401k Plan data: PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST plan

PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 401k Plan overview

Plan Name	PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST
Plan identification number	501

PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance

401k Sponsoring company profile

PULP SULPHITE & PAPER MILL WORKERS has sponsored the creation of one or more 401k plans.

Company Name: PULP SULPHITE & PAPER MILL WORKERS

Employer identification number (EIN): 237011588

NAIC Classification: 525100
NAIC Description: Insurance and Employee Benefit Funds

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2015-02-01 NICK SILK
501 2014-02-01 NICK SILK
501 2013-02-01 NICK SILK
501 2012-02-01 NICK SILK
501 2011-02-01 NICK SILK
501 2009-02-01 NICK SILK

Plan id#	Filing Submission Date	Name of Administrator
501	2015-02-01	NICK SILK
501	2014-02-01	NICK SILK
501	2013-02-01	NICK SILK
501	2012-02-01	NICK SILK
501	2011-02-01	NICK SILK
501	2009-02-01	NICK SILK

Plan Statistics for PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST

401k plan membership statisitcs for PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST

Measure Date Value
2015: PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2015 401k membership
Total participants, beginning-of-year 2015-02-01 139
Total number of active participants reported on line 7a of the Form 5500 2015-02-01 134
Total of all active and inactive participants 2015-02-01 134
Total participants 2015-02-01 0
2014: PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2014 401k membership
Total participants, beginning-of-year 2014-02-01 140
Total number of active participants reported on line 7a of the Form 5500 2014-02-01 139
Total of all active and inactive participants 2014-02-01 139
Total participants 2014-02-01 0
2013: PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2013 401k membership
Total participants, beginning-of-year 2013-02-01 107
Total number of active participants reported on line 7a of the Form 5500 2013-02-01 140
Total of all active and inactive participants 2013-02-01 140
Total participants 2013-02-01 0
2012: PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2012 401k membership
Total participants, beginning-of-year 2012-02-01 109
Total number of active participants reported on line 7a of the Form 5500 2012-02-01 107
Total of all active and inactive participants 2012-02-01 107
Total participants 2012-02-01 0
2011: PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2011 401k membership
Total participants, beginning-of-year 2011-02-01 109
Total number of active participants reported on line 7a of the Form 5500 2011-02-01 109
Total of all active and inactive participants 2011-02-01 109
Total participants 2011-02-01 109
2009: PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2009 401k membership
Total participants, beginning-of-year 2009-02-01 125
Total number of active participants reported on line 7a of the Form 5500 2009-02-01 107
Total of all active and inactive participants 2009-02-01 107

Measure	Date	Value
2015: PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2015 401k membership
Total participants, beginning-of-year	2015-02-01	139
Total number of active participants reported on line 7a of the Form 5500	2015-02-01	134
Total of all active and inactive participants	2015-02-01	134
Total participants	2015-02-01	0
2014: PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2014 401k membership
Total participants, beginning-of-year	2014-02-01	140
Total number of active participants reported on line 7a of the Form 5500	2014-02-01	139
Total of all active and inactive participants	2014-02-01	139
Total participants	2014-02-01	0
2013: PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2013 401k membership
Total participants, beginning-of-year	2013-02-01	107
Total number of active participants reported on line 7a of the Form 5500	2013-02-01	140
Total of all active and inactive participants	2013-02-01	140
Total participants	2013-02-01	0
2012: PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2012 401k membership
Total participants, beginning-of-year	2012-02-01	109
Total number of active participants reported on line 7a of the Form 5500	2012-02-01	107
Total of all active and inactive participants	2012-02-01	107
Total participants	2012-02-01	0
2011: PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2011 401k membership
Total participants, beginning-of-year	2011-02-01	109
Total number of active participants reported on line 7a of the Form 5500	2011-02-01	109
Total of all active and inactive participants	2011-02-01	109
Total participants	2011-02-01	109
2009: PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2009 401k membership
Total participants, beginning-of-year	2009-02-01	125
Total number of active participants reported on line 7a of the Form 5500	2009-02-01	107
Total of all active and inactive participants	2009-02-01	107

