UNITE HERE HEALTH has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan UNITE HERE HEALTH STAFF WELFARE PLAN
| Measure | Date | Value |
|---|
| 2023 : UNITE HERE HEALTH STAFF WELFARE PLAN 2023 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-03-31 | $1,194,506 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-03-31 | $850,101 |
| Total income from all sources (including contributions) | 2023-03-31 | $8,338,588 |
| Total of all expenses incurred | 2023-03-31 | $8,682,993 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2023-03-31 | $8,617,601 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2023-03-31 | $8,338,588 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2023-03-31 | $65,392 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2023-03-31 | No |
| Was this plan covered by a fidelity bond | 2023-03-31 | Yes |
| Value of fidelity bond cover | 2023-03-31 | $5,000,000 |
| If this is an individual account plan, was there a blackout period | 2023-03-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2023-03-31 | No |
| Contributions received from participants | 2023-03-31 | $450,017 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2023-03-31 | $6,670,793 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-03-31 | No |
| Value of net income/loss | 2023-03-31 | $-344,405 |
| Value of net assets at end of year (total assets less liabilities) | 2023-03-31 | $-1,194,506 |
| Value of net assets at beginning of year (total assets less liabilities) | 2023-03-31 | $-850,101 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2023-03-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2023-03-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2023-03-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2023-03-31 | $1,946,808 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2023-03-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2023-03-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2023-03-31 | No |
| Contributions received in cash from employer | 2023-03-31 | $7,888,571 |
| Contract administrator fees | 2023-03-31 | $65,392 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2023-03-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2023-03-31 | $1,194,506 |
| Liabilities. Value of benefit claims payable at beginning of year | 2023-03-31 | $850,101 |
| Did the plan have assets held for investment | 2023-03-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2023-03-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2023-03-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2023-03-31 | Unqualified |
| Accountancy firm name | 2023-03-31 | MACNELL ACCOUNTING & CONSULTING,LLP |
| Accountancy firm EIN | 2023-03-31 | 300510353 |
| 2022 : UNITE HERE HEALTH STAFF WELFARE PLAN 2022 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-03-31 | $850,101 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-03-31 | $1,023,869 |
| Total income from all sources (including contributions) | 2022-03-31 | $6,692,773 |
| Total of all expenses incurred | 2022-03-31 | $6,519,005 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-03-31 | $6,423,846 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-03-31 | $6,692,773 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-03-31 | $95,159 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-03-31 | No |
| Was this plan covered by a fidelity bond | 2022-03-31 | Yes |
| Value of fidelity bond cover | 2022-03-31 | $5,000,000 |
| If this is an individual account plan, was there a blackout period | 2022-03-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2022-03-31 | No |
| Contributions received from participants | 2022-03-31 | $576,171 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2022-03-31 | $4,438,322 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-03-31 | No |
| Value of net income/loss | 2022-03-31 | $173,768 |
| Value of net assets at end of year (total assets less liabilities) | 2022-03-31 | $-850,101 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-03-31 | $-1,023,869 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-03-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-03-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-03-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-03-31 | $1,985,524 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-03-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2022-03-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-03-31 | No |
| Contributions received in cash from employer | 2022-03-31 | $6,116,602 |
| Contract administrator fees | 2022-03-31 | $95,159 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2022-03-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2022-03-31 | $850,101 |
| Liabilities. Value of benefit claims payable at beginning of year | 2022-03-31 | $1,023,869 |
| Did the plan have assets held for investment | 2022-03-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-03-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-03-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2022-03-31 | Unqualified |
| Accountancy firm name | 2022-03-31 | MACNELL ACCOUNTING & CONSULTING,LLP |
| Accountancy firm EIN | 2022-03-31 | 300510353 |
| 2021 : UNITE HERE HEALTH STAFF WELFARE PLAN 2021 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-03-31 | $1,023,869 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-03-31 | $793,762 |
| Total income from all sources (including contributions) | 2021-03-31 | $7,454,540 |
| Total of all expenses incurred | 2021-03-31 | $7,684,647 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-03-31 | $7,583,886 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-03-31 | $7,454,540 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-03-31 | $100,761 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-03-31 | No |
| Was this plan covered by a fidelity bond | 2021-03-31 | Yes |
| Value of fidelity bond cover | 2021-03-31 | $5,000,000 |
| If this is an individual account plan, was there a blackout period | 2021-03-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2021-03-31 | No |
| Contributions received from participants | 2021-03-31 | $502,229 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2021-03-31 | $6,028,309 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-03-31 | No |
| Value of net income/loss | 2021-03-31 | $-230,107 |
| Value of net assets at end of year (total assets less liabilities) | 2021-03-31 | $-1,023,869 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-03-31 | $-793,762 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-03-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-03-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-03-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-03-31 | $1,555,577 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-03-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2021-03-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-03-31 | No |
| Contributions received in cash from employer | 2021-03-31 | $6,952,311 |
| Contract administrator fees | 2021-03-31 | $100,761 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2021-03-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2021-03-31 | $1,023,869 |
| Liabilities. Value of benefit claims payable at beginning of year | 2021-03-31 | $793,762 |
| Did the plan have assets held for investment | 2021-03-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-03-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-03-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2021-03-31 | Unqualified |
| Accountancy firm name | 2021-03-31 | MACNELL ACCOUNTING & CONSULTING,LLP |
| Accountancy firm EIN | 2021-03-31 | 300510353 |
| 2020 : UNITE HERE HEALTH STAFF WELFARE PLAN 2020 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-03-31 | $793,762 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-03-31 | $764,245 |
| Total income from all sources (including contributions) | 2020-03-31 | $7,702,520 |
| Total of all expenses incurred | 2020-03-31 | $7,732,037 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-03-31 | $7,629,765 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-03-31 | $7,702,520 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-03-31 | $102,272 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-03-31 | No |
| Was this plan covered by a fidelity bond | 2020-03-31 | Yes |
| Value of fidelity bond cover | 2020-03-31 | $5,000,000 |
| If this is an individual account plan, was there a blackout period | 2020-03-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-03-31 | No |
| Contributions received from participants | 2020-03-31 | $518,252 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2020-03-31 | $5,876,318 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-03-31 | No |
| Value of net income/loss | 2020-03-31 | $-29,517 |
| Value of net assets at end of year (total assets less liabilities) | 2020-03-31 | $-793,762 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-03-31 | $-764,245 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-03-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-03-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-03-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-03-31 | $1,753,447 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-03-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2020-03-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-03-31 | No |
| Contributions received in cash from employer | 2020-03-31 | $7,184,268 |
