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CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 401k Plan overview

Plan NameCARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND
Plan identification number 501

CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision

401k Sponsoring company profile

CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH & WELFARE TRUST F has sponsored the creation of one or more 401k plans.

Company Name:CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH & WELFARE TRUST F
Employer identification number (EIN):237116870
NAIC Classification:238300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-03-01
5012021-03-01GARY Y. MIYASHIRO2022-12-12 GARY Y. MIYASHIRO2022-12-12
5012021-03-01GARY Y. MIYASHIRO2023-10-11 GARY Y. MIYASHIRO2023-10-11
5012020-03-01DOUGLAS KEMA, JR.2021-12-08 MALCOLM K. NAKAMURA2021-12-08
5012019-03-01DOUGLAS KEMA JR.2020-12-10 MALCOLM K. NAKAMURA2020-12-09
5012019-03-01DOUGLAS KEMA JR.2020-12-10 MALCOLM K. NAKAMURA2020-12-09
5012018-03-01DOUGLAS KEMA JR2019-12-13 MALCOLM NAKAMURA2019-12-13
5012017-03-01
5012016-03-01MALCOLM NAKAMURA RYDEN VALMOJA2017-12-29
5012016-01-01RYDEN VALMOJA MALCOLM NAKAMURA2017-12-15
5012015-03-01MALCOLM NAKAMURA RYDEN VALMOJA2016-12-05
5012014-03-01RYDEN VALMOJA MALCOLM NAKAMURA2015-12-15
5012013-03-01RYDEN VALMOJA MALCOLM NAKAMURA2014-12-12
5012012-03-01RYDEN VALMOJA HARRIS NAKAMURA2013-12-12
5012011-03-01LYNN KINNEY HARRIS NAKAMURA2012-12-17
5012009-03-01LYNN KINNEY HARRIS NAKAMURA2010-12-14

Plan Statistics for CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND

401k plan membership statisitcs for CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND

Measure Date Value
2022: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2022 401k membership
Total participants, beginning-of-year2022-03-01169
Total number of active participants reported on line 7a of the Form 55002022-03-01211
Number of retired or separated participants receiving benefits2022-03-010
Number of other retired or separated participants entitled to future benefits2022-03-010
Total of all active and inactive participants2022-03-01211
Number of employers contributing to the scheme2022-03-0127
2021: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2021 401k membership
Total participants, beginning-of-year2021-03-01182
Total number of active participants reported on line 7a of the Form 55002021-03-01169
Number of retired or separated participants receiving benefits2021-03-010
Number of other retired or separated participants entitled to future benefits2021-03-010
Total of all active and inactive participants2021-03-01169
Number of employers contributing to the scheme2021-03-0127
2020: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2020 401k membership
Total participants, beginning-of-year2020-03-01195
Total number of active participants reported on line 7a of the Form 55002020-03-01175
Number of retired or separated participants receiving benefits2020-03-017
Total of all active and inactive participants2020-03-01182
Number of employers contributing to the scheme2020-03-0125
2019: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2019 401k membership
Total participants, beginning-of-year2019-03-01195
Total number of active participants reported on line 7a of the Form 55002019-03-01195
Total of all active and inactive participants2019-03-01195
Number of employers contributing to the scheme2019-03-0126
2018: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2018 401k membership
Total participants, beginning-of-year2018-03-01215
Total number of active participants reported on line 7a of the Form 55002018-03-01194
Number of retired or separated participants receiving benefits2018-03-011
Total of all active and inactive participants2018-03-01195
Number of employers contributing to the scheme2018-03-0125
2017: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2017 401k membership
Total participants, beginning-of-year2017-03-01238
Total number of active participants reported on line 7a of the Form 55002017-03-01214
Number of retired or separated participants receiving benefits2017-03-011
Total of all active and inactive participants2017-03-01215
Number of employers contributing to the scheme2017-03-0125
2016: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2016 401k membership
Total participants, beginning-of-year2016-03-01249
Total number of active participants reported on line 7a of the Form 55002016-03-01237
Number of retired or separated participants receiving benefits2016-03-011
Total of all active and inactive participants2016-03-01238
Total participants2016-03-01238
Number of employers contributing to the scheme2016-03-0123
Total participants, beginning-of-year2016-01-01249
Total number of active participants reported on line 7a of the Form 55002016-01-01237
Number of retired or separated participants receiving benefits2016-01-011
Total of all active and inactive participants2016-01-01238
Total participants2016-01-01238
Number of employers contributing to the scheme2016-01-0123
2015: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2015 401k membership
Total participants, beginning-of-year2015-03-01132
Total number of active participants reported on line 7a of the Form 55002015-03-01249
Number of retired or separated participants receiving benefits2015-03-011
Total of all active and inactive participants2015-03-01250
Total participants2015-03-01250
Number of employers contributing to the scheme2015-03-0125
2014: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2014 401k membership
Total participants, beginning-of-year2014-03-01108
Total number of active participants reported on line 7a of the Form 55002014-03-01132
Number of retired or separated participants receiving benefits2014-03-012
Total of all active and inactive participants2014-03-01134
Total participants2014-03-01134
Number of employers contributing to the scheme2014-03-0126
2013: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2013 401k membership
Total participants, beginning-of-year2013-03-01141
Total number of active participants reported on line 7a of the Form 55002013-03-01108
Number of retired or separated participants receiving benefits2013-03-011
Total of all active and inactive participants2013-03-01109
Number of employers contributing to the scheme2013-03-0129
2012: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2012 401k membership
Total participants, beginning-of-year2012-03-01149
Total number of active participants reported on line 7a of the Form 55002012-03-01139
Number of retired or separated participants receiving benefits2012-03-012
Total of all active and inactive participants2012-03-01141
Number of employers contributing to the scheme2012-03-0127
2011: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2011 401k membership
Total participants, beginning-of-year2011-03-01152
Total number of active participants reported on line 7a of the Form 55002011-03-01147
Number of retired or separated participants receiving benefits2011-03-012
Total of all active and inactive participants2011-03-01149
Number of employers contributing to the scheme2011-03-0122
2009: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2009 401k membership
Total participants, beginning-of-year2009-03-01115
Total number of active participants reported on line 7a of the Form 55002009-03-01106
Number of retired or separated participants receiving benefits2009-03-013
Total of all active and inactive participants2009-03-01109
Number of employers contributing to the scheme2009-03-0117

Financial Data on CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND

Measure Date Value
2023 : CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2023 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2023-02-28$-221,360
Total unrealized appreciation/depreciation of assets2023-02-28$-221,360
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-02-28$1,286,443
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-02-28$1,329,499
Total income from all sources (including contributions)2023-02-28$2,713,897
Total loss/gain on sale of assets2023-02-28$675
Total of all expenses incurred2023-02-28$2,828,339
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-02-28$2,670,251
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-02-28$2,861,379
Value of total assets at end of year2023-02-28$5,872,642
Value of total assets at beginning of year2023-02-28$6,030,140
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-02-28$158,088
Total interest from all sources2023-02-28$2,006
Total dividends received (eg from common stock, registered investment company shares)2023-02-28$71,197
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-02-28No
Total dividends received from registered investment company shares (eg mutual funds)2023-02-28$71,197
Administrative expenses professional fees incurred2023-02-28$67,291
Was this plan covered by a fidelity bond2023-02-28Yes
Value of fidelity bond cover2023-02-28$500,000
If this is an individual account plan, was there a blackout period2023-02-28No
Were there any nonexempt tranactions with any party-in-interest2023-02-28No
Contributions received from participants2023-02-28$28,810
Assets. Other investments not covered elsewhere at end of year2023-02-28$4,286,865
Assets. Other investments not covered elsewhere at beginning of year2023-02-28$4,508,226
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2023-02-28$-43,056
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2023-02-28$117,757
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2023-02-28$846,198
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2023-02-28$918,642
Administrative expenses (other) incurred2023-02-28$17,556
Total non interest bearing cash at end of year2023-02-28$853,843
Total non interest bearing cash at beginning of year2023-02-28$671,075
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-02-28No
Value of net income/loss2023-02-28$-114,442
Value of net assets at end of year (total assets less liabilities)2023-02-28$4,586,199
Value of net assets at beginning of year (total assets less liabilities)2023-02-28$4,700,641
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2023-02-28No
Were any leases to which the plan was party in default or uncollectible2023-02-28No
Investment advisory and management fees2023-02-28$10,864
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-02-28$448,305
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2023-02-28$435,832
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2023-02-28$435,832
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2023-02-28$2,006
Expenses. Payments to insurance carriers foe the provision of benefits2023-02-28$2,713,307
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-02-28Yes
Was there a failure to transmit to the plan any participant contributions2023-02-28No
Has the plan failed to provide any benefit when due under the plan2023-02-28No
Contributions received in cash from employer2023-02-28$2,832,569
Employer contributions (assets) at end of year2023-02-28$283,629
Employer contributions (assets) at beginning of year2023-02-28$297,250
Contract administrator fees2023-02-28$62,377
Liabilities. Value of benefit claims payable at end of year2023-02-28$440,245
Liabilities. Value of benefit claims payable at beginning of year2023-02-28$410,857
Did the plan have assets held for investment2023-02-28Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-02-28No
Aggregate proceeds on sale of assets2023-02-28$675
Opinion of an independent qualified public accountant for this plan2023-02-28Unqualified
Accountancy firm name2023-02-28MC GROUP HAWAII, INC.