Financial Data on PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST

Measure	Date	Value
2016 : PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2016 401k financial data
Total income from all sources (including contributions)	2016-01-31	$800,475
Total of all expenses incurred	2016-01-31	$664,810
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-01-31	$656,322
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-01-31	$800,253
Value of total assets at end of year	2016-01-31	$540,762
Value of total assets at beginning of year	2016-01-31	$405,097
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-01-31	$8,488
Total interest from all sources	2016-01-31	$222
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-01-31	No
Administrative expenses professional fees incurred	2016-01-31	$6,500
Was this plan covered by a fidelity bond	2016-01-31	Yes
Value of fidelity bond cover	2016-01-31	$1,000,000
If this is an individual account plan, was there a blackout period	2016-01-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-01-31	No
Contributions received from participants	2016-01-31	$223,866
Administrative expenses (other) incurred	2016-01-31	$1,880
Total non interest bearing cash at end of year	2016-01-31	$196,745
Total non interest bearing cash at beginning of year	2016-01-31	$61,302
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-01-31	No
Value of net income/loss	2016-01-31	$135,665
Value of net assets at end of year (total assets less liabilities)	2016-01-31	$540,762
Value of net assets at beginning of year (total assets less liabilities)	2016-01-31	$405,097
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-01-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-01-31	No
Were any leases to which the plan was party in default or uncollectible	2016-01-31	No
Investment advisory and management fees	2016-01-31	$108
Value of interest in common/collective trusts at end of year	2016-01-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-01-31	$344,017
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-01-31	$343,795
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-01-31	$343,795
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-01-31	$222
Expenses. Payments to insurance carriers foe the provision of benefits	2016-01-31	$656,322
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-01-31	No
Was there a failure to transmit to the plan any participant contributions	2016-01-31	No
Has the plan failed to provide any benefit when due under the plan	2016-01-31	No
Contributions received in cash from employer	2016-01-31	$576,387
Did the plan have assets held for investment	2016-01-31	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	2016-01-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-01-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-01-31	No
Opinion of an independent qualified public accountant for this plan	2016-01-31	Unqualified
Accountancy firm name	2016-01-31	KENNEDY & KENNEDY CPAS
Accountancy firm EIN	2016-01-31	956285205
2015 : PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2015 401k financial data
Total income from all sources (including contributions)	2015-01-31	$778,680
Total of all expenses incurred	2015-01-31	$652,721
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-01-31	$644,365
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-01-31	$778,475
Value of total assets at end of year	2015-01-31	$405,097
Value of total assets at beginning of year	2015-01-31	$279,138
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-01-31	$8,356
Total interest from all sources	2015-01-31	$205
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-01-31	No
Administrative expenses professional fees incurred	2015-01-31	$6,500
Was this plan covered by a fidelity bond	2015-01-31	Yes
Value of fidelity bond cover	2015-01-31	$1,000,000
If this is an individual account plan, was there a blackout period	2015-01-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-01-31	No
Contributions received from participants	2015-01-31	$219,587
Administrative expenses (other) incurred	2015-01-31	$1,748
Total non interest bearing cash at end of year	2015-01-31	$61,302
Total non interest bearing cash at beginning of year	2015-01-31	$164,096
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-01-31	No
Value of net income/loss	2015-01-31	$125,959
Value of net assets at end of year (total assets less liabilities)	2015-01-31	$405,097
Value of net assets at beginning of year (total assets less liabilities)	2015-01-31	$279,138
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-01-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-01-31	No
Were any leases to which the plan was party in default or uncollectible	2015-01-31	No
Investment advisory and management fees	2015-01-31	$108
Value of interest in common/collective trusts at end of year	2015-01-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-01-31	$343,795
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-01-31	$115,042
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-01-31	$115,042
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-01-31	$205
Expenses. Payments to insurance carriers foe the provision of benefits	2015-01-31	$644,365
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-01-31	No
Was there a failure to transmit to the plan any participant contributions	2015-01-31	No
Has the plan failed to provide any benefit when due under the plan	2015-01-31	No
Contributions received in cash from employer	2015-01-31	$558,888
Did the plan have assets held for investment	2015-01-31	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	2015-01-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-01-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-01-31	No
Opinion of an independent qualified public accountant for this plan	2015-01-31	Unqualified
