions) | 2015-12-31 | $282,346,300 |
| Total loss/gain on sale of assets | 2015-12-31 | $1,600,424 |
| Total of all expenses incurred | 2015-12-31 | $291,820,048 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $278,918,178 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-12-31 | $277,551,570 |
| Value of total assets at end of year | 2015-12-31 | $237,923,866 |
| Value of total assets at beginning of year | 2015-12-31 | $247,397,614 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $12,901,870 |
| Total interest from all sources | 2015-12-31 | $1,281,840 |
| Total dividends received (eg from common stock, registered investment company shares) | 2015-12-31 | $2,754,072 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-12-31 | No |
| Was this plan covered by a fidelity bond | 2015-12-31 | Yes |
| Value of fidelity bond cover | 2015-12-31 | $100,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
| Contributions received from participants | 2015-12-31 | $90,718,035 |
| Other income not declared elsewhere | 2015-12-31 | $-416,351 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Value of net income/loss | 2015-12-31 | $-9,473,748 |
| Value of net assets at end of year (total assets less liabilities) | 2015-12-31 | $237,923,866 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-12-31 | $247,397,614 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
| Investment advisory and management fees | 2015-12-31 | $0 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2015-12-31 | $12,061,499 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2015-12-31 | $8,928,980 |
| Value of interest in common/collective trusts at end of year | 2015-12-31 | $182,109,812 |
| Value of interest in common/collective trusts at beginning of year | 2015-12-31 | $71,287,741 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-12-31 | $159,048 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-12-31 | $192,095 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-12-31 | $192,095 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-12-31 | $1,281,840 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2015-12-31 | $43,593,507 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2015-12-31 | $42,728,018 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-12-31 | $55,047,687 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2015-12-31 | $73,911 |
| Net investment gain or loss from common/collective trusts | 2015-12-31 | $-499,166 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2015-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
| Contributions received in cash from employer | 2015-12-31 | $186,833,535 |
| Income. Dividends from common stock | 2015-12-31 | $2,754,072 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-12-31 | $223,870,491 |
| Contract administrator fees | 2015-12-31 | $12,901,870 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2015-12-31 | $0 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2015-12-31 | $124,260,780 |
| Did the plan have assets held for investment | 2015-12-31 | 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 | 2015-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-12-31 | No |
| Aggregate proceeds on sale of assets | 2015-12-31 | $246,392,916 |
| Aggregate carrying amount (costs) on sale of assets | 2015-12-31 | $244,792,492 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2015-12-31 | Disclaimer |
| Accountancy firm name | 2015-12-31 | SB AND COMPANY |
| Accountancy firm EIN | 2015-12-31 | 202153727 |
| 2014 : THE PRUDENTIAL WELFARE BENEFITS PLAN 2014 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2014-12-31 | $31,172,012 |
| Total unrealized appreciation/depreciation of assets | 2014-12-31 | $31,172,012 |
| Total transfer of assets from this plan | 2014-12-31 | $954,045,556 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $0 |
| Total income from all sources (including contributions) | 2014-12-31 | $329,608,881 |
| Total loss/gain on sale of assets | 2014-12-31 | $3,799,361 |
| Total of all expenses incurred | 2014-12-31 | $279,060,654 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $265,953,424 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-12-31 | $280,669,679 |
| Value of total assets at end of year | 2014-12-31 | $247,397,614 |
| Value of total assets at beginning of year | 2014-12-31 | $1,150,894,943 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $13,107,230 |
| Total interest from all sources | 2014-12-31 | $1,252,500 |
| Total dividends received (eg from common stock, registered investment company shares) | 2014-12-31 | $2,422,359 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-12-31 | No |
| Was this plan covered by a fidelity bond | 2014-12-31 | Yes |
| Value of fidelity bond cover | 2014-12-31 | $100,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
| Contributions received from participants | 2014-12-31 | $96,782,450 |
| Assets. Other investments not covered elsewhere at end of year | 2014-12-31 | $0 |
| Assets. Other investments not covered elsewhere at beginning of year | 2014-12-31 | $698,739,300 |
| Other income not declared elsewhere | 2014-12-31 | $766,215 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Value of net income/loss | 2014-12-31 | $50,548,227 |
| Value of net assets at end of year (total assets less liabilities) | 2014-12-31 | $247,397,614 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-12-31 | $1,150,894,943 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2014-12-31 | $8,928,980 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2014-12-31 | $39,587,400 |
| Value of interest in common/collective trusts at end of year | 2014-12-31 | $71,287,741 |
| Value of interest in common/collective trusts at beginning of year | 2014-12-31 | $260,663,713 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-12-31 | $192,095 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-12-31 | $134,146 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-12-31 | $134,146 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-12-31 | $1,252,500 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2014-12-31 | $42,728,018 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2014-12-31 | $41,750,015 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-12-31 | $47,462,182 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2014-12-31 | $39,804 |
| Net investment gain or loss from common/collective trusts | 2014-12-31 | $9,486,951 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2014-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
| Contributions received in cash from employer | 2014-12-31 | $183,887,229 |
| Income. Dividends from common stock | 2014-12-31 | $2,422,359 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-12-31 | $218,491,242 |
| Contract administrator fees | 2014-12-31 | $13,107,230 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2014-12-31 | $124,260,780 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2014-12-31 | $110,020,369 |
| Did the plan have assets held for investment | 2014-12-31 | 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 | 2014-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-12-31 | No |
| Aggregate proceeds on sale of assets | 2014-12-31 | $109,655,167 |
| Aggregate carrying amount (costs) on sale of assets | 2014-12-31 | $105,855,806 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2014-12-31 | Disclaimer |
| Accountancy firm name | 2014-12-31 | SB AND COMPANY |
| Accountancy firm EIN | 2014-12-31 | 202153727 |
| 2013 : THE PRUDENTIAL WELFARE BENEFITS PLAN 2013 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2013-12-31 | $168,562,566 |
| Total unrealized appreciation/depreciation of assets | 2013-12-31 | $168,562,566 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $0 |
| Total income from all sources (including contributions) | 2013-12-31 | $519,603,588 |
| Total loss/gain on sale of assets | 2013-12-31 | $14,369,824 |
| Total of all expenses incurred | 2013-12-31 | $297,877,666 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $284,523,155 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-12-31 | $284,295,265 |
| Value of total assets at end of year | 2013-12-31 | $1,150,894,943 |
| Value of total assets at beginning of year | 2013-12-31 | $929,169,021 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $13,354,511 |
| Total interest from all sources | 2013-12-31 | $1,843,653 |
| Total dividends received (eg from common stock, registered investment company shares) | 2013-12-31 | $2,548,998 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-12-31 | No |
| Was this plan covered by a fidelity bond | 2013-12-31 | Yes |
| Value of fidelity bond cover | 2013-12-31 | $100,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
| Contributions received from participants | 2013-12-31 | $111,575,063 |
| Assets. Other investments not covered elsewhere at end of year | 2013-12-31 | $698,739,300 |
| Assets. Other investments not covered elsewhere at beginning of year | 2013-12-31 | $546,375,311 |