Accountancy firm EIN2023-02-28273701730
2022 : CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-02-28$-134,462
Total unrealized appreciation/depreciation of assets2022-02-28$-134,462
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-02-28$1,329,499
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-02-28$1,119,023
Total income from all sources (including contributions)2022-02-28$3,143,573
Total of all expenses incurred2022-02-28$4,063,528
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-02-28$3,891,397
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-02-28$2,981,093
Value of total assets at end of year2022-02-28$5,912,383
Value of total assets at beginning of year2022-02-28$5,502,839
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-02-28$172,131
Total interest from all sources2022-02-28$155
Total dividends received (eg from common stock, registered investment company shares)2022-02-28$41,544
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-02-28No
Total dividends received from registered investment company shares (eg mutual funds)2022-02-28$41,544
Administrative expenses professional fees incurred2022-02-28$93,311
Was this plan covered by a fidelity bond2022-02-28Yes
Value of fidelity bond cover2022-02-28$500,000
If this is an individual account plan, was there a blackout period2022-02-28No
Were there any nonexempt tranactions with any party-in-interest2022-02-28No
Contributions received from participants2022-02-28$43,102
Assets. Other investments not covered elsewhere at end of year2022-02-28$4,508,226
Assets. Other investments not covered elsewhere at beginning of year2022-02-28$4,383,311
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-02-28$1,329,499
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-02-28$117,757
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-02-28$373,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-02-28$918,642
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-02-28$700,628
Other income not declared elsewhere2022-02-28$255,243
Administrative expenses (other) incurred2022-02-28$8,650
Total non interest bearing cash at end of year2022-02-28$671,075
Total non interest bearing cash at beginning of year2022-02-28$475,225
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-02-28No
Value of net income/loss2022-02-28$-919,955
Value of net assets at end of year (total assets less liabilities)2022-02-28$4,582,884
Value of net assets at beginning of year (total assets less liabilities)2022-02-28$5,502,839
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2022-02-28No
Were any leases to which the plan was party in default or uncollectible2022-02-28No
Investment advisory and management fees2022-02-28$9,479
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-02-28$435,832
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-02-28$644,303
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-02-28$644,303
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-02-28$155
Expenses. Payments to insurance carriers foe the provision of benefits2022-02-28$2,561,898
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-02-28Yes
Was there a failure to transmit to the plan any participant contributions2022-02-28No
Has the plan failed to provide any benefit when due under the plan2022-02-28No
Contributions received in cash from employer2022-02-28$2,937,991
Employer contributions (assets) at end of year2022-02-28$297,250
Employer contributions (assets) at beginning of year2022-02-28$290,335
Contract administrator fees2022-02-28$60,691
Liabilities. Value of benefit claims payable at end of year2022-02-28$410,857
Liabilities. Value of benefit claims payable at beginning of year2022-02-28$418,395
Did the plan have assets held for investment2022-02-28Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-02-28No
Opinion of an independent qualified public accountant for this plan2022-02-28Unqualified
Accountancy firm name2022-02-28MC GROUP HAWAII, INC.