Accountancy firm name	2015-01-31	KENNEDY & KENNEDY CPAS
Accountancy firm EIN	2015-01-31	956285205
2014 : PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2014 401k financial data
Total income from all sources (including contributions)	2014-01-31	$644,123
Total of all expenses incurred	2014-01-31	$631,773
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-01-31	$622,850
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-01-31	$643,975
Value of total assets at end of year	2014-01-31	$279,138
Value of total assets at beginning of year	2014-01-31	$266,788
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-01-31	$8,923
Total interest from all sources	2014-01-31	$148
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-01-31	No
Administrative expenses professional fees incurred	2014-01-31	$7,000
Was this plan covered by a fidelity bond	2014-01-31	Yes
Value of fidelity bond cover	2014-01-31	$1,000,000
If this is an individual account plan, was there a blackout period	2014-01-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-01-31	No
Contributions received from participants	2014-01-31	$228,592
Administrative expenses (other) incurred	2014-01-31	$1,748
Total non interest bearing cash at end of year	2014-01-31	$164,096
Total non interest bearing cash at beginning of year	2014-01-31	$201,894
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-01-31	No
Value of net income/loss	2014-01-31	$12,350
Value of net assets at end of year (total assets less liabilities)	2014-01-31	$279,138
Value of net assets at beginning of year (total assets less liabilities)	2014-01-31	$266,788
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-01-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-01-31	No
Were any leases to which the plan was party in default or uncollectible	2014-01-31	No
Investment advisory and management fees	2014-01-31	$175
Value of interest in common/collective trusts at end of year	2014-01-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-01-31	$115,042
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-01-31	$64,894
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-01-31	$64,894
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-01-31	$148
Expenses. Payments to insurance carriers foe the provision of benefits	2014-01-31	$622,850
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-01-31	No
Was there a failure to transmit to the plan any participant contributions	2014-01-31	No
Has the plan failed to provide any benefit when due under the plan	2014-01-31	No
Contributions received in cash from employer	2014-01-31	$415,383
Did the plan have assets held for investment	2014-01-31	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	2014-01-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-01-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-01-31	No
Opinion of an independent qualified public accountant for this plan	2014-01-31	Unqualified
Accountancy firm name	2014-01-31	KENNEDY & KENNEDY CPAS
Accountancy firm EIN	2014-01-31	956285205
2013 : PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2013 401k financial data
Total income from all sources (including contributions)	2013-01-31	$620,970
Total of all expenses incurred	2013-01-31	$622,251
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-01-31	$616,311
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-01-31	$620,893
Value of total assets at end of year	2013-01-31	$266,788
Value of total assets at beginning of year	2013-01-31	$268,069
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-01-31	$5,940
Total interest from all sources	2013-01-31	$77
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-01-31	No
Administrative expenses professional fees incurred	2013-01-31	$4,000
Was this plan covered by a fidelity bond	2013-01-31	Yes
Value of fidelity bond cover	2013-01-31	$1,000,000
Were there any nonexempt tranactions with any party-in-interest	2013-01-31	No
Contributions received from participants	2013-01-31	$167,682
Administrative expenses (other) incurred	2013-01-31	$1,748
Total non interest bearing cash at end of year	2013-01-31	$201,894
Total non interest bearing cash at beginning of year	2013-01-31	$199,110
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-01-31	No
Value of net income/loss	2013-01-31	$-1,281
Value of net assets at end of year (total assets less liabilities)	2013-01-31	$266,788
Value of net assets at beginning of year (total assets less liabilities)	2013-01-31	$268,069
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-01-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-01-31	No
Were any leases to which the plan was party in default or uncollectible	2013-01-31	No
Investment advisory and management fees	2013-01-31	$192
Value of interest in common/collective trusts at end of year	2013-01-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-01-31	$64,894
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-01-31	$68,959
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-01-31	$68,959
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-01-31	$77
Expenses. Payments to insurance carriers foe the provision of benefits	2013-01-31	$616,311
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-01-31	No
Was there a failure to transmit to the plan any participant contributions	2013-01-31	No
Has the plan failed to provide any benefit when due under the plan	2013-01-31	No
Contributions received in cash from employer	2013-01-31	$453,211
Did the plan have assets held for investment	2013-01-31	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	2013-01-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-01-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-01-31	No
Opinion of an independent qualified public accountant for this plan	2013-01-31	Unqualified