| Other income not declared elsewhere | 2013-12-31 | $9,931,895 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Value of net income/loss | 2013-12-31 | $221,725,922 |
| Value of net assets at end of year (total assets less liabilities) | 2013-12-31 | $1,150,894,943 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $929,169,021 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2013-12-31 | $39,587,400 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2013-12-31 | $7,315,500 |
| Value of interest in common/collective trusts at end of year | 2013-12-31 | $260,663,713 |
| Value of interest in common/collective trusts at beginning of year | 2013-12-31 | $228,874,721 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-12-31 | $134,146 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-12-31 | $108,065 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-12-31 | $108,065 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2013-12-31 | $1,843,653 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2013-12-31 | $41,750,015 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2013-12-31 | $43,532,037 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-12-31 | $60,192,286 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2013-12-31 | $18,456 |
| Net investment gain or loss from common/collective trusts | 2013-12-31 | $38,032,931 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2013-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
| Contributions received in cash from employer | 2013-12-31 | $172,720,202 |
| Income. Dividends from common stock | 2013-12-31 | $2,548,998 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-12-31 | $224,330,869 |
| Contract administrator fees | 2013-12-31 | $13,354,511 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2013-12-31 | $110,020,369 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2013-12-31 | $102,963,387 |
| Did the plan have assets held for investment | 2013-12-31 | 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 | 2013-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-12-31 | No |
| Aggregate proceeds on sale of assets | 2013-12-31 | $132,248,909 |
| Aggregate carrying amount (costs) on sale of assets | 2013-12-31 | $117,879,085 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2013-12-31 | Disclaimer |
| Accountancy firm name | 2013-12-31 | SB AND COMPANY |
| Accountancy firm EIN | 2013-12-31 | 202153727 |
| 2012 : THE PRUDENTIAL WELFARE BENEFITS PLAN 2012 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2012-12-31 | $69,410,315 |
| Total unrealized appreciation/depreciation of assets | 2012-12-31 | $69,410,315 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $0 |
| Total income from all sources (including contributions) | 2012-12-31 | $409,068,151 |
| Total loss/gain on sale of assets | 2012-12-31 | $7,103,998 |
| Total of all expenses incurred | 2012-12-31 | $334,355,574 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $318,569,793 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $283,887,659 |
| Value of total assets at end of year | 2012-12-31 | $929,169,021 |
| Value of total assets at beginning of year | 2012-12-31 | $854,456,444 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $15,785,781 |
| Total interest from all sources | 2012-12-31 | $1,267,902 |
| Total dividends received (eg from common stock, registered investment company shares) | 2012-12-31 | $2,429,456 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
| Was this plan covered by a fidelity bond | 2012-12-31 | Yes |
| Value of fidelity bond cover | 2012-12-31 | $100,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
| Contributions received from participants | 2012-12-31 | $103,235,304 |
| Assets. Other investments not covered elsewhere at end of year | 2012-12-31 | $546,375,311 |
| Assets. Other investments not covered elsewhere at beginning of year | 2012-12-31 | $484,650,871 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-12-31 | $0 |
| Other income not declared elsewhere | 2012-12-31 | $18,491,440 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Value of net income/loss | 2012-12-31 | $74,712,577 |
| Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $929,169,021 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $854,456,444 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2012-12-31 | $7,315,500 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2012-12-31 | $23,387,865 |
| Value of interest in common/collective trusts at end of year | 2012-12-31 | $228,874,721 |
| Value of interest in common/collective trusts at beginning of year | 2012-12-31 | $208,218,202 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-12-31 | $108,065 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-12-31 | $124,994 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-12-31 | $124,994 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-12-31 | $1,267,902 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2012-12-31 | $43,532,037 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2012-12-31 | $42,263,401 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-12-31 | $57,752,450 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2012-12-31 | $22,905 |
| Net investment gain or loss from common/collective trusts | 2012-12-31 | $26,454,476 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
| Contributions received in cash from employer | 2012-12-31 | $180,652,355 |
| Income. Dividends from common stock | 2012-12-31 | $2,429,456 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $260,817,343 |
| Contract administrator fees | 2012-12-31 | $15,785,781 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2012-12-31 | $102,963,387 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2012-12-31 | $95,811,111 |
| Did the plan have assets held for investment | 2012-12-31 | 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 | 2012-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
| Aggregate proceeds on sale of assets | 2012-12-31 | $101,774,112 |
| Aggregate carrying amount (costs) on sale of assets | 2012-12-31 | $94,670,114 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Disclaimer |
| Accountancy firm name | 2012-12-31 | SB AND COMPANY |
| Accountancy firm EIN | 2012-12-31 | 202153727 |
| 2011 : THE PRUDENTIAL WELFARE BENEFITS PLAN 2011 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2011-12-31 | $-16,985,567 |
| Total unrealized appreciation/depreciation of assets | 2011-12-31 | $-16,985,567 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $0 |
| Total income from all sources (including contributions) | 2011-12-31 | $289,767,255 |
| Total loss/gain on sale of assets | 2011-12-31 | $1,360,097 |
| Total of all expenses incurred | 2011-12-31 | $295,746,307 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $277,921,419 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $289,066,668 |
| Value of total assets at end of year | 2011-12-31 | $854,456,444 |
| Value of total assets at beginning of year | 2011-12-31 | $860,435,496 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $17,824,888 |
| Total interest from all sources | 2011-12-31 | $1,219,030 |
| Total dividends received (eg from common stock, registered investment company shares) | 2011-12-31 | $2,121,673 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
| Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
| Value of fidelity bond cover | 2011-12-31 | $100,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
| Contributions received from participants | 2011-12-31 | $100,903,515 |
| Assets. Other investments not covered elsewhere at end of year | 2011-12-31 | $484,650,871 |
| Assets. Other investments not covered elsewhere at beginning of year | 2011-12-31 | $501,000,733 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2011-12-31 | $14,244,380 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-12-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-12-31 | $0 |
| Other income not declared elsewhere | 2011-12-31 | $5,988,026 |
| Liabilities. Value of operating payables at beginning of year | 2011-12-31 | $0 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Value of net income/loss | 2011-12-31 | $-5,979,052 |
| Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $854,456,444 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $860,435,496 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2011-12-31 | $23,387,865 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2011-12-31 | $8,655,504 |
| Value of interest in common/collective trusts at end of year | 2011-12-31 | $208,218,202 |
| Value of interest in common/collective trusts at beginning of year | 2011-12-31 | $208,680,041 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-12-31 | $124,994 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-12-31 | $110,230 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-12-31 | $110,230 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-12-31 | $1,219,030 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2011-12-31 | $42,263,401 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2011-12-31 | $40,758,895 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-12-31 | $51,607,908 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2011-12-31 | $17,011 |