| Contract administrator fees | 2020-03-31 | $102,272 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2020-03-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2020-03-31 | $793,762 |
| Liabilities. Value of benefit claims payable at beginning of year | 2020-03-31 | $764,245 |
| Did the plan have assets held for investment | 2020-03-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-03-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-03-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2020-03-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2020-03-31 | Unqualified |
| Accountancy firm name | 2020-03-31 | MACNELL ACCOUNTING & CONSULTING,LLP |
| Accountancy firm EIN | 2020-03-31 | 300510353 |
| 2019 : UNITE HERE HEALTH STAFF WELFARE PLAN 2019 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-03-31 | $764,245 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-03-31 | $773,846 |
| Total income from all sources (including contributions) | 2019-03-31 | $7,162,945 |
| Total of all expenses incurred | 2019-03-31 | $7,153,344 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-03-31 | $7,061,070 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-03-31 | $7,162,945 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-03-31 | $92,274 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-03-31 | No |
| Was this plan covered by a fidelity bond | 2019-03-31 | Yes |
| Value of fidelity bond cover | 2019-03-31 | $5,000,000 |
| If this is an individual account plan, was there a blackout period | 2019-03-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-03-31 | No |
| Contributions received from participants | 2019-03-31 | $506,492 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2019-03-31 | $5,241,458 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-03-31 | No |
| Value of net income/loss | 2019-03-31 | $9,601 |
| Value of net assets at end of year (total assets less liabilities) | 2019-03-31 | $-764,245 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-03-31 | $-773,846 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-03-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-03-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-03-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-03-31 | $1,819,612 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-03-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2019-03-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-03-31 | No |
| Contributions received in cash from employer | 2019-03-31 | $6,656,453 |
| Contract administrator fees | 2019-03-31 | $92,274 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2019-03-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2019-03-31 | $764,245 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-03-31 | $773,846 |
| Did the plan have assets held for investment | 2019-03-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-03-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-03-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-03-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-03-31 | Unqualified |
| Accountancy firm name | 2019-03-31 | MACNELL ACCOUNTING & CONSULTING,LLP |
| Accountancy firm EIN | 2019-03-31 | 300510353 |
| 2018 : UNITE HERE HEALTH STAFF WELFARE PLAN 2018 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-03-31 | $773,846 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-03-31 | $945,466 |
| Total income from all sources (including contributions) | 2018-03-31 | $7,548,373 |
| Total of all expenses incurred | 2018-03-31 | $7,376,753 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-03-31 | $7,287,679 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-03-31 | $7,548,373 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-03-31 | $89,074 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-03-31 | No |
| Was this plan covered by a fidelity bond | 2018-03-31 | Yes |
| Value of fidelity bond cover | 2018-03-31 | $5,000,000 |
| If this is an individual account plan, was there a blackout period | 2018-03-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-03-31 | No |
| Contributions received from participants | 2018-03-31 | $562,265 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2018-03-31 | $5,505,492 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-03-31 | No |
| Value of net income/loss | 2018-03-31 | $171,620 |
| Value of net assets at end of year (total assets less liabilities) | 2018-03-31 | $-773,846 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-03-31 | $-945,466 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-03-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-03-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-03-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-03-31 | $1,782,187 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-03-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2018-03-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-03-31 | No |
| Contributions received in cash from employer | 2018-03-31 | $6,986,108 |
| Contract administrator fees | 2018-03-31 | $89,074 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2018-03-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2018-03-31 | $773,846 |
| Liabilities. Value of benefit claims payable at beginning of year | 2018-03-31 | $945,466 |
| Did the plan have assets held for investment | 2018-03-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-03-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-03-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-03-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-03-31 | Unqualified |
| Accountancy firm name | 2018-03-31 | MACNELL ACCOUNTING & CONSULTING,LLP |
| Accountancy firm EIN | 2018-03-31 | 300510353 |
| 2017 : UNITE HERE HEALTH STAFF WELFARE PLAN 2017 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-03-31 | $945,466 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-03-31 | $1,046,553 |
| Total income from all sources (including contributions) | 2017-03-31 | $6,924,475 |
| Total of all expenses incurred | 2017-03-31 | $6,823,388 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-03-31 | $6,739,669 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-03-31 | $6,924,475 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-03-31 | $83,719 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-03-31 | No |
| Was this plan covered by a fidelity bond | 2017-03-31 | Yes |
| Value of fidelity bond cover | 2017-03-31 | $5,000,000 |
| If this is an individual account plan, was there a blackout period | 2017-03-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-03-31 | No |
| Contributions received from participants | 2017-03-31 | $540,488 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2017-03-31 | $4,993,397 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-03-31 | No |
| Value of net income/loss | 2017-03-31 | $101,087 |
| Value of net assets at end of year (total assets less liabilities) | 2017-03-31 | $-945,466 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-03-31 | $-1,046,553 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-03-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-03-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-03-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-03-31 | $1,746,272 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-03-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2017-03-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-03-31 | No |
| Contributions received in cash from employer | 2017-03-31 | $6,383,987 |
| Contract administrator fees | 2017-03-31 | $83,719 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2017-03-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2017-03-31 | $945,466 |
| Liabilities. Value of benefit claims payable at beginning of year | 2017-03-31 | $1,046,553 |
| Did the plan have assets held for investment | 2017-03-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-03-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-03-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-03-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-03-31 | Unqualified |
| Accountancy firm name | 2017-03-31 | MACNELL ACCOUNTING & CONSULTING,LLP |
| Accountancy firm EIN | 2017-03-31 | 300510353 |
| 2016 : UNITE HERE HEALTH STAFF WELFARE PLAN 2016 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-03-31 | $1,046,553 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-03-31 | $793,212 |
| Total income from all sources (including contributions) | 2016-03-31 | $6,466,934 |
| Total of all expenses incurred | 2016-03-31 | $6,720,275 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-03-31 | $6,623,374 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-03-31 | $6,466,934 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-03-31 | $96,901 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-03-31 | No |
| Was this plan covered by a fidelity bond | 2016-03-31 | Yes |
| Value of fidelity bond cover | 2016-03-31 | $5,000,000 |
| If this is an individual account plan, was there a blackout period | 2016-03-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-03-31 | No |
| Contributions received from participants | 2016-03-31 | $497,208 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2016-03-31 | $4,668,363 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-03-31 | No |
| Value of net income/loss | 2016-03-31 | $-253,341 |