Accountancy firm EIN2022-02-28273701730
2021 : CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2021 401k financial data
Unrealized appreciation/depreciation of real estate assets2021-02-28$23,242
Total unrealized appreciation/depreciation of assets2021-02-28$23,242
Total income from all sources (including contributions)2021-02-28$2,627,759
Total loss/gain on sale of assets2021-02-28$6,100
Total of all expenses incurred2021-02-28$2,750,597
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-02-28$2,599,956
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-02-28$2,519,989
Value of total assets at end of year2021-02-28$5,502,839
Value of total assets at beginning of year2021-02-28$5,625,677
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-02-28$150,641
Total interest from all sources2021-02-28$1,264
Total dividends received (eg from common stock, registered investment company shares)2021-02-28$61,031
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-02-28No
Total dividends received from registered investment company shares (eg mutual funds)2021-02-28$61,031
Administrative expenses professional fees incurred2021-02-28$79,394
Was this plan covered by a fidelity bond2021-02-28Yes
Value of fidelity bond cover2021-02-28$500,000
If this is an individual account plan, was there a blackout period2021-02-28No
Were there any nonexempt tranactions with any party-in-interest2021-02-28No
Contributions received from participants2021-02-28$21,342
Assets. Other investments not covered elsewhere at end of year2021-02-28$4,383,311
Assets. Other investments not covered elsewhere at beginning of year2021-02-28$4,570,290
Other income not declared elsewhere2021-02-28$16,133
Administrative expenses (other) incurred2021-02-28$8,116
Total non interest bearing cash at end of year2021-02-28$597,159
Total non interest bearing cash at beginning of year2021-02-28$801,270
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-02-28No
Value of net income/loss2021-02-28$-122,838
Value of net assets at end of year (total assets less liabilities)2021-02-28$5,502,839
Value of net assets at beginning of year (total assets less liabilities)2021-02-28$5,625,677
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2021-02-28No
Were any leases to which the plan was party in default or uncollectible2021-02-28No
Investment advisory and management fees2021-02-28$10,796
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-02-28$522,369
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-02-28$254,117
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-02-28$254,117
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-02-28$1,264
Expenses. Payments to insurance carriers foe the provision of benefits2021-02-28$2,599,956
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-02-28No
Was there a failure to transmit to the plan any participant contributions2021-02-28No
Has the plan failed to provide any benefit when due under the plan2021-02-28No
Contributions received in cash from employer2021-02-28$2,498,647
Contract administrator fees2021-02-28$52,335
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-02-28No
Did the plan have assets held for investment2021-02-28Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-02-28No
Aggregate proceeds on sale of assets2021-02-28$6,100
Opinion of an independent qualified public accountant for this plan2021-02-28Unqualified
Accountancy firm name2021-02-28EIDE BALLY LLP
Accountancy firm EIN2021-02-28450250958
2020 : CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2020 401k financial data
Unrealized appreciation/depreciation of real estate assets2020-02-29$140,178
Total unrealized appreciation/depreciation of assets2020-02-29$140,178
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-02-29$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-02-29$981,037
Total income from all sources (including contributions)2020-02-29$2,908,938
Total loss/gain on sale of assets2020-02-29$228
Total of all expenses incurred2020-02-29$2,134,407
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-02-29$2,008,361
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-02-29$2,656,224
Value of total assets at end of year2020-02-29$5,625,677
Value of total assets at beginning of year2020-02-29$5,832,183
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-02-29$126,046
Total interest from all sources2020-02-29$105,959
Total dividends received (eg from common stock, registered investment company shares)2020-02-29$97,297
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-02-29No
Total dividends received from registered investment company shares (eg mutual funds)2020-02-29$97,297
Administrative expenses professional fees incurred2020-02-29$48,286
Was this plan covered by a fidelity bond2020-02-29Yes
Value of fidelity bond cover2020-02-29$500,000
If this is an individual account plan, was there a blackout period2020-02-29No
Were there any nonexempt tranactions with any party-in-interest2020-02-29No
Contributions received from participants2020-02-29$25,862
Assets. Other investments not covered elsewhere at end of year2020-02-29$4,570,290
Assets. Other investments not covered elsewhere at beginning of year2020-02-29$4,265,695
Income. Received or receivable in cash from other sources (including rollovers)2020-02-29$6,349
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-02-29$-627,167
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-02-29$255,243
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-02-29$1,084,696
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-02-29$587,899
Other income not declared elsewhere2020-02-29$6,349
Administrative expenses (other) incurred2020-02-29$15,026
Liabilities. Value of operating payables at end of year2020-02-29$0
Liabilities. Value of operating payables at beginning of year2020-02-29$8,950
Total non interest bearing cash at end of year2020-02-29$801,270
Total non interest bearing cash at beginning of year2020-02-29$500,310
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-02-29No
Value of net income/loss2020-02-29$774,531
Value of net assets at end of year (total assets less liabilities)2020-02-29$5,625,677
Value of net assets at beginning of year (total assets less liabilities)2020-02-29$4,851,146
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-02-29No
Were any loans by the plan or fixed income obligations due to the plan in default2020-02-29No
Were any leases to which the plan was party in default or uncollectible2020-02-29No
Investment advisory and management fees2020-02-29$10,399
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-02-29$4,570,290
Interest earned on other investments2020-02-29$96,605
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-02-29$254,117
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-02-29$712,306
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-02-29$712,306
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-02-29$9,354
Expenses. Payments to insurance carriers foe the provision of benefits2020-02-29$2,635,528
Asset value of US Government securities at beginning of year2020-02-29$712,306
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-02-29$140,406
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-02-29No
Was there a failure to transmit to the plan any participant contributions2020-02-29No
Has the plan failed to provide any benefit when due under the plan2020-02-29No
Contributions received in cash from employer2020-02-29$2,630,362
Employer contributions (assets) at end of year2020-02-29$0
Employer contributions (assets) at beginning of year2020-02-29$353,872
Contract administrator fees2020-02-29$52,335
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-02-29No
Liabilities. Value of benefit claims payable at end of year2020-02-29$0
Liabilities. Value of benefit claims payable at beginning of year2020-02-29$384,188
Did the plan have assets held for investment2020-02-29Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-02-29No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-02-29No
Aggregate proceeds on sale of assets2020-02-29$228
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-02-29No
Opinion of an independent qualified public accountant for this plan2020-02-29Unqualified
Accountancy firm name2020-02-29EIDE BAILLY LLP
Accountancy firm EIN2020-02-29450250958
2019 : CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2019-02-28$26,277
Total unrealized appreciation/depreciation of assets2019-02-28$26,277
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-02-28$981,037
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-02-28$1,008,099
Total income from all sources (including contributions)2019-02-28$2,690,361
Total of all expenses incurred2019-02-28$2,466,248
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-02-28$2,336,842
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-02-28$2,570,894
Value of total assets at end of year2019-02-28$5,832,183
Value of total assets at beginning of year2019-02-28$5,635,132
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-02-28$129,406
Total interest from all sources2019-02-28$90,145
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-02-28No
Administrative expenses professional fees incurred2019-02-28$47,442
Was this plan covered by a fidelity bond2019-02-28Yes
Value of fidelity bond cover2019-02-28$500,000
Were there any nonexempt tranactions with any party-in-interest2019-02-28No
Contributions received from participants2019-02-28$40,849
Assets. Other investments not covered elsewhere at end of year2019-02-28$4,265,695
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-02-28$-42,802
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-02-28$587,899
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-02-28$630,701
Other income not declared elsewhere2019-02-28$3,045
Administrative expenses (other) incurred2019-02-28$19,599
Liabilities. Value of operating payables at end of year2019-02-28$8,950
Total non interest bearing cash at end of year2019-02-28$500,310
Total non interest bearing cash at beginning of year2019-02-28$817,914
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-02-28No
Value of net income/loss2019-02-28$224,113
Value of net assets at end of year (total assets less liabilities)2019-02-28$4,851,146
Value of net assets at beginning of year (total assets less liabilities)2019-02-28$4,627,033
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2019-02-28No
Were any leases to which the plan was party in default or uncollectible2019-02-28No
Investment advisory and management fees2019-02-28$10,030
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-02-28$4,239,418
Interest earned on other investments2019-02-28$83,182
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-02-28$712,306
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-02-28$245,375
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-02-28$245,375
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-02-28$6,963
Expenses. Payments to insurance carriers foe the provision of benefits2019-02-28$2,379,644
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-02-28No