| Net investment gain or loss from common/collective trusts | 2011-12-31 | $6,980,317 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
| Contributions received in cash from employer | 2011-12-31 | $173,918,773 |
| Income. Dividends from common stock | 2011-12-31 | $2,121,673 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $226,313,511 |
| Contract administrator fees | 2011-12-31 | $17,824,888 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2011-12-31 | $95,811,111 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2011-12-31 | $101,230,093 |
| Did the plan have assets held for investment | 2011-12-31 | 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 | 2011-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
| Aggregate proceeds on sale of assets | 2011-12-31 | $92,428,644 |
| Aggregate carrying amount (costs) on sale of assets | 2011-12-31 | $91,068,547 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Disclaimer |
| Accountancy firm name | 2011-12-31 | BAZILIO COBB ASSOCIATES |
| Accountancy firm EIN | 2011-12-31 | 521563500 |
| 2010 : THE PRUDENTIAL WELFARE BENEFITS PLAN 2010 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2010-12-31 | $61,207,041 |
| Total unrealized appreciation/depreciation of assets | 2010-12-31 | $61,207,041 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $0 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $4,389,506 |
| Total income from all sources (including contributions) | 2010-12-31 | $379,707,347 |
| Total loss/gain on sale of assets | 2010-12-31 | $2,046,626 |
| Total of all expenses incurred | 2010-12-31 | $333,935,698 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $318,390,156 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $271,527,908 |
| Value of total assets at end of year | 2010-12-31 | $860,435,496 |
| Value of total assets at beginning of year | 2010-12-31 | $819,053,353 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $15,545,542 |
| Total interest from all sources | 2010-12-31 | $1,051,193 |
| Total dividends received (eg from common stock, registered investment company shares) | 2010-12-31 | $2,008,782 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
| Was this plan covered by a fidelity bond | 2010-12-31 | Yes |
| Value of fidelity bond cover | 2010-12-31 | $100,000,000 |
| Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
| Contributions received from participants | 2010-12-31 | $90,912,117 |
| Assets. Other investments not covered elsewhere at end of year | 2010-12-31 | $501,000,733 |
| Assets. Other investments not covered elsewhere at beginning of year | 2010-12-31 | $448,741,255 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2010-12-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2010-12-31 | $4,399,395 |
| Other income not declared elsewhere | 2010-12-31 | $18,997,940 |
| Liabilities. Value of operating payables at end of year | 2010-12-31 | $0 |
| Liabilities. Value of operating payables at beginning of year | 2010-12-31 | $4,389,506 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Value of net income/loss | 2010-12-31 | $45,771,649 |
| Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $860,435,496 |
| Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $814,663,847 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2010-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2010-12-31 | $8,655,504 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2010-12-31 | $8,208,706 |
| Value of interest in common/collective trusts at end of year | 2010-12-31 | $208,680,041 |
| Value of interest in common/collective trusts at beginning of year | 2010-12-31 | $225,219,775 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2010-12-31 | $110,230 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2010-12-31 | $168,288 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2010-12-31 | $168,288 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2010-12-31 | $1,051,193 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2010-12-31 | $40,758,895 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2010-12-31 | $35,039,759 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2010-12-31 | $56,037,330 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2010-12-31 | $18,134 |
| Net investment gain or loss from common/collective trusts | 2010-12-31 | $22,849,723 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
| Contributions received in cash from employer | 2010-12-31 | $180,615,791 |
| Income. Dividends from common stock | 2010-12-31 | $2,008,782 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2010-12-31 | $262,352,826 |
| Contract administrator fees | 2010-12-31 | $15,545,542 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2010-12-31 | $101,230,093 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2010-12-31 | $97,276,175 |
| Did the plan have assets held for investment | 2010-12-31 | 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 | 2010-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-12-31 | No |
| Aggregate proceeds on sale of assets | 2010-12-31 | $2,046,627 |
| Aggregate carrying amount (costs) on sale of assets | 2010-12-31 | $1 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Disclaimer |
| Accountancy firm name | 2010-12-31 | THOMPSON COBB BAZILIO & ASSOCIATES |
| Accountancy firm EIN | 2010-12-31 | 521563500 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 234499 |
| Policy instance | 13 |
| Insurance contract or identification number | 234499 | | Number of Individuals Covered | 149 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $2,398,053 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0242444 |
| Policy instance | 14 |
| Insurance contract or identification number | 0242444 | | Number of Individuals Covered | 27650 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $4,091,582 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 7430001 |
| Policy instance | 1 |
| Insurance contract or identification number | 7430001 | | Number of Individuals Covered | 4994 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | LEGAL | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $708,408 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 01690-1 |
| Policy instance | 2 |
| Insurance contract or identification number | 01690-1 | | Number of Individuals Covered | 16784 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | Yes | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 01690-2 |
| Policy instance | 3 |
| Insurance contract or identification number | 01690-2 | | Number of Individuals Covered | 19591 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 01690-3 |
| Policy instance | 4 |
| Insurance contract or identification number | 01690-3 | | Number of Individuals Covered | 16593 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | BUSINESS TRAVEL, CRITICAL ILLNESS, ACC, HI | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $3,195,110 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 01690-4 |
| Policy instance | 5 |
| Insurance contract or identification number | 01690-4 | | Number of Individuals Covered | 17979 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 01690-5 |
| Policy instance | 6 |
| Insurance contract or identification number | 01690-5 | | Number of Individuals Covered | 775 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00620B |
| Policy instance | 7 |
| Insurance contract or identification number | 00620B | | Number of Individuals Covered | 43 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $779,938 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 22216-LTC |
| Policy instance | 8 |
| Insurance contract or identification number | 22216-LTC | | Number of Individuals Covered | 4444 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | LONG TERM CARE | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $9,466,328 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 01690-6 |
| Policy instance | 9 |
| Insurance contract or identification number | 01690-6 | | Number of Individuals Covered | 301 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 01690-7 |
| Policy instance | 10 |
| Insurance contract or identification number | 01690-7 | | Number of Individuals Covered | 5140 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 2461894 |
| Policy instance | 11 |
| Insurance contract or identification number | 2461894 | | Number of Individuals Covered | 7619 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | PREPAID DENTAL | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $2,364,427 | | 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 | 606369 |
| Policy instance | 12 |
| Insurance contract or identification number | 606369 | | Number of Individuals Covered | 129 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,846,327 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-6 |
| Policy instance | 10 |
| Insurance contract or identification number | 0001690-6 | | Number of Individuals Covered | 309 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 22216-LTC |