Accountancy firm name	2013-01-31	KENNEDY & KENNEDY CPAS
Accountancy firm EIN	2013-01-31	956285205
2012 : PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2012 401k financial data
Total income from all sources (including contributions)	2012-01-31	$523,084
Total of all expenses incurred	2012-01-31	$532,328
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-01-31	$522,655
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-01-31	$523,020
Value of total assets at end of year	2012-01-31	$268,069
Value of total assets at beginning of year	2012-01-31	$277,313
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-01-31	$9,673
Total interest from all sources	2012-01-31	$64
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-01-31	No
Administrative expenses professional fees incurred	2012-01-31	$7,805
Was this plan covered by a fidelity bond	2012-01-31	Yes
Value of fidelity bond cover	2012-01-31	$1,000,000
Were there any nonexempt tranactions with any party-in-interest	2012-01-31	No
Contributions received from participants	2012-01-31	$160,253
Administrative expenses (other) incurred	2012-01-31	$1,748
Total non interest bearing cash at end of year	2012-01-31	$199,110
Total non interest bearing cash at beginning of year	2012-01-31	$208,293
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-01-31	No
Value of net income/loss	2012-01-31	$-9,244
Value of net assets at end of year (total assets less liabilities)	2012-01-31	$268,069
Value of net assets at beginning of year (total assets less liabilities)	2012-01-31	$277,313
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-01-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-01-31	No
Were any leases to which the plan was party in default or uncollectible	2012-01-31	No
Investment advisory and management fees	2012-01-31	$120
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-01-31	$68,959
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-01-31	$69,020
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-01-31	$69,020
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-01-31	$64
Expenses. Payments to insurance carriers foe the provision of benefits	2012-01-31	$522,655
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-01-31	No
Was there a failure to transmit to the plan any participant contributions	2012-01-31	No
Has the plan failed to provide any benefit when due under the plan	2012-01-31	No
Contributions received in cash from employer	2012-01-31	$362,767
Did the plan have assets held for investment	2012-01-31	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	2012-01-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-01-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-01-31	No
Opinion of an independent qualified public accountant for this plan	2012-01-31	Unqualified
Accountancy firm name	2012-01-31	KENNEDY & KENNEDY CPAS
Accountancy firm EIN	2012-01-31	956285205
2011 : PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2011 401k financial data
Total income from all sources (including contributions)	2011-01-31	$492,576
Total of all expenses incurred	2011-01-31	$450,487
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-01-31	$441,537
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-01-31	$492,507
Value of total assets at end of year	2011-01-31	$277,313
Value of total assets at beginning of year	2011-01-31	$235,224
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-01-31	$8,950
Total interest from all sources	2011-01-31	$69
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-01-31	No
Administrative expenses professional fees incurred	2011-01-31	$4,500
Was this plan covered by a fidelity bond	2011-01-31	Yes
Value of fidelity bond cover	2011-01-31	$1,000,000
If this is an individual account plan, was there a blackout period	2011-01-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-01-31	No
Contributions received from participants	2011-01-31	$150,946
Administrative expenses (other) incurred	2011-01-31	$4,285
Total non interest bearing cash at end of year	2011-01-31	$208,293
Total non interest bearing cash at beginning of year	2011-01-31	$166,148
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-01-31	No
Value of net income/loss	2011-01-31	$42,089
Value of net assets at end of year (total assets less liabilities)	2011-01-31	$277,313
Value of net assets at beginning of year (total assets less liabilities)	2011-01-31	$235,224
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-01-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-01-31	No
Were any leases to which the plan was party in default or uncollectible	2011-01-31	No
Investment advisory and management fees	2011-01-31	$165
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-01-31	$69,020
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-01-31	$69,076
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-01-31	$69,076
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-01-31	$69
Expenses. Payments to insurance carriers foe the provision of benefits	2011-01-31	$441,537
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-01-31	No
Was there a failure to transmit to the plan any participant contributions	2011-01-31	No
Has the plan failed to provide any benefit when due under the plan	2011-01-31	No
Contributions received in cash from employer	2011-01-31	$341,561
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-01-31	No
Did the plan have assets held for investment	2011-01-31	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	2011-01-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-01-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-01-31	No
Opinion of an independent qualified public accountant for this plan	2011-01-31	Unqualified
Accountancy firm name	2011-01-31	MILLER AND CO. LLP
Accountancy firm EIN	2011-01-31	951754087