Was there a failure to transmit to the plan any participant contributions2019-02-28No
Has the plan failed to provide any benefit when due under the plan2019-02-28No
Contributions received in cash from employer2019-02-28$2,530,045
Employer contributions (assets) at end of year2019-02-28$353,872
Employer contributions (assets) at beginning of year2019-02-28$332,425
Contract administrator fees2019-02-28$52,335
Liabilities. Value of benefit claims payable at end of year2019-02-28$384,188
Liabilities. Value of benefit claims payable at beginning of year2019-02-28$377,398
Did the plan have assets held for investment2019-02-28Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-02-28No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-02-28No
Opinion of an independent qualified public accountant for this plan2019-02-28Unqualified
Accountancy firm name2019-02-28EIDE BAILLY LLP
Accountancy firm EIN2019-02-28450250958
2018 : CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2018-02-28$-9,728
Total unrealized appreciation/depreciation of assets2018-02-28$-9,728
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-02-28$1,008,099
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-02-28$1,236,339
Total income from all sources (including contributions)2018-02-28$2,764,699
Total of all expenses incurred2018-02-28$2,324,833
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-02-28$2,207,552
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-02-28$2,706,895
Value of total assets at end of year2018-02-28$5,635,132
Value of total assets at beginning of year2018-02-28$5,423,506
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-02-28$117,281
Total interest from all sources2018-02-28$3,062
Total dividends received (eg from common stock, registered investment company shares)2018-02-28$51,470
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-02-28No
Total dividends received from registered investment company shares (eg mutual funds)2018-02-28$51,470
Administrative expenses professional fees incurred2018-02-28$37,894
Was this plan covered by a fidelity bond2018-02-28Yes
Value of fidelity bond cover2018-02-28$500,000
If this is an individual account plan, was there a blackout period2018-02-28No
Were there any nonexempt tranactions with any party-in-interest2018-02-28No
Contributions received from participants2018-02-28$30,348
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-02-28$-226,632
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-02-28$1,951
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-02-28$630,701
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-02-28$857,333
Other income not declared elsewhere2018-02-28$69,672
Administrative expenses (other) incurred2018-02-28$18,099
Liabilities. Value of operating payables at beginning of year2018-02-28$98
Total non interest bearing cash at end of year2018-02-28$817,914
Total non interest bearing cash at beginning of year2018-02-28$1,421,722
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-02-28No
Value of net income/loss2018-02-28$439,866
Value of net assets at end of year (total assets less liabilities)2018-02-28$4,627,033
Value of net assets at beginning of year (total assets less liabilities)2018-02-28$4,187,167
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2018-02-28No
Were any leases to which the plan was party in default or uncollectible2018-02-28No
Investment advisory and management fees2018-02-28$8,953
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-02-28$4,239,418
Income. Interest from US Government securities2018-02-28$2,292
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-02-28$245,375
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-02-28$3,684,540
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-02-28$3,684,540
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-02-28$770
Expenses. Payments to insurance carriers foe the provision of benefits2018-02-28$2,434,184
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-02-28$-56,672
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-02-28Yes
Was there a failure to transmit to the plan any participant contributions2018-02-28No
Has the plan failed to provide any benefit when due under the plan2018-02-28No
Contributions received in cash from employer2018-02-28$2,676,547
Employer contributions (assets) at end of year2018-02-28$332,425
Employer contributions (assets) at beginning of year2018-02-28$315,293
Contract administrator fees2018-02-28$52,335
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-02-28No
Liabilities. Value of benefit claims payable at end of year2018-02-28$377,398
Liabilities. Value of benefit claims payable at beginning of year2018-02-28$378,908
Did the plan have assets held for investment2018-02-28Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-02-28No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-02-28No
Opinion of an independent qualified public accountant for this plan2018-02-28Unqualified
Accountancy firm name2018-02-28VAVRINEK, TRINE, DAY & CO., LLP
Accountancy firm EIN2018-02-28952648289
2017 : CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-02-28$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-02-28$98
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-02-28$16,079
Total income from all sources (including contributions)2017-02-28$3,275,889
Total loss/gain on sale of assets2017-02-28$0
Total of all expenses incurred2017-02-28$2,384,870
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-02-28$2,271,464
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-02-28$3,235,116
Value of total assets at end of year2017-02-28$5,423,506
Value of total assets at beginning of year2017-02-28$4,548,468
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-02-28$113,406
Total interest from all sources2017-02-28$18,413
Total dividends received (eg from common stock, registered investment company shares)2017-02-28$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-02-28No
Administrative expenses professional fees incurred2017-02-28$43,420
Was this plan covered by a fidelity bond2017-02-28Yes
Value of fidelity bond cover2017-02-28$500,000
If this is an individual account plan, was there a blackout period2017-02-28No
Were there any nonexempt tranactions with any party-in-interest2017-02-28No
Contributions received from participants2017-02-28$22,595
Income. Received or receivable in cash from other sources (including rollovers)2017-02-28$30,512
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-02-28$1,951
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-02-28$3,139
Other income not declared elsewhere2017-02-28$22,360
Administrative expenses (other) incurred2017-02-28$9,799
Liabilities. Value of operating payables at end of year2017-02-28$98
Liabilities. Value of operating payables at beginning of year2017-02-28$16,079
Total non interest bearing cash at end of year2017-02-28$1,421,722
Total non interest bearing cash at beginning of year2017-02-28$554,885
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-02-28No
Value of net income/loss2017-02-28$891,019
Value of net assets at end of year (total assets less liabilities)2017-02-28$5,423,408
Value of net assets at beginning of year (total assets less liabilities)2017-02-28$4,532,389
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2017-02-28No
Were any leases to which the plan was party in default or uncollectible2017-02-28No
Investment advisory and management fees2017-02-28$7,852
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-02-28$3,684,540
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-02-28$3,670,708
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-02-28$3,670,708
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-02-28$18,413
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-02-28No
Was there a failure to transmit to the plan any participant contributions2017-02-28No
Has the plan failed to provide any benefit when due under the plan2017-02-28No
Contributions received in cash from employer2017-02-28$3,182,009
Employer contributions (assets) at end of year2017-02-28$315,293
Employer contributions (assets) at beginning of year2017-02-28$319,736
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-02-28$2,271,464
Contract administrator fees2017-02-28$52,335
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-02-28No
Did the plan have assets held for investment2017-02-28Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-02-28No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-02-28No
Opinion of an independent qualified public accountant for this plan2017-02-28Unqualified
Accountancy firm name2017-02-28G. USHIJIMA CPA LLC
Accountancy firm EIN2017-02-28201318913
2016 : CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$98
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$16,079
Total income from all sources (including contributions)2016-12-31$3,275,889
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$2,384,870
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$2,271,464
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$3,235,116
Value of total assets at end of year2016-12-31$5,423,506
Value of total assets at beginning of year2016-12-31$4,548,468
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$113,406
Total interest from all sources2016-12-31$18,413
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 year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$43,420
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$22,595
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$30,512
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$1,951
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$3,139
Other income not declared elsewhere2016-12-31$22,360
Administrative expenses (other) incurred2016-12-31$9,799
Liabilities. Value of operating payables at end of year2016-12-31$98
Liabilities. Value of operating payables at beginning of year2016-12-31$16,079
Total non interest bearing cash at end of year2016-12-31$1,421,722
Total non interest bearing cash at beginning of year2016-12-31$554,885
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$891,019
Value of net assets at end of year (total assets less liabilities)2016-12-31$5,423,408
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$4,532,389
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Investment advisory and management fees2016-12-31$7,852
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$3,684,540
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$3,670,708
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$3,670,708
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$18,413
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$3,182,009
Employer contributions (assets) at end of year2016-12-31$315,293
Employer contributions (assets) at beginning of year2016-12-31$319,736
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$2,271,464
Contract administrator fees2016-12-31$52,335
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31G. USHIJIMA CPA LLC
Accountancy firm EIN2016-12-31201318913