| Policy instance | 9 |
| Insurance contract or identification number | 22216-LTC | | Number of Individuals Covered | 4592 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | LONG TERM CARE | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $9,158,033 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00620B |
| Policy instance | 8 |
| Insurance contract or identification number | 00620B | | Number of Individuals Covered | 39 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $470,197 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-5 |
| Policy instance | 7 |
| Insurance contract or identification number | 0001690-5 | | Number of Individuals Covered | 811 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-4 |
| Policy instance | 6 |
| Insurance contract or identification number | 0001690-4 | | Number of Individuals Covered | 18379 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-3 |
| Policy instance | 5 |
| Insurance contract or identification number | 0001690-3 | | Number of Individuals Covered | 16329 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | BUSINESS TRAVEL, CRITICAL ILLNESS, ACC, HI | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $3,247,459 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-7 |
| Policy instance | 11 |
| Insurance contract or identification number | 0001690-7 | | Number of Individuals Covered | 5284 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 2461894 |
| Policy instance | 12 |
| Insurance contract or identification number | 2461894 | | Number of Individuals Covered | 7331 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | PREPAID DENTAL | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $2,116,459 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-2 |
| Policy instance | 4 |
| Insurance contract or identification number | 0001690-2 | | Number of Individuals Covered | 20354 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-1 |
| Policy instance | 3 |
| Insurance contract or identification number | 0001690-1 | | Number of Individuals Covered | 16508 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | Yes | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 7430001 |
| Policy instance | 2 |
| Insurance contract or identification number | 7430001 | | Number of Individuals Covered | 3914 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | LEGAL | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $557,593 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | PIC-1,2,3,COB |
| Policy instance | 1 |
| Insurance contract or identification number | PIC-1,2,3,COB | | Number of Individuals Covered | 21151 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $3,114,316 | | 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 | 234499 |
| Policy instance | 15 |
| Insurance contract or identification number | 234499 | | Number of Individuals Covered | 137 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | 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 | 606369 |
| Policy instance | 14 |
| Insurance contract or identification number | 606369 | | Number of Individuals Covered | 121 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $1,920 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 01690-Y |
| Policy instance | 13 |
| Insurance contract or identification number | 01690-Y | | Number of Individuals Covered | 680 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | PAID LEAVE | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $94,400 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 01690-Y |
| Policy instance | 13 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 2461894 |
| Policy instance | 12 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-7 |
| Policy instance | 11 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-6 |
| Policy instance | 10 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 22216-LTC |
| Policy instance | 9 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00620B |
| Policy instance | 8 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 606369 |
| Policy instance | 14 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 234499 |
| Policy instance | 15 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-5 |
| Policy instance | 7 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-4 |
| Policy instance | 6 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-3 |
| Policy instance | 5 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-2 |
| Policy instance | 4 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-1 |
| Policy instance | 3 |
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 7430001 |
| Policy instance | 2 |
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | PIC-1,2,3,COB |
| Policy instance | 1 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-4 |
| Policy instance | 6 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-3 |
| Policy instance | 5 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-2 |
| Policy instance | 4 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-1 |
| Policy instance | 3 |
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 7430001 |
| Policy instance | 2 |
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | PIC-1,2,3,COB |
| Policy instance | 1 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-5 |
| Policy instance | 7 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 22216-LTC |
| Policy instance | 9 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 234499 |
| Policy instance | 15 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 606369 |
| Policy instance | 14 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 01690-Y |
| Policy instance | 13 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 2461894 |
| Policy instance | 12 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-7 |
| Policy instance | 11 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-6 |
| Policy instance | 10 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00620B |
| Policy instance | 8 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-2 |
| Policy instance | 4 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-1 |
| Policy instance | 3 |
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 7430001 |
| Policy instance | 2 |
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | PIC-1,2,3,COB |
| Policy instance | 1 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00620B |
| Policy instance | 8 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-3 |
| Policy instance | 5 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-4 |
| Policy instance | 6 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-5 |
| Policy instance | 7 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 01690-Y |
| Policy instance | 13 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 2461894 |
| Policy instance | 12 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-7 |
| Policy instance | 11 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-6 |
| Policy instance | 10 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 22216-LTC |
| Policy instance | 9 |
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | PIC-1,2,3,COB |
| Policy instance | 1 |
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 7430001 |
| Policy instance | 2 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-1 |
| Policy instance | 3 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-2 |
| Policy instance | 4 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-3 |
| Policy instance | 5 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-4 |
| Policy instance | 6 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-5 |
| Policy instance | 7 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 2461894 |
| Policy instance | 12 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-7 |
| Policy instance | 11 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-6 |
| Policy instance | 10 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 22216-LTC |
| Policy instance | 9 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00620B |
| Policy instance | 8 |
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 7430001 |
| Policy instance | 9 |
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | PIC-1,2,3,COB |
| Policy instance | 8 |
| GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 ) |
| Policy contract number | 101639 |
| Policy instance | 7 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 800256 |
| Policy instance | 6 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95094 ) |
| Policy contract number | 800256 |
| Policy instance | 5 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95003 ) |
| Policy contract number | 800256 |
| Policy instance | 4 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 800256 |
| Policy instance | 3 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 800256 |
| Policy instance | 2 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 800256 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 157 |