Form 5500 Responses for PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST

2015: PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2015 form 5500 responses
2015-02-01	Type of plan entity	Single employer plan
2015-02-01	Plan is a collectively bargained plan	Yes
2015-02-01	Plan funding arrangement – Insurance	Yes
2015-02-01	Plan funding arrangement – Trust	Yes
2015-02-01	Plan benefit arrangement – Insurance	Yes
2015-02-01	Plan benefit arrangement - Trust	Yes
2014: PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2014 form 5500 responses
2014-02-01	Type of plan entity	Single employer plan
2014-02-01	Plan is a collectively bargained plan	Yes
2014-02-01	Plan funding arrangement – Insurance	Yes
2014-02-01	Plan funding arrangement – Trust	Yes
2014-02-01	Plan benefit arrangement – Insurance	Yes
2014-02-01	Plan benefit arrangement - Trust	Yes
2013: PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2013 form 5500 responses
2013-02-01	Type of plan entity	Single employer plan
2013-02-01	Plan is a collectively bargained plan	Yes
2013-02-01	Plan funding arrangement – Insurance	Yes
2013-02-01	Plan funding arrangement – Trust	Yes
2013-02-01	Plan benefit arrangement – Insurance	Yes
2013-02-01	Plan benefit arrangement - Trust	Yes
2012: PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2012 form 5500 responses
2012-02-01	Type of plan entity	Single employer plan
2012-02-01	Submission has been amended	Yes
2012-02-01	Plan is a collectively bargained plan	Yes
2012-02-01	Plan funding arrangement – Insurance	Yes
2012-02-01	Plan funding arrangement – Trust	Yes
2012-02-01	Plan benefit arrangement – Insurance	Yes
2012-02-01	Plan benefit arrangement - Trust	Yes
2011: PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2011 form 5500 responses
2011-02-01	Type of plan entity	Single employer plan
2011-02-01	Submission has been amended	Yes
2011-02-01	Plan is a collectively bargained plan	Yes
2011-02-01	Plan funding arrangement – Insurance	Yes
2011-02-01	Plan funding arrangement – Trust	Yes
2011-02-01	Plan benefit arrangement – Insurance	Yes
2011-02-01	Plan benefit arrangement - Trust	Yes
2009: PULP SULPHITE & PAPER MILL WORKERS LOS ANGELES INSURANCE TRUST 2009 form 5500 responses
2009-02-01	Type of plan entity	Single employer plan
2009-02-01	This submission is the final filing	No
2009-02-01	Plan is a collectively bargained plan	Yes
2009-02-01	Plan funding arrangement – Insurance	Yes
2009-02-01	Plan funding arrangement – Trust	Yes
2009-02-01	Plan benefit arrangement – Insurance	Yes
2009-02-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010076819

Policy instance

Insurance contract or identification number	000010076819
Number of Individuals Covered	134
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Welfare Benefit Premiums Paid to Carrier	USD $3,092
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	PATRIOT RISK & INSURANCE SERVICES

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

228151

Policy instance

Insurance contract or identification number	228151
Number of Individuals Covered	134
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Welfare Benefit Premiums Paid to Carrier	USD $652,104
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker name	PATRIOT RISK & INSURANCE SERVICES

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010076819

Policy instance

Insurance contract or identification number	000010076819
Number of Individuals Covered	139
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Welfare Benefit Premiums Paid to Carrier	USD $3,230
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	PATRIOT RISK & INSURANCE SERVICES

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

228151

Policy instance

Insurance contract or identification number	228151
Number of Individuals Covered	139
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Welfare Benefit Premiums Paid to Carrier	USD $640,492
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker name	PATRIOT RISK & INSURANCE SERVICES

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010076819

Policy instance

Insurance contract or identification number	000010076819
Number of Individuals Covered	140
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Welfare Benefit Premiums Paid to Carrier	USD $2,672
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	PATRIOT RISK & INSURANCE SERVICES

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

228151

Policy instance

Insurance contract or identification number	228151
Number of Individuals Covered	140
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Welfare Benefit Premiums Paid to Carrier	USD $625,579
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker name	PATRIOT RISK & INSURANCE SERVICES

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

228151

Policy instance

Insurance contract or identification number	228151
Number of Individuals Covered	109
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Welfare Benefit Premiums Paid to Carrier	USD $613,584
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	HUB INTL OF CA INS. SERV., INC.

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010076819

Policy instance

Insurance contract or identification number	000010076819
Number of Individuals Covered	109
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,748
Welfare Benefit Premiums Paid to Carrier	USD $2,727
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,748
Insurance broker organization code?	3
Insurance broker name	HUB INTL OF CA INS. SERV., INC.

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

228151

Policy instance

Insurance contract or identification number	228151
Number of Individuals Covered	109
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $23,388
Welfare Benefit Premiums Paid to Carrier	USD $517,377
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010076819

Policy instance

Insurance contract or identification number	000010076819
Number of Individuals Covered	109
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $456
Welfare Benefit Premiums Paid to Carrier	USD $2,281
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010076819

Policy instance

Insurance contract or identification number	000010076819
Number of Individuals Covered	109
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $532
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,660
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $532
Insurance broker organization code?	3
Insurance broker name	HUB INTL OF CA INS. SERV., INC

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

228151

Policy instance

Insurance contract or identification number	228151
Number of Individuals Covered	105
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $19,463
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $430,542
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $19,463
Insurance broker organization code?	3
Insurance broker name	HUB INTL OF CA INS. SERV., INC

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Company Name:	PULP SULPHITE & PAPER MILL WORKERS
Employer identification number (EIN):	237011588
NAIC Classification:	525100
NAIC Description:	Insurance and Employee Benefit Funds