Total unrealized appreciation/depreciation of assets2016-02-29$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-02-29$344,735
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-02-29$262,509
Total income from all sources (including contributions)2016-02-29$2,390,333
Total loss/gain on sale of assets2016-02-29$0
Total of all expenses incurred2016-02-29$1,948,661
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-02-29$1,833,079
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-02-29$2,339,010
Value of total assets at end of year2016-02-29$4,548,468
Value of total assets at beginning of year2016-02-29$4,024,570
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-02-29$115,582
Total interest from all sources2016-02-29$41,495
Total dividends received (eg from common stock, registered investment company shares)2016-02-29$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-02-29No
Administrative expenses professional fees incurred2016-02-29$46,331
Was this plan covered by a fidelity bond2016-02-29Yes
Value of fidelity bond cover2016-02-29$500,000
If this is an individual account plan, was there a blackout period2016-02-29No
Were there any nonexempt tranactions with any party-in-interest2016-02-29No
Contributions received from participants2016-02-29$22,110
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-02-29$3,139
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-02-29$2,310
Other income not declared elsewhere2016-02-29$9,828
Administrative expenses (other) incurred2016-02-29$9,107
Liabilities. Value of operating payables at end of year2016-02-29$16,079
Liabilities. Value of operating payables at beginning of year2016-02-29$9,918
Total non interest bearing cash at end of year2016-02-29$554,885
Total non interest bearing cash at beginning of year2016-02-29$422,170
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-02-29No
Value of net income/loss2016-02-29$441,672
Value of net assets at end of year (total assets less liabilities)2016-02-29$4,203,733
Value of net assets at beginning of year (total assets less liabilities)2016-02-29$3,762,061
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-02-29No
Were any loans by the plan or fixed income obligations due to the plan in default2016-02-29No
Were any leases to which the plan was party in default or uncollectible2016-02-29No
Investment advisory and management fees2016-02-29$7,809
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-02-29$3,670,708
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-02-29$3,480,528
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-02-29$3,480,528
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-02-29$41,495
Expenses. Payments to insurance carriers foe the provision of benefits2016-02-29$1,833,079
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-02-29No
Was there a failure to transmit to the plan any participant contributions2016-02-29No
Has the plan failed to provide any benefit when due under the plan2016-02-29No
Contributions received in cash from employer2016-02-29$2,316,900
Employer contributions (assets) at end of year2016-02-29$319,736
Employer contributions (assets) at beginning of year2016-02-29$119,562
Contract administrator fees2016-02-29$52,335
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-02-29No
Liabilities. Value of benefit claims payable at end of year2016-02-29$328,656
Liabilities. Value of benefit claims payable at beginning of year2016-02-29$252,591
Did the plan have assets held for investment2016-02-29Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-02-29No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-02-29No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-02-29No
Opinion of an independent qualified public accountant for this plan2016-02-29Unqualified
Accountancy firm name2016-02-29U. SHIJIMA CPA LLC
Accountancy firm EIN2016-02-29201318913
2015 : CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-02-28$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-02-28$262,509
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-02-28$333,521
Total income from all sources (including contributions)2015-02-28$1,658,470
Total loss/gain on sale of assets2015-02-28$0
Total of all expenses incurred2015-02-28$1,583,823
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-02-28$1,459,119
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-02-28$1,640,434
Value of total assets at end of year2015-02-28$4,024,570
Value of total assets at beginning of year2015-02-28$4,020,935
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-02-28$124,704
Total interest from all sources2015-02-28$17,224
Total dividends received (eg from common stock, registered investment company shares)2015-02-28$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-02-28No
Administrative expenses professional fees incurred2015-02-28$53,736
Was this plan covered by a fidelity bond2015-02-28Yes
Value of fidelity bond cover2015-02-28$500,000
If this is an individual account plan, was there a blackout period2015-02-28No
Were there any nonexempt tranactions with any party-in-interest2015-02-28No
Contributions received from participants2015-02-28$22,957
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-02-28$2,310
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-02-28$8,613
Other income not declared elsewhere2015-02-28$812
Administrative expenses (other) incurred2015-02-28$11,327
Liabilities. Value of operating payables at end of year2015-02-28$9,918
Liabilities. Value of operating payables at beginning of year2015-02-28$5,976
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-02-28No
Value of net income/loss2015-02-28$74,647
Value of net assets at end of year (total assets less liabilities)2015-02-28$3,762,061
Value of net assets at beginning of year (total assets less liabilities)2015-02-28$3,687,414
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2015-02-28No
Were any leases to which the plan was party in default or uncollectible2015-02-28No
Investment advisory and management fees2015-02-28$7,306
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-02-28$3,902,698
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-02-28$3,929,817
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-02-28$3,929,817
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-02-28$17,224
Expenses. Payments to insurance carriers foe the provision of benefits2015-02-28$1,459,119
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-02-28Yes
Was there a failure to transmit to the plan any participant contributions2015-02-28No
Has the plan failed to provide any benefit when due under the plan2015-02-28No
Contributions received in cash from employer2015-02-28$1,617,477
Employer contributions (assets) at end of year2015-02-28$119,562
Employer contributions (assets) at beginning of year2015-02-28$82,505
Contract administrator fees2015-02-28$52,335
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-02-28No
Liabilities. Value of benefit claims payable at end of year2015-02-28$252,591
Liabilities. Value of benefit claims payable at beginning of year2015-02-28$327,545
Did the plan have assets held for investment2015-02-28Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-02-28No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-02-28No
Opinion of an independent qualified public accountant for this plan2015-02-28Unqualified
Accountancy firm name2015-02-28G. USHIJIMA CPA LLC
Accountancy firm EIN2015-02-28201318913
2014 : CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-02-28$0
Total unrealized appreciation/depreciation of assets2014-02-28$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-02-28$333,521
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-02-28$225,496
Total income from all sources (including contributions)2014-02-28$1,316,718
Total loss/gain on sale of assets2014-02-28$0
Total of all expenses incurred2014-02-28$1,463,777
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-02-28$1,332,117
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-02-28$1,303,372
Value of total assets at end of year2014-02-28$4,020,935
Value of total assets at beginning of year2014-02-28$4,059,969
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-02-28$131,660
Total interest from all sources2014-02-28$1,519
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-02-28No
Administrative expenses professional fees incurred2014-02-28$65,065
Was this plan covered by a fidelity bond2014-02-28Yes
Value of fidelity bond cover2014-02-28$500,000
If this is an individual account plan, was there a blackout period2014-02-28No
Were there any nonexempt tranactions with any party-in-interest2014-02-28No
Contributions received from participants2014-02-28$28,302
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-02-28$8,613
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-02-28$63,467
Other income not declared elsewhere2014-02-28$11,827
Administrative expenses (other) incurred2014-02-28$6,715
Liabilities. Value of operating payables at end of year2014-02-28$5,976
Liabilities. Value of operating payables at beginning of year2014-02-28$6,192
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-02-28No
Value of net income/loss2014-02-28$-147,059
Value of net assets at end of year (total assets less liabilities)2014-02-28$3,687,414
Value of net assets at beginning of year (total assets less liabilities)2014-02-28$3,834,473
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2014-02-28No
Were any leases to which the plan was party in default or uncollectible2014-02-28No
Investment advisory and management fees2014-02-28$7,545
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-02-28$3,929,817
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-02-28$3,852,536
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-02-28$3,852,536
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-02-28$1,519
Expenses. Payments to insurance carriers foe the provision of benefits2014-02-28$1,332,117
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-02-28Yes
Was there a failure to transmit to the plan any participant contributions2014-02-28No
Has the plan failed to provide any benefit when due under the plan2014-02-28No
Contributions received in cash from employer2014-02-28$1,275,070
Employer contributions (assets) at end of year2014-02-28$82,505
Employer contributions (assets) at beginning of year2014-02-28$143,966
Contract administrator fees2014-02-28$52,335
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-02-28No
Liabilities. Value of benefit claims payable at end of year2014-02-28$327,545
Liabilities. Value of benefit claims payable at beginning of year2014-02-28$219,304
Did the plan have assets held for investment2014-02-28Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-02-28No
Aggregate proceeds on sale of assets2014-02-28$3,007,005
Aggregate carrying amount (costs) on sale of assets2014-02-28$3,007,005
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-02-28No
Opinion of an independent qualified public accountant for this plan2014-02-28Unqualified
Accountancy firm name2014-02-28LEMKE, CHINEN & TANAKA, CPA, INC.