| Policy instance | 10 |
| MEDICAL ASSOCIATES HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 52559 ) |
| Policy contract number | 0264340001 |
| Policy instance | 11 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 22216-LTC |
| Policy instance | 20 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00620B |
| Policy instance | 19 |
| TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 ) |
| Policy contract number | 50232 |
| Policy instance | 18 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-5 |
| Policy instance | 17 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-4 |
| Policy instance | 16 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-3 |
| Policy instance | 15 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-2 |
| Policy instance | 14 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-1 |
| Policy instance | 13 |
| MEDICAL ASSOCIATES HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 52559 ) |
| Policy contract number | 0264340003 |
| Policy instance | 12 |
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 7430001 |
| Policy instance | 9 |
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | PIC-1,2,3,COB |
| Policy instance | 8 |
| GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 ) |
| Policy contract number | 101639 |
| Policy instance | 7 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 800256 |
| Policy instance | 6 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95094 ) |
| Policy contract number | 800256 |
| Policy instance | 5 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95003 ) |
| Policy contract number | 800256 |
| Policy instance | 4 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 800256 |
| Policy instance | 3 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 800256 |
| Policy instance | 2 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 800256 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 157 |
| Policy instance | 10 |
| MEDICAL ASSOCIATES HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 52559 ) |
| Policy contract number | 0264340001 |
| Policy instance | 11 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 22216-LTC |
| Policy instance | 20 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00620B |
| Policy instance | 19 |
| TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 ) |
| Policy contract number | 50232 |
| Policy instance | 18 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-5 |
| Policy instance | 17 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-4 |
| Policy instance | 16 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-3 |
| Policy instance | 15 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-2 |
| Policy instance | 14 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 0001690-1 |
| Policy instance | 13 |
| MEDICAL ASSOCIATES HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 52559 ) |
| Policy contract number | 0264340003 |
| Policy instance | 12 |
| UNITEDHEALTHCARE OF ALABAMA, INC. (National Association of Insurance Commissioners NAIC id number: 95784 ) |
| Policy contract number | 02271 |
| Policy instance | 73 |
| UNITEDHEALTHCARE OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 95617 ) |
| Policy contract number | 060486 |
| Policy instance | 74 |
| UNITEDHEALTHCARE OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95434 ) |
| Policy contract number | 092167 |
| Policy instance | 75 |
| UNITEDHEALTHCARE OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95434 ) |
| Policy contract number | 092168 |
| Policy instance | 76 |
| UNITED HEALTHCARE OF OHIO (National Association of Insurance Commissioners NAIC id number: 95186 ) |
| Policy contract number | 10248 |
| Policy instance | 77 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7158 |
| Policy instance | 44 |
| UNITED HEALTHCARE OF OHIO (National Association of Insurance Commissioners NAIC id number: 95186 ) |
| Policy contract number | 10460 |
| Policy instance | 78 |
| UNITED HEALTHCARE OF OHIO (National Association of Insurance Commissioners NAIC id number: 95186 ) |
| Policy contract number | 10967 |
| Policy instance | 79 |
| UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 0 ) |
| Policy contract number | 149753 |
| Policy instance | 81 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 12352 |
| Policy instance | 72 |
| UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 ) |
| Policy contract number | 018403 |
| Policy instance | 71 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 1690-0000003 |
| Policy instance | 62 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 1690-0000004 |
| Policy instance | 63 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 1690-0000005 |
| Policy instance | 64 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | G-22310 |
| Policy instance | 66 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | G-21615 |
| Policy instance | 65 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 22216-LTC |
| Policy instance | 67 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 99700000 |
| Policy instance | 68 |
| TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 ) |
| Policy contract number | 50232 |
| Policy instance | 69 |
| TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 ) |
| Policy contract number | 1432 |
| Policy instance | 70 |
| UNITEDHEALTHCARE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 60093 ) |
| Policy contract number | 14100 |
| Policy instance | 80 |
| UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 0 ) |
| Policy contract number | 149758 |
| Policy instance | 82 |
| UNITED HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 95378 ) |
| Policy contract number | 17032 |
| Policy instance | 83 |
| UNITED HEALTHCARE OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95264 ) |
| Policy contract number | 82009 |
| Policy instance | 95 |
| UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 ) |
| Policy contract number | 018404 |
| Policy instance | 96 |
| UNITED HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 95378 ) |
| Policy contract number | 17233 |
| Policy instance | 97 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 40014 |
| Policy instance | 99 |
| UNITEDHEALTHCARE OF GEORGIA, INC. (National Association of Insurance Commissioners NAIC id number: 95850 ) |
| Policy contract number | 06054 |
| Policy instance | 98 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 40530 |
| Policy instance | 100 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 66045 |
| Policy instance | 101 |
| UNITED HEALTHCARE OF THE MIDWEST (National Association of Insurance Commissioners NAIC id number: 96385 ) |
| Policy contract number | 55761 |
| Policy instance | 102 |
| UNITEDHEALTHCARE OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 48038 ) |
| Policy contract number | 804249 |
| Policy instance | 93 |
| UNITED HEALTHCARE OF OKLAHOMA (National Association of Insurance Commissioners NAIC id number: 96903 ) |
| Policy contract number | 808299 |
| Policy instance | 94 |
| UNITEDHEALTHCARE OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 95103 ) |
| Policy contract number | 71516 |
| Policy instance | 91 |
| UNITED HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 95378 ) |
| Policy contract number | 17409 |
| Policy instance | 84 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 27021 |
| Policy instance | 85 |
| UNITEDHEALTHCARE OF GEORGIA, INC. (National Association of Insurance Commissioners NAIC id number: 95850 ) |
| Policy contract number | 50273 |
| Policy instance | 86 |
| UNITED HEALTHCARE OF THE MIDWEST (National Association of Insurance Commissioners NAIC id number: 96385 ) |
| Policy contract number | 55759 |
| Policy instance | 87 |
| UNITED HEALTHCARE OF THE MIDWEST (National Association of Insurance Commissioners NAIC id number: 96385 ) |
| Policy contract number | 55760 |
| Policy instance | 88 |
| UNITEDHEALTHCARE OF NEVADA (National Association of Insurance Commissioners NAIC id number: 95685 ) |
| Policy contract number | 667192 |
| Policy instance | 89 |
| UNITED HEALTHCARE OF WISCONSIN, INC. (MEDICARE COMPLETE) (National Association of Insurance Commissioners NAIC id number: 95710 ) |
| Policy contract number | 70069 |
| Policy instance | 90 |
| EVERCARE OF TEXAS, LLC (National Association of Insurance Commissioners NAIC id number: 11141 ) |
| Policy contract number | 79014 |
| Policy instance | 92 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00620B |
| Policy instance | 103 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 1690-0000002 |
| Policy instance | 61 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 800256 |
| Policy instance | 1 |
| AETNA US HEALTHCARE - MA (National Association of Insurance Commissioners NAIC id number: 95236 ) |
| Policy contract number | US354317 |
| Policy instance | 16 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95517 ) |
| Policy contract number | US354317 |
| Policy instance | 18 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65756 ) |
| Policy contract number | US354317 |