| Value of net assets at end of year (total assets less liabilities) | 2016-03-31 | $-1,046,553 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-03-31 | $-793,212 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-03-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-03-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-03-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-03-31 | $1,955,011 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-03-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2016-03-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-03-31 | No |
| Contributions received in cash from employer | 2016-03-31 | $5,969,726 |
| Contract administrator fees | 2016-03-31 | $96,901 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2016-03-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2016-03-31 | $1,046,553 |
| Liabilities. Value of benefit claims payable at beginning of year | 2016-03-31 | $793,212 |
| Did the plan have assets held for investment | 2016-03-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-03-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-03-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-03-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-03-31 | Unqualified |
| Accountancy firm name | 2016-03-31 | MACNELL ACCOUNTING & CONSULTING,LLP |
| Accountancy firm EIN | 2016-03-31 | 300510353 |
| 2015 : UNITE HERE HEALTH STAFF WELFARE PLAN 2015 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-03-31 | $793,212 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-03-31 | $558,748 |
| Total income from all sources (including contributions) | 2015-03-31 | $5,861,759 |
| Total of all expenses incurred | 2015-03-31 | $6,096,223 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-03-31 | $6,012,787 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-03-31 | $5,861,759 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-03-31 | $83,436 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-03-31 | No |
| Was this plan covered by a fidelity bond | 2015-03-31 | Yes |
| Value of fidelity bond cover | 2015-03-31 | $5,000,000 |
| If this is an individual account plan, was there a blackout period | 2015-03-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-03-31 | No |
| Contributions received from participants | 2015-03-31 | $466,698 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2015-03-31 | $4,041,027 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-03-31 | No |
| Value of net income/loss | 2015-03-31 | $-234,464 |
| Value of net assets at end of year (total assets less liabilities) | 2015-03-31 | $-793,212 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-03-31 | $-558,748 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-03-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-03-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-03-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-03-31 | $1,971,760 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-03-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2015-03-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-03-31 | No |
| Contributions received in cash from employer | 2015-03-31 | $5,395,061 |
| Contract administrator fees | 2015-03-31 | $83,436 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2015-03-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2015-03-31 | $793,212 |
| Liabilities. Value of benefit claims payable at beginning of year | 2015-03-31 | $558,748 |
| Did the plan have assets held for investment | 2015-03-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-03-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-03-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-03-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-03-31 | Unqualified |
| Accountancy firm name | 2015-03-31 | MACNELL ACCOUNTING & CONSULTING,LLP |
| Accountancy firm EIN | 2015-03-31 | 300510353 |
| 2014 : UNITE HERE HEALTH STAFF WELFARE PLAN 2014 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-03-31 | $558,748 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-03-31 | $470,986 |
| Total income from all sources (including contributions) | 2014-03-31 | $4,565,318 |
| Total of all expenses incurred | 2014-03-31 | $4,653,080 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-03-31 | $4,589,524 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-03-31 | $4,565,318 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-03-31 | $63,556 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-03-31 | No |
| Was this plan covered by a fidelity bond | 2014-03-31 | Yes |
| Value of fidelity bond cover | 2014-03-31 | $5,000,000 |
| If this is an individual account plan, was there a blackout period | 2014-03-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-03-31 | No |
| Contributions received from participants | 2014-03-31 | $393,268 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2014-03-31 | $2,770,415 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-03-31 | No |
| Value of net income/loss | 2014-03-31 | $-87,762 |
| Value of net assets at end of year (total assets less liabilities) | 2014-03-31 | $-558,748 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-03-31 | $-470,986 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-03-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-03-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-03-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-03-31 | $1,819,109 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-03-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2014-03-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-03-31 | No |
| Contributions received in cash from employer | 2014-03-31 | $4,172,050 |
| Contract administrator fees | 2014-03-31 | $63,556 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2014-03-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2014-03-31 | $558,748 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-03-31 | $470,986 |
| Did the plan have assets held for investment | 2014-03-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-03-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-03-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-03-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-03-31 | Unqualified |
| Accountancy firm name | 2014-03-31 | MACNELL ACCOUNTING & CONSULTING,LLP |
| Accountancy firm EIN | 2014-03-31 | 300510353 |
| 2013 : UNITE HERE HEALTH STAFF WELFARE PLAN 2013 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-03-31 | $470,986 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-03-31 | $449,365 |
| Total income from all sources (including contributions) | 2013-03-31 | $4,080,854 |
| Total of all expenses incurred | 2013-03-31 | $4,102,475 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-03-31 | $4,045,744 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-03-31 | $4,080,854 |
| Value of total assets at end of year | 2013-03-31 | $0 |
| Value of total assets at beginning of year | 2013-03-31 | $0 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-03-31 | $56,731 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-03-31 | No |
| Was this plan covered by a fidelity bond | 2013-03-31 | Yes |
| Value of fidelity bond cover | 2013-03-31 | $5,000,000 |
| If this is an individual account plan, was there a blackout period | 2013-03-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-03-31 | No |
| Contributions received from participants | 2013-03-31 | $351,908 |
| Assets. Other investments not covered elsewhere at end of year | 2013-03-31 | $0 |
| Assets. Other investments not covered elsewhere at beginning of year | 2013-03-31 | $0 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2013-03-31 | $2,374,421 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-03-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-03-31 | $0 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-03-31 | No |
| Value of net income/loss | 2013-03-31 | $-21,621 |
| Value of net assets at end of year (total assets less liabilities) | 2013-03-31 | $-470,986 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-03-31 | $-449,365 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-03-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-03-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-03-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-03-31 | $1,671,323 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-03-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2013-03-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-03-31 | No |
| Contributions received in cash from employer | 2013-03-31 | $3,728,946 |
| Contract administrator fees | 2013-03-31 | $56,731 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2013-03-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2013-03-31 | $470,986 |
| Liabilities. Value of benefit claims payable at beginning of year | 2013-03-31 | $449,365 |
| Did the plan have assets held for investment | 2013-03-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-03-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-03-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-03-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-03-31 | Unqualified |
| Accountancy firm name | 2013-03-31 | MACNELL ACCOUNTING & CONSULTING,LLP |
| Accountancy firm EIN | 2013-03-31 | 300510353 |
| 2012 : UNITE HERE HEALTH STAFF WELFARE PLAN 2012 401k financial data |
|---|
| Unrealized appreciation/depreciation of real estate assets | 2012-03-31 | $0 |