Accountancy firm EIN2014-02-28990155373
2013 : CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-02-28$3,525
Total unrealized appreciation/depreciation of assets2013-02-28$3,525
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-02-28$225,496
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-02-28$128,608
Total income from all sources (including contributions)2013-02-28$1,366,967
Total loss/gain on sale of assets2013-02-28$-6,617
Total of all expenses incurred2013-02-28$1,685,414
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-02-28$1,562,189
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-02-28$1,357,658
Value of total assets at end of year2013-02-28$4,059,969
Value of total assets at beginning of year2013-02-28$4,281,528
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-02-28$123,225
Total interest from all sources2013-02-28$8,365
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-02-28No
Administrative expenses professional fees incurred2013-02-28$56,841
Was this plan covered by a fidelity bond2013-02-28Yes
Value of fidelity bond cover2013-02-28$500,000
If this is an individual account plan, was there a blackout period2013-02-28No
Were there any nonexempt tranactions with any party-in-interest2013-02-28No
Contributions received from participants2013-02-28$35,348
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-02-28$63,467
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-02-28$14,907
Other income not declared elsewhere2013-02-28$4,036
Administrative expenses (other) incurred2013-02-28$6,623
Liabilities. Value of operating payables at end of year2013-02-28$6,192
Liabilities. Value of operating payables at beginning of year2013-02-28$9,447
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-02-28No
Value of net income/loss2013-02-28$-318,447
Value of net assets at end of year (total assets less liabilities)2013-02-28$3,834,473
Value of net assets at beginning of year (total assets less liabilities)2013-02-28$4,152,920
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2013-02-28No
Were any leases to which the plan was party in default or uncollectible2013-02-28No
Investment advisory and management fees2013-02-28$7,426
Income. Interest from US Government securities2013-02-28$3,228
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-02-28$3,852,536
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-02-28$1,982,061
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-02-28$1,982,061
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-02-28$5,137
Expenses. Payments to insurance carriers foe the provision of benefits2013-02-28$1,562,189
Asset value of US Government securities at end of year2013-02-28$0
Asset value of US Government securities at beginning of year2013-02-28$2,176,085
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-02-28Yes
Was there a failure to transmit to the plan any participant contributions2013-02-28No
Has the plan failed to provide any benefit when due under the plan2013-02-28No
Contributions received in cash from employer2013-02-28$1,322,310
Employer contributions (assets) at end of year2013-02-28$143,966
Employer contributions (assets) at beginning of year2013-02-28$108,475
Contract administrator fees2013-02-28$52,335
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-02-28No
Liabilities. Value of benefit claims payable at end of year2013-02-28$219,304
Liabilities. Value of benefit claims payable at beginning of year2013-02-28$119,161
Did the plan have assets held for investment2013-02-28Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-02-28No
Aggregate proceeds on sale of assets2013-02-28$2,180,506
Aggregate carrying amount (costs) on sale of assets2013-02-28$2,187,123
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-02-28No
Opinion of an independent qualified public accountant for this plan2013-02-28Unqualified
Accountancy firm name2013-02-28LEMKE, CHINEN & TANAKA, C.P.A., INC
Accountancy firm EIN2013-02-28990155373
2012 : CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-02-29$-16,147
Total unrealized appreciation/depreciation of assets2012-02-29$-16,147
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-02-29$128,608
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-02-29$41,847
Total income from all sources (including contributions)2012-02-29$1,480,140
Total loss/gain on sale of assets2012-02-29$-8,810
Total of all expenses incurred2012-02-29$1,568,215
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-02-29$1,445,766
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-02-29$1,465,647
Value of total assets at end of year2012-02-29$4,281,528
Value of total assets at beginning of year2012-02-29$4,282,842
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-02-29$122,449
Total interest from all sources2012-02-29$32,231
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-02-29No
Administrative expenses professional fees incurred2012-02-29$54,086
Was this plan covered by a fidelity bond2012-02-29Yes
Value of fidelity bond cover2012-02-29$500,000
If this is an individual account plan, was there a blackout period2012-02-29No
Were there any nonexempt tranactions with any party-in-interest2012-02-29No
Contributions received from participants2012-02-29$33,814
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-02-29$14,907
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-02-29$6,875
Other income not declared elsewhere2012-02-29$7,219
Administrative expenses (other) incurred2012-02-29$7,965
Liabilities. Value of operating payables at end of year2012-02-29$9,447
Liabilities. Value of operating payables at beginning of year2012-02-29$6,186
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-02-29No
Value of net income/loss2012-02-29$-88,075
Value of net assets at end of year (total assets less liabilities)2012-02-29$4,152,920
Value of net assets at beginning of year (total assets less liabilities)2012-02-29$4,240,995
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-02-29No
Were any loans by the plan or fixed income obligations due to the plan in default2012-02-29No
Were any leases to which the plan was party in default or uncollectible2012-02-29No
Investment advisory and management fees2012-02-29$8,063
Income. Interest from US Government securities2012-02-29$31,039
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-02-29$1,982,061
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-02-29$368,334
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-02-29$368,334
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-02-29$1,192
Expenses. Payments to insurance carriers foe the provision of benefits2012-02-29$1,445,766
Asset value of US Government securities at end of year2012-02-29$2,176,085
Asset value of US Government securities at beginning of year2012-02-29$3,804,534
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-02-29Yes
Was there a failure to transmit to the plan any participant contributions2012-02-29No
Has the plan failed to provide any benefit when due under the plan2012-02-29No
Contributions received in cash from employer2012-02-29$1,431,833
Employer contributions (assets) at end of year2012-02-29$108,475
Employer contributions (assets) at beginning of year2012-02-29$103,099
Contract administrator fees2012-02-29$52,335
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-02-29No
Liabilities. Value of benefit claims payable at end of year2012-02-29$119,161
Liabilities. Value of benefit claims payable at beginning of year2012-02-29$35,661
Did the plan have assets held for investment2012-02-29Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-02-29No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-02-29No
Aggregate proceeds on sale of assets2012-02-29$6,717,403
Aggregate carrying amount (costs) on sale of assets2012-02-29$6,726,213
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-02-29No
Opinion of an independent qualified public accountant for this plan2012-02-29Unqualified
Accountancy firm name2012-02-29LEMKE, CHINEN & TANAKA, C.P.A., INC
Accountancy firm EIN2012-02-29990155373
2011 : CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-02-28$-769
Total unrealized appreciation/depreciation of assets2011-02-28$-769
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-02-28$41,847
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-02-28$17,750
Total income from all sources (including contributions)2011-02-28$1,263,272
Total loss/gain on sale of assets2011-02-28$0
Total of all expenses incurred2011-02-28$1,171,002
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-02-28$1,046,566
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-02-28$1,248,457
Value of total assets at end of year2011-02-28$4,282,842
Value of total assets at beginning of year2011-02-28$4,166,475
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-02-28$124,436
Total interest from all sources2011-02-28$14,977
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-02-28No
Administrative expenses professional fees incurred2011-02-28$48,851
Was this plan covered by a fidelity bond2011-02-28Yes
Value of fidelity bond cover2011-02-28$500,000
If this is an individual account plan, was there a blackout period2011-02-28No
Were there any nonexempt tranactions with any party-in-interest2011-02-28No
Contributions received from participants2011-02-28$27,991
Assets. Other investments not covered elsewhere at beginning of year2011-02-28$802,310
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-02-28$6,875
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-02-28$38,566
Other income not declared elsewhere2011-02-28$607
Administrative expenses (other) incurred2011-02-28$15,000
Liabilities. Value of operating payables at end of year2011-02-28$6,186
Liabilities. Value of operating payables at beginning of year2011-02-28$6,963
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-02-28No
Value of net income/loss2011-02-28$92,270