| Policy instance | 19 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95810 ) |
| Policy contract number | US354317 |
| Policy instance | 20 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95343 ) |
| Policy contract number | US354317 |
| Policy instance | 21 |
| AETNA HEALTH INC. (National Association of Insurance Commissioners NAIC id number: 95237 ) |
| Policy contract number | US354317 |
| Policy instance | 22 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95287 ) |
| Policy contract number | US354317 |
| Policy instance | 23 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95490 ) |
| Policy contract number | US354317 |
| Policy instance | 24 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 92534 ) |
| Policy contract number | US354317 |
| Policy instance | 25 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 96518 ) |
| Policy contract number | US354317 |
| Policy instance | 26 |
| AETNA HEALTH INC (National Association of Insurance Commissioners NAIC id number: 95757 ) |
| Policy contract number | US354317 |
| Policy instance | 27 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 ) |
| Policy contract number | US354317 |
| Policy instance | 28 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95094 ) |
| Policy contract number | US354317 |
| Policy instance | 17 |
| AETNA HEALTH INC. (National Association of Insurance Commissioners NAIC id number: 95002 ) |
| Policy contract number | US354317 |
| Policy instance | 15 |
| AETNA HEALTH INC (National Association of Insurance Commissioners NAIC id number: 95397 ) |
| Policy contract number | US354317 |
| Policy instance | 14 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 800256 |
| Policy instance | 2 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 800256 |
| Policy instance | 3 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95003 ) |
| Policy contract number | 800256 |
| Policy instance | 4 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95094 ) |
| Policy contract number | 800256 |
| Policy instance | 5 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 800256 |
| Policy instance | 6 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95003 ) |
| Policy contract number | US354317 |
| Policy instance | 7 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | US354317 |
| Policy instance | 8 |
| AETNA HEALTH, INC (National Association of Insurance Commissioners NAIC id number: 95935 ) |
| Policy contract number | US354317 |
| Policy instance | 10 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95256 ) |
| Policy contract number | US354317 |
| Policy instance | 9 |
| AETNA HEALTH INC (National Association of Insurance Commissioners NAIC id number: 95245 ) |
| Policy contract number | US354317 |
| Policy instance | 11 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95094 ) |
| Policy contract number | US354317 |
| Policy instance | 13 |
| AETNA HEALTH INC (National Association of Insurance Commissioners NAIC id number: 95088 ) |
| Policy contract number | US354317 |
| Policy instance | 12 |
| AETNA HEALTH INC. (National Association of Insurance Commissioners NAIC id number: 95006 ) |
| Policy contract number | US354317 |
| Policy instance | 29 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95490 ) |
| Policy contract number | US354317 |
| Policy instance | 30 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 1690-0000001 |
| Policy instance | 60 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | Q0818 |
| Policy instance | 48 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | R3058 |
| Policy instance | 49 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | R3063 |
| Policy instance | 50 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | R3064 |
| Policy instance | 51 |
| HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
| Policy contract number | R3080 |
| Policy instance | 52 |
| HUMANA ADVANTAGE CARE PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 10126 ) |
| Policy contract number | R3180 |
| Policy instance | 53 |
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 7430001 |
| Policy instance | 54 |
| MEDICAL ASSOCIATES HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 52559 ) |
| Policy contract number | 0264340001 |
| Policy instance | 56 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 157 |
| Policy instance | 55 |
| MEDICAL ASSOCIATES HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 52559 ) |
| Policy contract number | 0264340003 |
| Policy instance | 57 |
| MEDICAL ASSOCIATES HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 52559 ) |
| Policy contract number | 0264340004 |
| Policy instance | 58 |
| MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
| Policy contract number | 706529 |
| Policy instance | 59 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7171 |
| Policy instance | 47 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7170 |
| Policy instance | 46 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7168 |
| Policy instance | 45 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 47060 ) |
| Policy contract number | US354317 |
| Policy instance | 31 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95484 ) |
| Policy contract number | US354317 |
| Policy instance | 32 |
| CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
| Policy contract number | 00620B |
| Policy instance | 33 |
| GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 ) |
| Policy contract number | 101639 |
| Policy instance | 34 |
| HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 52628 ) |
| Policy contract number | 0684 |
| Policy instance | 35 |
| HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
| Policy contract number | P7090 |
| Policy instance | 37 |
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | PIC-ALL |
| Policy instance | 36 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7105 |
| Policy instance | 38 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7155 |
| Policy instance | 43 |
| HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
| Policy contract number | P7152 |
| Policy instance | 42 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7151 |
| Policy instance | 41 |
| HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
| Policy contract number | P7113 |
| Policy instance | 39 |
| HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
| Policy contract number | P7143 |
| Policy instance | 40 |
| HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
| Policy contract number | R3080 |
| Policy instance | 54 |
| HUMANA ADVANTAGE CARE PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 10126 ) |
| Policy contract number | R3180 |
| Policy instance | 55 |
| HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 7430001 |
| Policy instance | 56 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 157 |
| Policy instance | 57 |
| MEDICA (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 70832 |
| Policy instance | 58 |
| MEDICAL ASSOCIATES HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 52559 ) |
| Policy contract number | 0264340001 |
| Policy instance | 59 |
| MEDICAL ASSOCIATES HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 52559 ) |
| Policy contract number | 0264340003 |
| Policy instance | 60 |
| MEDICAL ASSOCIATES HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 52559 ) |
| Policy contract number | 0264340004 |
| Policy instance | 61 |
| HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
| Policy contract number | R3070 |
| Policy instance | 53 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | R3064 |
| Policy instance | 52 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | R3058 |
| Policy instance | 50 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7151 |
| Policy instance | 42 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7155 |
| Policy instance | 44 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7168 |
| Policy instance | 46 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7158 |
| Policy instance | 45 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7170 |
| Policy instance | 47 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7171 |
| Policy instance | 48 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | Q0818 |
| Policy instance | 49 |
| Insurance contract or identification number | 30029876 | | Number of Individuals Covered | 269 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $2,399 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $51,895 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | R3063 |
| Policy instance | 51 |
| MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
| Policy contract number | 706529 |
| Policy instance | 62 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 1690-0000001 |
| Policy instance | 63 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 1690-0000003 |
| Policy instance | 65 |
| UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 ) |
| Policy contract number | 018403 |
| Policy instance | 75 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 18500 |
| Policy instance | 76 |