| Unrealized appreciation/depreciation of other (non real estate) assets | 2012-03-31 | $0 |
| Total unrealized appreciation/depreciation of assets | 2012-03-31 | $0 |
| Total transfer of assets to this plan | 2012-03-31 | $0 |
| Total transfer of assets from this plan | 2012-03-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-03-31 | $449,365 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-03-31 | $336,734 |
| Expenses. Interest paid | 2012-03-31 | $0 |
| Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102 | 2012-03-31 | $0 |
| Total income from all sources (including contributions) | 2012-03-31 | $3,628,366 |
| Total loss/gain on sale of assets | 2012-03-31 | $0 |
| Total of all expenses incurred | 2012-03-31 | $3,740,997 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-03-31 | $3,692,527 |
| Expenses. Certain deemed distributions of participant loans | 2012-03-31 | $0 |
| Value of total corrective distributions | 2012-03-31 | $0 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-03-31 | $3,628,366 |
| Value of total assets at end of year | 2012-03-31 | $0 |
| Value of total assets at beginning of year | 2012-03-31 | $0 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-03-31 | $48,470 |
| Total income from rents | 2012-03-31 | $0 |
| Total interest from all sources | 2012-03-31 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2012-03-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-03-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2012-03-31 | $0 |
| Administrative expenses professional fees incurred | 2012-03-31 | $0 |
| Was this plan covered by a fidelity bond | 2012-03-31 | Yes |
| Value of fidelity bond cover | 2012-03-31 | $5,000,000 |
| If this is an individual account plan, was there a blackout period | 2012-03-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-03-31 | No |
| Contributions received from participants | 2012-03-31 | $315,089 |
| Participant contributions at end of year | 2012-03-31 | $0 |
| Participant contributions at beginning of year | 2012-03-31 | $0 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2012-03-31 | $0 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2012-03-31 | $2,230,538 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-03-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-03-31 | $0 |
| Liabilities. Value of operating payables at end of year | 2012-03-31 | $0 |
| Liabilities. Value of operating payables at beginning of year | 2012-03-31 | $0 |
| Total non interest bearing cash at end of year | 2012-03-31 | $0 |
| Total non interest bearing cash at beginning of year | 2012-03-31 | $0 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-03-31 | No |
| Income. Non cash contributions | 2012-03-31 | $0 |
| Value of net income/loss | 2012-03-31 | $-112,631 |
| Value of net assets at end of year (total assets less liabilities) | 2012-03-31 | $-449,365 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-03-31 | $-336,734 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-03-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-03-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-03-31 | No |
| Investment advisory and management fees | 2012-03-31 | $0 |
| Interest on participant loans | 2012-03-31 | $0 |
| Income. Interest from loans (other than to participants) | 2012-03-31 | $0 |
| Interest earned on other investments | 2012-03-31 | $0 |
| Income. Interest from US Government securities | 2012-03-31 | $0 |
| Income. Interest from corporate debt instruments | 2012-03-31 | $0 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-03-31 | $0 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-03-31 | $1,461,989 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2012-03-31 | $0 |
| Net investment gain/loss from pooled separate accounts | 2012-03-31 | $0 |
| Net investment gain or loss from common/collective trusts | 2012-03-31 | $0 |
| Net gain/loss from 103.12 investment entities | 2012-03-31 | $0 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-03-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2012-03-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-03-31 | No |
| Contributions received in cash from employer | 2012-03-31 | $3,313,277 |
| Employer contributions (assets) at end of year | 2012-03-31 | $0 |
| Employer contributions (assets) at beginning of year | 2012-03-31 | $0 |
| Income. Dividends from preferred stock | 2012-03-31 | $0 |
| Income. Dividends from common stock | 2012-03-31 | $0 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-03-31 | $0 |
| Contract administrator fees | 2012-03-31 | $48,470 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2012-03-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2012-03-31 | $449,365 |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-03-31 | $336,734 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2012-03-31 | $0 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2012-03-31 | $0 |
| Did the plan have assets held for investment | 2012-03-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-03-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-03-31 | No |
| Aggregate proceeds on sale of assets | 2012-03-31 | $0 |
| Aggregate carrying amount (costs) on sale of assets | 2012-03-31 | $0 |
| Liabilities. Value of acquisition indebtedness at end of year | 2012-03-31 | $0 |
| Liabilities. Value of acquisition indebtedness at beginning of year | 2012-03-31 | $0 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-03-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-03-31 | Unqualified |
| Accountancy firm name | 2012-03-31 | MACNELL ACCOUNTING & CONSULTING,LLP |
| Accountancy firm EIN | 2012-03-31 | 300510353 |
| 2011 : UNITE HERE HEALTH STAFF WELFARE PLAN 2011 401k financial data |
|---|
| Unrealized appreciation/depreciation of real estate assets | 2011-03-31 | $0 |
| Unrealized appreciation/depreciation of other (non real estate) assets | 2011-03-31 | $0 |
| Total unrealized appreciation/depreciation of assets | 2011-03-31 | $0 |
| Total transfer of assets to this plan | 2011-03-31 | $0 |
| Total transfer of assets from this plan | 2011-03-31 | $0 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-03-31 | $336,734 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-03-31 | $323,233 |
| Expenses. Interest paid | 2011-03-31 | $0 |
| Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102 | 2011-03-31 | $0 |
| Total income from all sources (including contributions) | 2011-03-31 | $3,043,082 |
| Total loss/gain on sale of assets | 2011-03-31 | $0 |
| Total of all expenses incurred | 2011-03-31 | $3,056,583 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-03-31 | $3,013,849 |
| Expenses. Certain deemed distributions of participant loans | 2011-03-31 | $0 |
| Value of total corrective distributions | 2011-03-31 | $0 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-03-31 | $3,043,082 |
| Value of total assets at end of year | 2011-03-31 | $0 |
| Value of total assets at beginning of year | 2011-03-31 | $0 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-03-31 | $42,734 |
| Total income from rents | 2011-03-31 | $0 |
| Total interest from all sources | 2011-03-31 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2011-03-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-03-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2011-03-31 | $0 |
| Assets. Real estate other than employer real property at end of year | 2011-03-31 | $0 |
| Assets. Real estate other than employer real property at beginning of year | 2011-03-31 | $0 |
| Administrative expenses professional fees incurred | 2011-03-31 | $0 |
| Assets. Corporate prefeered stocks other than exployer securities at end of year | 2011-03-31 | $0 |
| Assets. Corporate prefeered stocks other than exployer securities at beginning of year | 2011-03-31 | $0 |
| Was this plan covered by a fidelity bond | 2011-03-31 | Yes |
| Value of fidelity bond cover | 2011-03-31 | $5,000,000 |
| If this is an individual account plan, was there a blackout period | 2011-03-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-03-31 | No |
| Contributions received from participants | 2011-03-31 | $316,794 |
| Participant contributions at end of year | 2011-03-31 | $0 |
| Participant contributions at beginning of year | 2011-03-31 | $0 |
| Participant contributions at end of year | 2011-03-31 | $0 |
| Participant contributions at beginning of year | 2011-03-31 | $0 |
| Assets. Other investments not covered elsewhere at end of year | 2011-03-31 | $0 |
| Assets. Other investments not covered elsewhere at beginning of year | 2011-03-31 | $0 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2011-03-31 | $0 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2011-03-31 | $1,646,276 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-03-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-03-31 | $0 |
| Assets. Loans (other than to participants) at end of year | 2011-03-31 | $0 |
| Assets. Loans (other than to participants) at beginning of year | 2011-03-31 | $0 |
| Liabilities. Value of operating payables at end of year | 2011-03-31 | $0 |
| Liabilities. Value of operating payables at beginning of year | 2011-03-31 | $0 |
| Total non interest bearing cash at end of year | 2011-03-31 | $0 |
| Total non interest bearing cash at beginning of year | 2011-03-31 | $0 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-03-31 | No |
| Income. Non cash contributions | 2011-03-31 | $0 |