Value of net assets at end of year (total assets less liabilities)2011-02-28$4,240,995
Value of net assets at beginning of year (total assets less liabilities)2011-02-28$4,148,725
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2011-02-28No
Were any leases to which the plan was party in default or uncollectible2011-02-28No
Investment advisory and management fees2011-02-28$8,250
Income. Interest from US Government securities2011-02-28$14,760
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-02-28$368,334
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-02-28$203,290
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-02-28$203,290
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-02-28$217
Expenses. Payments to insurance carriers foe the provision of benefits2011-02-28$1,046,566
Asset value of US Government securities at end of year2011-02-28$3,804,534
Asset value of US Government securities at beginning of year2011-02-28$3,048,630
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-02-28Yes
Was there a failure to transmit to the plan any participant contributions2011-02-28No
Has the plan failed to provide any benefit when due under the plan2011-02-28No
Contributions received in cash from employer2011-02-28$1,220,466
Employer contributions (assets) at end of year2011-02-28$103,099
Employer contributions (assets) at beginning of year2011-02-28$73,679
Contract administrator fees2011-02-28$52,335
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-02-28No
Liabilities. Value of benefit claims payable at end of year2011-02-28$35,661
Liabilities. Value of benefit claims payable at beginning of year2011-02-28$10,787
Did the plan have assets held for investment2011-02-28Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-02-28No
Aggregate proceeds on sale of assets2011-02-28$6,236,348
Aggregate carrying amount (costs) on sale of assets2011-02-28$6,236,348
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-02-28No
Opinion of an independent qualified public accountant for this plan2011-02-28Unqualified
Accountancy firm name2011-02-28LEMKE, CHINEN & TANAKA, C.P.A., INC
Accountancy firm EIN2011-02-28990155373

Form 5500 Responses for CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND

2022: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2022 form 5500 responses
2022-03-01Type of plan entityMulti-employer plan
2022-03-01Submission has been amendedYes
2022-03-01Plan is a collectively bargained planYes
2022-03-01Plan funding arrangement – TrustYes
2022-03-01Plan benefit arrangement – InsuranceYes
2022-03-01Plan benefit arrangement - TrustYes
2021: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2021 form 5500 responses
2021-03-01Type of plan entityMulti-employer plan
2021-03-01Submission has been amendedYes
2021-03-01Plan is a collectively bargained planYes
2021-03-01Plan funding arrangement – TrustYes
2021-03-01Plan benefit arrangement – InsuranceYes
2021-03-01Plan benefit arrangement - TrustYes
2020: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2020 form 5500 responses
2020-03-01Type of plan entityMulti-employer plan
2020-03-01Plan is a collectively bargained planYes
2020-03-01Plan funding arrangement – TrustYes
2020-03-01Plan benefit arrangement – InsuranceYes
2020-03-01Plan benefit arrangement - TrustYes
2019: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2019 form 5500 responses
2019-03-01Type of plan entityMulti-employer plan
2019-03-01Submission has been amendedYes
2019-03-01Plan is a collectively bargained planYes
2019-03-01Plan funding arrangement – TrustYes
2019-03-01Plan benefit arrangement – InsuranceYes
2019-03-01Plan benefit arrangement - TrustYes
2018: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2018 form 5500 responses
2018-03-01Type of plan entityMulti-employer plan
2018-03-01Plan is a collectively bargained planYes
2018-03-01Plan funding arrangement – TrustYes
2018-03-01Plan benefit arrangement – InsuranceYes
2018-03-01Plan benefit arrangement - TrustYes
2017: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2017 form 5500 responses
2017-03-01Type of plan entityMulti-employer plan
2017-03-01Plan is a collectively bargained planYes
2017-03-01Plan funding arrangement – TrustYes
2017-03-01Plan benefit arrangement – InsuranceYes
2017-03-01Plan benefit arrangement - TrustYes
2016: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2016 form 5500 responses
2016-03-01Type of plan entityMulti-employer plan
2016-03-01Submission has been amendedYes
2016-03-01This submission is the final filingNo
2016-03-01This return/report is a short plan year return/report (less than 12 months)No
2016-03-01Plan is a collectively bargained planYes
2016-03-01Plan funding arrangement – TrustYes
2016-03-01Plan benefit arrangement – InsuranceYes
2016-03-01Plan benefit arrangement - TrustYes
2016-01-01Type of plan entityMulti-employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2015 form 5500 responses
2015-03-01Type of plan entityMulti-employer plan
2015-03-01Submission has been amendedNo
2015-03-01This submission is the final filingNo
2015-03-01This return/report is a short plan year return/report (less than 12 months)No
2015-03-01Plan is a collectively bargained planYes
2015-03-01Plan funding arrangement – TrustYes
2015-03-01Plan benefit arrangement – InsuranceYes
2015-03-01Plan benefit arrangement - TrustYes
2014: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2014 form 5500 responses
2014-03-01Type of plan entityMulti-employer plan
2014-03-01Submission has been amendedNo
2014-03-01This submission is the final filingNo
2014-03-01This return/report is a short plan year return/report (less than 12 months)No
2014-03-01Plan is a collectively bargained planYes
2014-03-01Plan funding arrangement – TrustYes
2014-03-01Plan benefit arrangement – InsuranceYes
2014-03-01Plan benefit arrangement - TrustYes
2013: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2013 form 5500 responses
2013-03-01Type of plan entityMulti-employer plan
2013-03-01Plan is a collectively bargained planYes
2013-03-01Plan funding arrangement – TrustYes
2013-03-01Plan benefit arrangement – InsuranceYes
2013-03-01Plan benefit arrangement - TrustYes
2012: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2012 form 5500 responses
2012-03-01Type of plan entityMulti-employer plan
2012-03-01Plan is a collectively bargained planYes
2012-03-01Plan funding arrangement – TrustYes
2012-03-01Plan benefit arrangement – InsuranceYes
2012-03-01Plan benefit arrangement - TrustYes
2011: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2011 form 5500 responses
2011-03-01Type of plan entityMulti-employer plan
2011-03-01Plan is a collectively bargained planYes
2011-03-01Plan funding arrangement – TrustYes
2011-03-01Plan benefit arrangement – InsuranceYes
2011-03-01Plan benefit arrangement - TrustYes
2009: CARPET, LINOLEUM & SOFT TILE LOCAL UNION 1926 HEALTH AND WELFARE TRUST FUND 2009 form 5500 responses
2009-03-01Type of plan entityMulti-employer plan
2009-03-01This submission is the final filingNo
2009-03-01Plan is a collectively bargained planYes
2009-03-01Plan funding arrangement – TrustYes
2009-03-01Plan benefit arrangement – InsuranceYes
2009-03-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number185
Policy instance 4
Insurance contract or identification number185
Number of Individuals Covered192
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $4,368
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,368
Insurance broker organization code?3
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number20592
Policy instance 3
Insurance contract or identification number20592
Number of Individuals Covered211
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $1,644
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD & D
Welfare Benefit Premiums Paid to CarrierUSD $36,791
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,644
Insurance broker organization code?3
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number2918,117,203,94
Policy instance 2
Insurance contract or identification number2918,117,203,94
Number of Individuals Covered521
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid in cash?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number184
Policy instance 1
Insurance contract or identification number184
Number of Individuals Covered47
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Welfare Benefit Premiums Paid to CarrierUSD $233,681
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: 0000 )
Policy contract number184
Policy instance 1
Insurance contract or identification number184
Number of Individuals Covered49
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number2918,117,203,94
Policy instance 2
Insurance contract or identification number2918,117,203,94
Number of Individuals Covered484
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid in cash?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number20592
Policy instance 3
Insurance contract or identification number20592
Number of Individuals Covered192
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $1,563
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD & D
Welfare Benefit Premiums Paid to CarrierUSD $33,959
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,563
Insurance broker organization code?3
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number185
Policy instance 4
Insurance contract or identification number185
Number of Individuals Covered182
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,318
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,318
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number184
Policy instance 1
Insurance contract or identification number184
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number2918,117,94,203
Policy instance 2
Insurance contract or identification number2918,117,94,203
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number20592-100
Policy instance 3