| UNITEDHEALTHCARE OF ALABAMA, INC. (National Association of Insurance Commissioners NAIC id number: 95784 ) |
| Policy contract number | 02271 |
| Policy instance | 77 |
| UNITEDHEALTHCARE OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 95617 ) |
| Policy contract number | 060486 |
| Policy instance | 78 |
| UNITEDHEALTHCARE OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95434 ) |
| Policy contract number | 092167 |
| Policy instance | 79 |
| UNITEDHEALTHCARE OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95434 ) |
| Policy contract number | 092168 |
| Policy instance | 80 |
| UNITED HEALTHCARE OF OHIO (National Association of Insurance Commissioners NAIC id number: 95186 ) |
| Policy contract number | 10248 |
| Policy instance | 81 |
| UNITED HEALTHCARE OF OHIO (National Association of Insurance Commissioners NAIC id number: 95186 ) |
| Policy contract number | 10460 |
| Policy instance | 82 |
| TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 ) |
| Policy contract number | 60219900 |
| Policy instance | 74 |
| TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 ) |
| Policy contract number | 60219000 |
| Policy instance | 73 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 1690-0000002 |
| Policy instance | 64 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 1690-0000004 |
| Policy instance | 66 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 1690-0000005 |
| Policy instance | 67 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | G-21615 |
| Policy instance | 68 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | G-22310 |
| Policy instance | 69 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 22216-LTC |
| Policy instance | 70 |
| TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 ) |
| Policy contract number | 1432 |
| Policy instance | 72 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 99700000 |
| Policy instance | 71 |
| UNITED HEALTHCARE OF OHIO (National Association of Insurance Commissioners NAIC id number: 95186 ) |
| Policy contract number | 10967 |
| Policy instance | 83 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 800256 |
| Policy instance | 1 |
| AETNA HEALTH INC (National Association of Insurance Commissioners NAIC id number: 95088 ) |
| Policy contract number | US354317 |
| Policy instance | 12 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95094 ) |
| Policy contract number | US354317 |
| Policy instance | 13 |
| AETNA HEALTH INC. (National Association of Insurance Commissioners NAIC id number: 95002 ) |
| Policy contract number | US354317 |
| Policy instance | 15 |
| AETNA HEALTH INC (National Association of Insurance Commissioners NAIC id number: 95397 ) |
| Policy contract number | US354317 |
| Policy instance | 14 |
| AETNA US HEALTHCARE - MA (National Association of Insurance Commissioners NAIC id number: 95236 ) |
| Policy contract number | US354317 |
| Policy instance | 16 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95094 ) |
| Policy contract number | US354317 |
| Policy instance | 17 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65756 ) |
| Policy contract number | US354317 |
| Policy instance | 19 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95517 ) |
| Policy contract number | US354317 |
| Policy instance | 18 |
| AETNA HEALTH INC (National Association of Insurance Commissioners NAIC id number: 95245 ) |
| Policy contract number | US354317 |
| Policy instance | 11 |
| AETNA HEALTH, INC (National Association of Insurance Commissioners NAIC id number: 95935 ) |
| Policy contract number | US354317 |
| Policy instance | 10 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 800256 |
| Policy instance | 2 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 800256 |
| Policy instance | 3 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95003 ) |
| Policy contract number | 800256 |
| Policy instance | 4 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95094 ) |
| Policy contract number | 800256 |
| Policy instance | 5 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 800256 |
| Policy instance | 6 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95003 ) |
| Policy contract number | US354317 |
| Policy instance | 7 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | US354317 |
| Policy instance | 8 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95256 ) |
| Policy contract number | US354317 |
| Policy instance | 9 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95810 ) |
| Policy contract number | US354317 |
| Policy instance | 20 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95343 ) |
| Policy contract number | US354317 |
| Policy instance | 21 |
| AETNA HEALTH INC. (National Association of Insurance Commissioners NAIC id number: 95237 ) |
| Policy contract number | US354317 |
| Policy instance | 22 |
| GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 ) |
| Policy contract number | 101639 |
| Policy instance | 34 |
| HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 52628 ) |
| Policy contract number | 0684 |
| Policy instance | 35 |
| HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
| Policy contract number | 50501915 |
| Policy instance | 36 |
| HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
| Policy contract number | P7090 |
| Policy instance | 38 |
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | PIC-ALL |
| Policy instance | 37 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7105 |
| Policy instance | 39 |
| HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
| Policy contract number | P7113 |
| Policy instance | 40 |
| HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
| Policy contract number | P7143 |
| Policy instance | 41 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95484 ) |
| Policy contract number | US354317 |
| Policy instance | 32 |
| CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
| Policy contract number | 00620B |
| Policy instance | 33 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95287 ) |
| Policy contract number | US354317 |
| Policy instance | 23 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95490 ) |
| Policy contract number | US354317 |
| Policy instance | 24 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 92534 ) |
| Policy contract number | US354317 |
| Policy instance | 25 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 96518 ) |
| Policy contract number | US354317 |
| Policy instance | 26 |
| AETNA HEALTH INC (National Association of Insurance Commissioners NAIC id number: 95757 ) |
| Policy contract number | US354317 |
| Policy instance | 27 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 ) |
| Policy contract number | US354317 |
| Policy instance | 28 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95490 ) |
| Policy contract number | US354317 |
| Policy instance | 30 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 47060 ) |
| Policy contract number | US354317 |
| Policy instance | 31 |
| HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
| Policy contract number | P7152 |
| Policy instance | 43 |
| UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 0 ) |
| Policy contract number | 149753 |
| Policy instance | 85 |
| UNITED HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 95378 ) |
| Policy contract number | 17233 |
| Policy instance | 103 |
| UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 ) |
| Policy contract number | 018404 |
| Policy instance | 102 |
| UNITEDHEALTHCARE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 60093 ) |
| Policy contract number | 14100 |
| Policy instance | 84 |
| UNITED HEALTHCARE OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95264 ) |
| Policy contract number | 54012 |
| Policy instance | 101 |
| UNITED HEALTHCARE OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95264 ) |
| Policy contract number | 82009 |
| Policy instance | 100 |
| UNITED HEALTHCARE OF OKLAHOMA (National Association of Insurance Commissioners NAIC id number: 96903 ) |
| Policy contract number | 808299 |
| Policy instance | 99 |
| UNITEDHEALTHCARE OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 48038 ) |
| Policy contract number | 804249 |
| Policy instance | 98 |
| UNITED HEALTHCARE OF TENNESSEE, INC (National Association of Insurance Commissioners NAIC id number: 11147 ) |
| Policy contract number | 80013 |
| Policy instance | 97 |
| EVERCARE OF TEXAS, LLC (National Association of Insurance Commissioners NAIC id number: 11141 ) |
| Policy contract number | 79014 |
| Policy instance | 96 |
| UNITEDHEALTHCARE OF NEVADA (National Association of Insurance Commissioners NAIC id number: 95685 ) |
| Policy contract number | 667192 |
| Policy instance | 93 |
| UNITEDHEALTHCARE OF GEORGIA, INC. (National Association of Insurance Commissioners NAIC id number: 95850 ) |
| Policy contract number | 06054 |
| Policy instance | 104 |
| UNITED HEALTHCARE OF THE MIDWEST (National Association of Insurance Commissioners NAIC id number: 96385 ) |
| Policy contract number | 55760 |
| Policy instance | 92 |