| Value of net income/loss | 2011-03-31 | $-13,501 |
| Value of net assets at end of year (total assets less liabilities) | 2011-03-31 | $-336,734 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-03-31 | $-323,233 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-03-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-03-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-03-31 | No |
| Assets. partnership/joint venture interests at end of year | 2011-03-31 | $0 |
| Assets. partnership/joint venture interests at beginning of year | 2011-03-31 | $0 |
| Investment advisory and management fees | 2011-03-31 | $0 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2011-03-31 | $0 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2011-03-31 | $0 |
| Value of interest in pooled separate accounts at end of year | 2011-03-31 | $0 |
| Value of interest in pooled separate accounts at beginning of year | 2011-03-31 | $0 |
| Interest on participant loans | 2011-03-31 | $0 |
| Income. Interest from loans (other than to participants) | 2011-03-31 | $0 |
| Interest earned on other investments | 2011-03-31 | $0 |
| Income. Interest from US Government securities | 2011-03-31 | $0 |
| Income. Interest from corporate debt instruments | 2011-03-31 | $0 |
| Value of interest in master investment trust accounts at end of year | 2011-03-31 | $0 |
| Value of interest in master investment trust accounts at beginning of year | 2011-03-31 | $0 |
| Value of interest in common/collective trusts at end of year | 2011-03-31 | $0 |
| Value of interest in common/collective trusts at beginning of year | 2011-03-31 | $0 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-03-31 | $0 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-03-31 | $0 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-03-31 | $0 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-03-31 | $0 |
| Assets. Value of investments in 103.12 investment entities at end of year | 2011-03-31 | $0 |
| Assets. Value of investments in 103.12 investment entities at beginning of year | 2011-03-31 | $0 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2011-03-31 | $0 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2011-03-31 | $0 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-03-31 | $1,367,573 |
| Asset value of US Government securities at end of year | 2011-03-31 | $0 |
| Asset value of US Government securities at beginning of year | 2011-03-31 | $0 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2011-03-31 | $0 |
| Net investment gain/loss from pooled separate accounts | 2011-03-31 | $0 |
| Net investment gain or loss from common/collective trusts | 2011-03-31 | $0 |
| Net gain/loss from 103.12 investment entities | 2011-03-31 | $0 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-03-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2011-03-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-03-31 | No |
| Assets. Invements in employer securities at end of year | 2011-03-31 | $0 |
| Assets. Invements in employer securities at beginning of year | 2011-03-31 | $0 |
| Assets. Value of employer real property at end of year | 2011-03-31 | $0 |
| Assets. Value of employer real property at beginning of year | 2011-03-31 | $0 |
| Contributions received in cash from employer | 2011-03-31 | $2,726,288 |
| Employer contributions (assets) at end of year | 2011-03-31 | $0 |
| Employer contributions (assets) at beginning of year | 2011-03-31 | $0 |
| Income. Dividends from preferred stock | 2011-03-31 | $0 |
| Income. Dividends from common stock | 2011-03-31 | $0 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-03-31 | $0 |
| Asset. Corporate debt instrument preferred debt at end of year | 2011-03-31 | $0 |
| Asset. Corporate debt instrument preferred debt at beginning of year | 2011-03-31 | $0 |
| Asset. Corporate debt instrument debt (other) at end of year | 2011-03-31 | $0 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2011-03-31 | $0 |
| Contract administrator fees | 2011-03-31 | $42,734 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2011-03-31 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2011-03-31 | $0 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2011-03-31 | $0 |
| Liabilities. Value of benefit claims payable at end of year | 2011-03-31 | $336,734 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-03-31 | $323,233 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2011-03-31 | $0 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2011-03-31 | $0 |
| Did the plan have assets held for investment | 2011-03-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-03-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-03-31 | No |
| Aggregate proceeds on sale of assets | 2011-03-31 | $0 |
| Aggregate carrying amount (costs) on sale of assets | 2011-03-31 | $0 |
| Liabilities. Value of acquisition indebtedness at end of year | 2011-03-31 | $0 |
| Liabilities. Value of acquisition indebtedness at beginning of year | 2011-03-31 | $0 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-03-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-03-31 | Unqualified |
| Accountancy firm name | 2011-03-31 | MACNELL ACCOUNTING & CONSULTING,LLP |
| Accountancy firm EIN | 2011-03-31 | 300510353 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
| Policy contract number | 30061977 |
| Policy instance | 5 |
| Insurance contract or identification number | 30061977 | | Number of Individuals Covered | 387 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $1,249 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $41,780 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,249 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00579087 |
| Policy instance | 12 |
| Insurance contract or identification number | 00579087 | | Number of Individuals Covered | 383 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $44,794 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $447,941 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $44,794 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F019003 |
| Policy instance | 1 |
| Insurance contract or identification number | F019003 | | Number of Individuals Covered | 382 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $140,290 | | 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 number | 100600 |
| Policy instance | 2 |
| Insurance contract or identification number | 100600 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $45,892 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 262001 |
| Policy instance | 3 |
| Insurance contract or identification number | 262001 | | Number of Individuals Covered | 160 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,040,811 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 5931517 |
| Policy instance | 4 |
| Insurance contract or identification number | 5931517 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $59 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 59 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 6 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 319 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $10,181 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $67,872 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,181 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 11 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | NEW YORK PAID FAMILY LEAVE | | Welfare Benefit Premiums Paid to Carrier | USD $1,600 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 7 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 62 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $7,109 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | LONG-TERM DISABILITY BUY UP | | Welfare Benefit Premiums Paid to Carrier | USD $47,393 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,109 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 8 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 353 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $10,555 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $70,365 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,555 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 9 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $51 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | NEW YORK DBL | | Welfare Benefit Premiums Paid to Carrier | USD $344 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $51 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 10 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 21 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $1,751 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | NEW JERSEY TDB | | Welfare Benefit Premiums Paid to Carrier | USD $11,673 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,751 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 5931517 |
| Policy instance | 4 |
| Insurance contract or identification number | 5931517 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $9,486 | | Total amount of fees paid to insurance company | USD $1,487 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $-811 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,486 | | Amount paid for insurance broker fees | 45 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 262001 |
| Policy instance | 3 |
| Insurance contract or identification number | 262001 | | Number of Individuals Covered | 184 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,072,633 | | 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 number | 100600 |