Insurance contract or identification number20592-100
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number185
Policy instance 4
Insurance contract or identification number185
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number184
Policy instance 1
Insurance contract or identification number184
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number20592-100
Policy instance 3
Insurance contract or identification number20592-100
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number2918,117,94,203
Policy instance 2
Insurance contract or identification number2918,117,94,203
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number185
Policy instance 4
Insurance contract or identification number185
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number184
Policy instance 1
Insurance contract or identification number184
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number2918,117,94,203
Policy instance 2
Insurance contract or identification number2918,117,94,203
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number20592-100
Policy instance 3
Insurance contract or identification number20592-100
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number185
Policy instance 4
Insurance contract or identification number185
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number185
Policy instance 4
Insurance contract or identification number185
Number of Individuals Covered510
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $4,778
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $187,046
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,778
Insurance broker organization code?3
Insurance broker nameGROUP PLAN ADMINISTRATORS
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number20592-100
Policy instance 3
Insurance contract or identification number20592-100
Number of Individuals Covered180
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $1,698
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $38,496
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,698
Insurance broker organization code?3
Insurance broker nameGROUP PLAN ADMINISTRATORS
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number2918,117,94,203
Policy instance 2
Insurance contract or identification number2918,117,94,203
Number of Individuals Covered568
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid in cash?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameNONE
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number184
Policy instance 1
Insurance contract or identification number184
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Insurance broker nameNONE
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract numberGL-20592-100
Policy instance 1
Insurance contract or identification numberGL-20592-100
Number of Individuals Covered157
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,463
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $30,359
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,463
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameGROUP PLAN ADMINISTRATORS, INC
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number2918,117,94,203
Policy instance 2
Insurance contract or identification number2918,117,94,203
Number of Individuals Covered432
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?Yes
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number184
Policy instance 3
Insurance contract or identification number184
Number of Individuals Covered54
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $143,775
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number185
Policy instance 4
Insurance contract or identification number185
Number of Individuals Covered425
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,242
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,242
Insurance broker organization code?3
Insurance broker nameGROUP PLAN ADMINISTRATIONS, INC
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number184
Policy instance 1
Insurance contract or identification number184
Number of Individuals Covered58
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $157,635
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number2918
Policy instance 2
Insurance contract or identification number2918
Number of Individuals Covered394
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?Yes
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number185
Policy instance 3
Insurance contract or identification number185
Number of Individuals Covered394
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,861
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,861
Insurance broker organization code?3
Insurance broker nameGROUP PLAN ADMINISTRATORS, INC
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract numberGL-20592-100
Policy instance 4
Insurance contract or identification numberGL-20592-100
Number of Individuals Covered141
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,326
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $26,466
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,326
Insurance broker organization code?3
Insurance broker nameGROUP PLAN ADMINISTRATORS, INC
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract numberGL-20592-100
Policy instance 4
Insurance contract or identification numberGL-20592-100
Number of Individuals Covered130
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $1,369
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $27,782
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,369
Insurance broker organization code?3
Insurance broker nameGROUP PLAN ADMINISTRATORS
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number184
Policy instance 1
Insurance contract or identification number184
Number of Individuals Covered49
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $156,030
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number2918
Policy instance 2
Insurance contract or identification number2918
Number of Individuals Covered344
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid in cash?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number185
Policy instance 3
Insurance contract or identification number185
Number of Individuals Covered304
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,631
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid as a credit?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,631
Insurance broker organization code?3
Insurance broker nameGROUP PLAN ADMINISTRATOR
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number2918
Policy instance 2
Insurance contract or identification number2918
Number of Individuals Covered371
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid in cash?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number185
Policy instance 3
Insurance contract or identification number185
Number of Individuals Covered353
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $2,889
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,889
Insurance broker organization code?3
Insurance broker nameGROUP PLAN ADMINISTRATOR
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number184/12
Policy instance 1
Insurance contract or identification number184/12
Number of Individuals Covered57
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $152,818
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract numberGL-20592-100
Policy instance 4
Insurance contract or identification numberGL-20592-100
Number of Individuals Covered141
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $1,380
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $30,443
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,380
Insurance broker organization code?3
Insurance broker nameGROUP PLAN ADMINISTRATORS
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract numberGL-20592-100
Policy instance 4
Insurance contract or identification numberGL-20592-100
Number of Individuals Covered161
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $1,503
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $31,845
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number185
Policy instance 3
Insurance contract or identification number185
Number of Individuals Covered425
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $2,876
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number2918
Policy instance 2
Insurance contract or identification number2918
Number of Individuals Covered409
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid in cash?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number184/12
Policy instance 1
Insurance contract or identification number184/12
Number of Individuals Covered57
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $148,642
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract numberGL-20592-100
Policy instance 4
Insurance contract or identification numberGL-20592-100
Number of Individuals Covered158
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $1,293
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $25,526
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number2918
Policy instance 2
Insurance contract or identification number2918
Number of Individuals Covered338
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Were dividends or retroactive rate refunds paid in cash?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HAWAII DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number185
Policy instance 3
Insurance contract or identification number185
Number of Individuals Covered361
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,986
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number184/12
Policy instance 1
Insurance contract or identification number184/12
Number of Individuals Covered50
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $99,710
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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