| UNITEDHEALTHCARE OF GEORGIA, INC. (National Association of Insurance Commissioners NAIC id number: 95850 ) |
| Policy contract number | 50273 |
| Policy instance | 90 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 66045 |
| Policy instance | 107 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 40530 |
| Policy instance | 106 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 40014 |
| Policy instance | 105 |
| UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 0 ) |
| Policy contract number | 149758 |
| Policy instance | 86 |
| UNITEDHEALTHCARE OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 95103 ) |
| Policy contract number | 71516 |
| Policy instance | 95 |
| UNITED HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 95378 ) |
| Policy contract number | 17032 |
| Policy instance | 87 |
| AETNA HEALTH INC. (National Association of Insurance Commissioners NAIC id number: 95006 ) |
| Policy contract number | US354317 |
| Policy instance | 29 |
| UNITED HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 95378 ) |
| Policy contract number | 17409 |
| Policy instance | 88 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 27021 |
| Policy instance | 89 |
| UNITED HEALTHCARE OF THE MIDWEST (National Association of Insurance Commissioners NAIC id number: 96385 ) |
| Policy contract number | 55759 |
| Policy instance | 91 |
| UNITED HEALTHCARE OF WISCONSIN, INC. (MEDICARE COMPLETE) (National Association of Insurance Commissioners NAIC id number: 95710 ) |
| Policy contract number | 70069 |
| Policy instance | 94 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 78853 |
| Policy instance | 2 |
| HEALTH NET (National Association of Insurance Commissioners NAIC id number: 95567 ) |
| Policy contract number | RF121A |
| Policy instance | 3 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 20249 |
| Policy instance | 7 |
| HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
| Policy contract number | 50500890 |
| Policy instance | 4 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 109104 |
| Policy instance | 5 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 600805 |
| Policy instance | 6 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 30007445 |
| Policy instance | 8 |
| ALTIUS HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95407 ) |
| Policy contract number | 6872200000 |
| Policy instance | 1 |
| HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 ) |
| Policy contract number | 50501915 |
| Policy instance | 7 |
| HEALTHNET (National Association of Insurance Commissioners NAIC id number: 95351 ) |
| Policy contract number | A40076 200534 |
| Policy instance | 6 |
| HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 0684 |
| Policy instance | 8 |
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | PIC-ALL |
| Policy instance | 9 |
| HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
| Policy contract number | P7090 |
| Policy instance | 10 |
| GEISINGER QUALITY OPTIONS, INC (National Association of Insurance Commissioners NAIC id number: 95923 ) |
| Policy contract number | 101639 |
| Policy instance | 5 |
| CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
| Policy contract number | 00620B |
| Policy instance | 4 |
| AIG PREMIER INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 7430001 |
| Policy instance | 3 |
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95287 ) |
| Policy contract number | US354317 |
| Policy instance | 2 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 800256 |
| Policy instance | 1 |
| MEDICA (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 70832 |
| Policy instance | 27 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 01690-5 |
| Policy instance | 42 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 99700000 |
| Policy instance | 47 |
| HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
| Policy contract number | P7113 |
| Policy instance | 11 |
| UNITEDHEALTHCARE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 60093 ) |
| Policy contract number | 14100 |
| Policy instance | 52 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | G-22310 |
| Policy instance | 45 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 22216-LTC |
| Policy instance | 44 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | G-21615 |
| Policy instance | 43 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 01690-4 |
| Policy instance | 41 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 01690-3 |
| Policy instance | 40 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 01690-2 |
| Policy instance | 39 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 01690-1 |
| Policy instance | 38 |
| UNITEDHEALTHCARE OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 48038 ) |
| Policy contract number | 804249 |
| Policy instance | 37 |
| UNITED HEALTHCARE BENEFITS OF TX (National Association of Insurance Commissioners NAIC id number: 95174 ) |
| Policy contract number | 018403 |
| Policy instance | 36 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 73174-1 |
| Policy instance | 46 |
| SELECTCARE OF TEXAS (National Association of Insurance Commissioners NAIC id number: 10096 ) |
| Policy contract number | H-4506 |
| Policy instance | 48 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 18500/18087 |
| Policy instance | 53 |
| UNITED HEALTHCARE OF THE MIDWEST (National Association of Insurance Commissioners NAIC id number: 96385 ) |
| Policy contract number | 55759, 60, 61 |
| Policy instance | 54 |
| UNITEDHEALTHCARE OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 95103 ) |
| Policy contract number | 71516 |
| Policy instance | 55 |
| UNITED HEALTHCARE OF OHIO (National Association of Insurance Commissioners NAIC id number: 95186 ) |
| Policy contract number | 10248,10460, |
| Policy instance | 56 |
| UNITEDHEALTHCARE OF GEORGIA, INC. (National Association of Insurance Commissioners NAIC id number: 95850 ) |
| Policy contract number | 50273 |
| Policy instance | 57 |
| UNITED HEALTHCARE OF WISCONSIN, INC. (MEDICARE COMPLETE) (National Association of Insurance Commissioners NAIC id number: 95710 ) |
| Policy contract number | 70069 |
| Policy instance | 58 |
| UNITEDHEALTHCARE OF ALABAMA, INC. (National Association of Insurance Commissioners NAIC id number: 95784 ) |
| Policy contract number | 17032, 06054 |
| Policy instance | 51 |
| TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 ) |
| Policy contract number | G1432 |
| Policy instance | 50 |
| TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 ) |
| Policy contract number | 60219000 |
| Policy instance | 49 |
| UNITED HEALTHCARE OF OKLAHOMA (National Association of Insurance Commissioners NAIC id number: 96903 ) |
| Policy contract number | 808299 |
| Policy instance | 35 |
| UNITEDHEALTHCARE OF NEVADA (National Association of Insurance Commissioners NAIC id number: 95685 ) |
| Policy contract number | 667192 |
| Policy instance | 34 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7637 |
| Policy instance | 21 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7171 |
| Policy instance | 20 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7170 |
| Policy instance | 19 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7158 |
| Policy instance | 18 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7155 |
| Policy instance | 17 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7152 |
| Policy instance | 16 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7151 |
| Policy instance | 15 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7105 |
| Policy instance | 14 |
| HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
| Policy contract number | P7646 |
| Policy instance | 13 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7669 |
| Policy instance | 22 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | P7678 |
| Policy instance | 23 |
| UNITEDHEALTHCARE OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95434 ) |
| Policy contract number | 092167 |
| Policy instance | 33 |
| UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 0 ) |
| Policy contract number | 149753 |
| Policy instance | 32 |
| UNITEDHEALTHCARE OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 95617 ) |
| Policy contract number | 060486 |
| Policy instance | 31 |
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 78026 ) |
| Policy contract number | PR1365 |
| Policy instance | 30 |
| MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) |
| Policy contract number | X0181 |
| Policy instance | 29 |
| MEDICAL ASSOCIATES HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 52559 ) |
| Policy contract number | 0264341,2,3,4 |
| Policy instance | 28 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 157 |
| Policy instance | 26 |
| HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
| Policy contract number | Q1526 |
| Policy instance | 25 |
| HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 ) |
| Policy contract number | Q0818 |
| Policy instance | 24 |
| HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
| Policy contract number | P7143 |
| Policy instance | 12 |