| Policy instance | 2 |
| Insurance contract or identification number | 100600 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $95,314 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F019003 |
| Policy instance | 1 |
| Insurance contract or identification number | F019003 | | Number of Individuals Covered | 360 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $92,928 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 10 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 23 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,644 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | NEW JERSEY TDB | | Welfare Benefit Premiums Paid to Carrier | USD $10,961 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,644 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
| Policy contract number | 30061977 |
| Policy instance | 5 |
| Insurance contract or identification number | 30061977 | | Number of Individuals Covered | 367 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,051 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $39,146 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,051 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 6 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 303 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $9,483 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $63,221 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,483 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 7 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 56 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $6,265 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | LONG-TERM DISABILITY BUY UP | | Welfare Benefit Premiums Paid to Carrier | USD $41,764 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,265 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 8 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 328 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $10,493 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $69,956 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,493 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 9 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $61 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | NEW YORK DBL | | Welfare Benefit Premiums Paid to Carrier | USD $405 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $61 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 11 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | NEW YORK PAID FAMILY LEAVE | | Welfare Benefit Premiums Paid to Carrier | USD $1,637 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00579087 |
| Policy instance | 12 |
| Insurance contract or identification number | 00579087 | | Number of Individuals Covered | 362 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $50,985 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $509,845 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $50,985 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 5931517 |
| Policy instance | 4 |
| Insurance contract or identification number | 5931517 | | Number of Individuals Covered | 915 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $60,548 | | Total amount of fees paid to insurance company | USD $9,134 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $597,276 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $60,548 | | Amount paid for insurance broker fees | 21 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 262001 |
| Policy instance | 3 |
| Insurance contract or identification number | 262001 | | Number of Individuals Covered | 187 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,198,380 | | 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 number | 100600 |
| Policy instance | 2 |
| Insurance contract or identification number | 100600 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $142,514 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F019003 |
| Policy instance | 1 |
| Insurance contract or identification number | F019003 | | Number of Individuals Covered | 367 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $101,933 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
| Policy contract number | 30061977 |
| Policy instance | 5 |
| Insurance contract or identification number | 30061977 | | Number of Individuals Covered | 414 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $1,364 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $49,096 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,364 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 6 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 308 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $10,291 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $68,604 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,291 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 7 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 57 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $6,361 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | LONG-TERM DISABILITY BUY UP | | Welfare Benefit Premiums Paid to Carrier | USD $42,410 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,361 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 8 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 324 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $11,350 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $75,670 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,350 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 10 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 26 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $1,700 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | NEW JERSEY TDB | | Welfare Benefit Premiums Paid to Carrier | USD $11,333 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,700 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 11 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | NEW YORK PAID FAMILY LEAVE | | Welfare Benefit Premiums Paid to Carrier | USD $757 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 9 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $61 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | NEW YORK DBL | | Welfare Benefit Premiums Paid to Carrier | USD $405 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $61 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 9 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $79 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | NEW YORK DBL | | Welfare Benefit Premiums Paid to Carrier | USD $528 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $79 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 262001 |
| Policy instance | 3 |
| Insurance contract or identification number | 262001 | | Number of Individuals Covered | 210 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,255,832 | | 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 number | 100600 |
| Policy instance | 2 |
| Insurance contract or identification number | 100600 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $185,558 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F019003 |
| Policy instance | 1 |
| Insurance contract or identification number | F019003 | | Number of Individuals Covered | 447 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $110,613 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 5931517 |
| Policy instance | 4 |
| Insurance contract or identification number | 5931517 | | Number of Individuals Covered | 1057 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $56,021 | | Total amount of fees paid to insurance company | USD $7,172 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $617,932 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $56,021 | | Amount paid for insurance broker fees | 54 | | Additional information about fees paid to insurance broker | BASE COMMISSIONS AND FEES PAID | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 6 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 382 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $11,060 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $73,734 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,060 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
| Policy contract number | 30061977 |
| Policy instance | 5 |
| Insurance contract or identification number | 30061977 | | Number of Individuals Covered | 453 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $41,361 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 10 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 33 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $1,767 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | NEW JERSEY TDB | | Welfare Benefit Premiums Paid to Carrier | USD $11,779 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,767 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 7 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 65 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $6,519 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | LONG-TERM DISABILITY BUY UP | | Welfare Benefit Premiums Paid to Carrier | USD $43,457 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,519 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 8 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 395 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $12,399 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $82,660 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,399 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 11 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | NEW YORK PAID FAMILY LEAVE | | Welfare Benefit Premiums Paid to Carrier | USD $556 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F019003 |
| Policy instance | 1 |
| Insurance contract or identification number | F019003 | | Number of Individuals Covered | 448 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $106,438 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 11 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | NEW YORK PAID FAMILY LEAVE | | Welfare Benefit Premiums Paid to Carrier | USD $348 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 10 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 36 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $1,930 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | NEW JERSEY TDB | | Welfare Benefit Premiums Paid to Carrier | USD $12,864 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,930 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 9 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $62 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | NEW YORK DBL | | Welfare Benefit Premiums Paid to Carrier | USD $413 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $62 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 7 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 60 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $5,578 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | LONG-TERM DISABILITY BUY UP | | Welfare Benefit Premiums Paid to Carrier | USD $37,187 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,578 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 6 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 388 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $10,867 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $72,450 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,867 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 5931517 |
| Policy instance | 4 |
| Insurance contract or identification number | 5931517 | | Number of Individuals Covered | 1050 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $55,097 | | Total amount of fees paid to insurance company | USD $8,732 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $514,658 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $55,097 | | Amount paid for insurance broker fees | 55 | | Insurance broker organization code? | 3 |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | 262001 |
| Policy instance | 3 |
| Insurance contract or identification number | 262001 | | Number of Individuals Covered | 222 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,336,655 | | 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 number | 100600 |
| Policy instance | 2 |
| Insurance contract or identification number | 100600 | | Number of Individuals Covered | 14 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $177,657 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
| Policy contract number | 30061977 |
| Policy instance | 5 |
| Insurance contract or identification number | 30061977 | | Number of Individuals Covered | 456 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $35,815 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 60550 |
| Policy instance | 8 |
| Insurance contract or identification number | 60550 | | Number of Individuals Covered | 394 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $12,265 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $81,765 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,265 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | | Insurance broker organization code? | 3 |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
| Policy contract number | 100600 |
| Policy instance | 2 |
| Insurance contract or identification number | 100600 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $147,958 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F019003 |
| Policy instance | 1 |
| Insurance contract or identification number | F019003 | | Number of Individuals Covered | 443 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $99,134 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | B62001 |
| Policy instance | 3 |
| Insurance contract or identification number | B62001 | | Number of Individuals Covered | 226 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,297,708 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLK960703 |
| Policy instance | 4 |
| Insurance contract or identification number | FLK960703 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $21,215 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $141,435 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,051 | | Insurance broker organization code? | 3 | | Insurance broker name | HUB INTERNATIONAL |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 751278 |
| Policy instance | 5 |
| Insurance contract or identification number | LK 751278 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $11,618 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $77,456 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,019 | | Insurance broker organization code? | 3 | | Insurance broker name | HUB INTERNATIONAL |
|
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
| Policy contract number | NYDO75062 |
| Policy instance | 6 |
| Insurance contract or identification number | NYDO75062 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | STATUTORY DISABLITY | | Welfare Benefit Premiums Paid to Carrier | USD $410 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | SDJ960344 |
| Policy instance | 7 |
| Insurance contract or identification number | SDJ960344 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | STATUTORY DISABLITY | | Welfare Benefit Premiums Paid to Carrier | USD $15,713 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 5931517 |
| Policy instance | 8 |
| Insurance contract or identification number | 5931517 | | Number of Individuals Covered | 1032 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $47,673 | | Total amount of fees paid to insurance company | USD $4,630 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $457,217 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $28,557 | | Amount paid for insurance broker fees | 807 | | Additional information about fees paid to insurance broker | 772 SUPPLEMENTAL COMPENSATION AND 35 NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | HUB INTERNATIONAL |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) |
| Policy contract number | 30061977 |
| Policy instance | 9 |
| Insurance contract or identification number | 30061977 | | Number of Individuals Covered | 450 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $38,509 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | SDJ960344 |
| Policy instance | 8 |
| Insurance contract or identification number | SDJ960344 | | Number of Individuals Covered | 34 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $243 | | Other welfare benefits provided | STATUTORY DISABLITY | | Welfare Benefit Premiums Paid to Carrier | USD $14,519 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 243 | | Insurance broker organization code? | 3 | | Insurance broker name | COTTINGHAM & BUTLER |
|
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
| Policy contract number | NYDO75062 |
| Policy instance | 7 |
| Insurance contract or identification number | NYDO75062 | | Number of Individuals Covered | 13 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $23 | | Other welfare benefits provided | STATUTORY DISABLITY | | Welfare Benefit Premiums Paid to Carrier | USD $653 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 23 | | Insurance broker organization code? | 3 | | Insurance broker name | COTTINGHAM & BUTLER |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F019003 |
| Policy instance | 1 |
| Insurance contract or identification number | F019003 | | Number of Individuals Covered | 403 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $89,204 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLK960703 |
| Policy instance | 5 |
| Insurance contract or identification number | FLK960703 | | Number of Individuals Covered | 399 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $18,521 | | Total amount of fees paid to insurance company | USD $1,893 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $123,474 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,268 | | Amount paid for insurance broker fees | 1893 | | Insurance broker organization code? | 3 | | Insurance broker name | ASSURANCE AGENCY LTD |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | B62001 |
| Policy instance | 4 |
| Insurance contract or identification number | B62001 | | Number of Individuals Covered | 257 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,403,581 | | 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 number | 100600 |
| Policy instance | 3 |
| Insurance contract or identification number | 100600 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $119,826 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BCS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38245 ) |
| Policy contract number | EXL-30300 |
| Policy instance | 2 |
| Insurance contract or identification number | EXL-30300 | | Number of Individuals Covered | 283 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Welfare Benefit Premiums Paid to Carrier | USD $191,218 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 751278 |
| Policy instance | 6 |
| Insurance contract or identification number | LK 751278 | | Number of Individuals Covered | 340 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $8,564 | | Total amount of fees paid to insurance company | USD $900 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $57,093 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,647 | | Amount paid for insurance broker fees | 900 | | Insurance broker organization code? | 3 | | Insurance broker name | ASSURANCE AGENCY LTD |
|
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
| Policy contract number | NYDO75062 |
| Policy instance | 7 |
| Insurance contract or identification number | NYDO75062 | | Number of Individuals Covered | 37 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | STATUTORY DISABLITY | | Welfare Benefit Premiums Paid to Carrier | USD $1,378 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | SDJ960344 |
| Policy instance | 8 |
| Insurance contract or identification number | SDJ960344 | | Number of Individuals Covered | 33 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | STATUTORY DISABLITY | | Welfare Benefit Premiums Paid to Carrier | USD $13,838 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 751278 |
| Policy instance | 6 |
| Insurance contract or identification number | LK 751278 | | Number of Individuals Covered | 318 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $7,578 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $50,523 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,578 | | Insurance broker organization code? | 3 | | Insurance broker name | CMC ADVISORY GROUP |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | B62001 |
| Policy instance | 4 |
| Insurance contract or identification number | B62001 | | Number of Individuals Covered | 252 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,379,453 | | 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 number | 100600 |
| Policy instance | 3 |
| Insurance contract or identification number | 100600 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $121,793 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F019003 |
| Policy instance | 1 |
| Insurance contract or identification number | F019003 | | Number of Individuals Covered | 377 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $85,231 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | P14451 |
| Policy instance | 2 |
| Insurance contract or identification number | P14451 | | Number of Individuals Covered | 263 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $192,339 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLK960703 |
| Policy instance | 5 |
| Insurance contract or identification number | FLK960703 | | Number of Individuals Covered | 377 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $16,100 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $107,333 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,100 | | Insurance broker organization code? | 3 | | Insurance broker name | CMC ADVISORY GROUP |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | P14451 |
| Policy instance | 2 |
| Insurance contract or identification number | P14451 | | Number of Individuals Covered | 206 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $268,519 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F019003 |
| Policy instance | 1 |
| Insurance contract or identification number | F019003 | | Number of Individuals Covered | 312 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $65,690 | | 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 number | 100600 |
| Policy instance | 3 |
| Insurance contract or identification number | 100600 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $102,890 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | H62001 |
| Policy instance | 4 |
| Insurance contract or identification number | H62001 | | Number of Individuals Covered | 246 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,192,620 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLK960703 |
| Policy instance | 5 |
| Insurance contract or identification number | FLK960703 | | Number of Individuals Covered | 312 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $13,542 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $90,279 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,542 | | Insurance broker organization code? | 3 | | Insurance broker name | G-S CONSULTING, INC. |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 751278 |
| Policy instance | 6 |
| Insurance contract or identification number | LK 751278 | | Number of Individuals Covered | 256 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $5,834 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $38,896 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,834 | | Insurance broker organization code? | 3 | | Insurance broker name | G-S CONSULTING, INC. |
|
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
| Policy contract number | NYDO75062 |
| Policy instance | 7 |
| Insurance contract or identification number | NYDO75062 | | Number of Individuals Covered | 14 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | STATUTORY DISABLITY | | Welfare Benefit Premiums Paid to Carrier | USD $625 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | SDJ960344 |
| Policy instance | 8 |
| Insurance contract or identification number | SDJ960344 | | Number of Individuals Covered | 30 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | STATUTORY DISABLITY | | Welfare Benefit Premiums Paid to Carrier | USD $11,487 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F019003 |
| Policy instance | 2 |
| Insurance contract or identification number | F019003 | | Number of Individuals Covered | 295 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $63,691 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | P14451 |
| Policy instance | 3 |
| Insurance contract or identification number | P14451 | | Number of Individuals Covered | 200 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $223,428 | | 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 number | 100600 |
| Policy instance | 4 |
| Insurance contract or identification number | 100600 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $59,486 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | H62001 |
| Policy instance | 5 |
| Insurance contract or identification number | H62001 | | Number of Individuals Covered | 226 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,135,220 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 868124G |
| Policy instance | 1 |
| Insurance contract or identification number | 868124G | | Number of Individuals Covered | 275 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $9,231 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $157,767 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,231 | | Insurance broker organization code? | 3 | | Insurance broker name | G-S CONSULTING, INC. |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 868124G |
| Policy instance | 2 |
| Insurance contract or identification number | 868124G | | Number of Individuals Covered | 240 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $9,187 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $126,075 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | H62001 |
| Policy instance | 1 |
| Insurance contract or identification number | H62001 | | Number of Individuals Covered | 226 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,068,861 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | P14451 |
| Policy instance | 4 |
| Insurance contract or identification number | P14451 | | Number of Individuals Covered | 165 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $173,607 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F019003 |
| Policy instance | 3 |
| Insurance contract or identification number | F019003 | | Number of Individuals Covered | 253 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $54,698 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F019003 |
| Policy instance | 4 |
| Insurance contract or identification number | F019003 | | Number of Individuals Covered | 236 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $51,561 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | H62001 |
| Policy instance | 2 |
| Insurance contract or identification number | H62001 | | Number of Individuals Covered | 235 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,020,484 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 502534 |
| Policy instance | 1 |
| Insurance contract or identification number | 502534 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-01-01 | | Total amount of commissions paid to insurance broker | USD $-4 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $-87 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
| Policy contract number | P14451 |
| Policy instance | 5 |
| Insurance contract or identification number | P14451 | | Number of Individuals Covered | 147 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $138,920 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 868124G |
| Policy instance | 3 |
| Insurance contract or identification number | 868124G | | Number of Individuals Covered | 237 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $8,927 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $127,892 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
