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XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN 401k Plan overview

Plan NameXEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN
Plan identification number 505

XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Other welfare benefit cover

401k Sponsoring company profile

CONDUENT BUSINESS SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name:CONDUENT BUSINESS SERVICES, LLC
Employer identification number (EIN):320293031
NAIC Classification:561110
NAIC Description:Office Administrative Services

Additional information about CONDUENT BUSINESS SERVICES, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date: 2012-02-09
Company Identification Number: 4587044
Legal Registered Office Address: 2900 Sw Wanamaker Drive Suite 204

Topeka
United States of America (USA)
66614

More information about CONDUENT BUSINESS SERVICES, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052020-01-01
5052019-01-01
5052018-01-01
5052017-01-01JEFFREY FRIEDEL
5052016-01-01JEFFREY FRIEDEL
5052015-01-01PETER DOWD
5052014-01-01PETER DOWD
5052013-01-01ANN F. VEZINA
5052012-01-01ANN VEZINA

Financial Data on XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN

Measure Date Value
2019 : XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$25,583,563
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$22,751,057
Total income from all sources (including contributions)2019-12-31$171,662,584
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$172,231,624
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$168,931,584
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$171,632,248
Value of total assets at end of year2019-12-31$25,591,653
Value of total assets at beginning of year2019-12-31$23,328,187
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$3,300,040
Total interest from all sources2019-12-31$30,336
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$15,000,000
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$68,545,760
Participant contributions at end of year2019-12-31$0
Participant contributions at beginning of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$1,355,927
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$1,288,065
Administrative expenses (other) incurred2019-12-31$3,300,040
Liabilities. Value of operating payables at end of year2019-12-31$6,498,636
Liabilities. Value of operating payables at beginning of year2019-12-31$4,440,992
Total non interest bearing cash at end of year2019-12-31$2,098
Total non interest bearing cash at beginning of year2019-12-31$2,822,023
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$-569,040
Value of net assets at end of year (total assets less liabilities)2019-12-31$8,090
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$577,130
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Interest earned on other investments2019-12-31$30,336
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$9,190,855
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$103,086,488
Employer contributions (assets) at end of year2019-12-31$25,589,555
Employer contributions (assets) at beginning of year2019-12-31$20,506,164
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$159,740,729
Liabilities. Value of benefit claims payable at end of year2019-12-31$17,729,000
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$17,022,000
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31CHAPMAN, HEXT & CO.
Accountancy firm EIN2019-12-31752053526
2018 : XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$22,751,057
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$26,554,536
Total income from all sources (including contributions)2018-12-31$202,114,135
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$207,546,719
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$202,969,786
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$202,089,631
Value of total assets at end of year2018-12-31$23,328,187
Value of total assets at beginning of year2018-12-31$32,564,250
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$4,576,933
Total interest from all sources2018-12-31$24,504
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$15,000,000
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$76,206,873
Participant contributions at end of year2018-12-31$0
Participant contributions at beginning of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$1,288,065
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$422,911
Administrative expenses (other) incurred2018-12-31$4,576,933
Liabilities. Value of operating payables at end of year2018-12-31$4,440,992
Liabilities. Value of operating payables at beginning of year2018-12-31$4,943,625
Total non interest bearing cash at end of year2018-12-31$2,822,023
Total non interest bearing cash at beginning of year2018-12-31$1,780,882
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-5,432,584
Value of net assets at end of year (total assets less liabilities)2018-12-31$577,130
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$6,009,714
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Interest earned on other investments2018-12-31$24,504
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$10,194,566
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$125,882,758
Employer contributions (assets) at end of year2018-12-31$20,506,164
Employer contributions (assets) at beginning of year2018-12-31$30,783,368
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$192,775,220
Liabilities. Value of benefit claims payable at end of year2018-12-31$17,022,000
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$21,188,000
Did the plan have assets held for investment2018-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31CHAPMAN, HEXT & CO.
Accountancy firm EIN2018-12-31752053526
2017 : XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$26,554,536
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$31,527,055
Total income from all sources (including contributions)2017-12-31$223,319,359
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$216,416,316
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$206,769,092
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$223,297,882
Value of total assets at end of year2017-12-31$32,564,250
Value of total assets at beginning of year2017-12-31$30,633,726
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$9,647,224
Total interest from all sources2017-12-31$21,477
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$15,000,000
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$79,048,559
Participant contributions at end of year2017-12-31$0
Participant contributions at beginning of year2017-12-31$197,308
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$422,911
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$1,973,667
Administrative expenses (other) incurred2017-12-31$9,647,224
Liabilities. Value of operating payables at end of year2017-12-31$4,943,625
Liabilities. Value of operating payables at beginning of year2017-12-31$5,677,388
Total non interest bearing cash at end of year2017-12-31$1,780,882
Total non interest bearing cash at beginning of year2017-12-31$3,537,068
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$6,903,043
Value of net assets at end of year (total assets less liabilities)2017-12-31$6,009,714
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$-893,329
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Interest earned on other investments2017-12-31$21,477
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$10,438,075
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$144,249,323
Employer contributions (assets) at end of year2017-12-31$30,783,368
Employer contributions (assets) at beginning of year2017-12-31$26,899,350
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$196,331,017
Liabilities. Value of benefit claims payable at end of year2017-12-31$21,188,000
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$23,876,000
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31CHAPMAN, HEXT & CO.
Accountancy firm EIN2017-12-31752053526
2016 : XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$31,527,055
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$35,223,817
Total income from all sources (including contributions)2016-12-31$265,104,120
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$256,246,200
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$238,701,805
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$265,094,388
Value of total assets at end of year2016-12-31$30,633,726
Value of total assets at beginning of year2016-12-31$25,472,568
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$17,544,395
Total interest from all sources2016-12-31$9,732
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$15,000,000
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$83,266,973
Participant contributions at end of year2016-12-31$197,308
Participant contributions at beginning of year2016-12-31$6,299,914
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$1,973,667
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$220,719
Administrative expenses (other) incurred2016-12-31$17,544,395
Liabilities. Value of operating payables at end of year2016-12-31$5,677,388
Liabilities. Value of operating payables at beginning of year2016-12-31$9,566,098
Total non interest bearing cash at end of year2016-12-31$3,537,068
Total non interest bearing cash at beginning of year2016-12-31$4,315,948
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$8,857,920
Value of net assets at end of year (total assets less liabilities)2016-12-31$-893,329
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$-9,751,249
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Interest earned on other investments2016-12-31$9,732
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$11,796,369
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$181,827,415
Employer contributions (assets) at end of year2016-12-31$26,899,350
Employer contributions (assets) at beginning of year2016-12-31$14,856,706
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$226,905,436
Liabilities. Value of benefit claims payable at end of year2016-12-31$23,876,000
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$25,437,000
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31CHAPMAN, HEXT & CO.
Accountancy firm EIN2016-12-31752053526
2015 : XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$35,223,817
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$25,612,578
Total income from all sources (including contributions)2015-12-31$270,188,840
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$273,438,606
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$260,474,942
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$270,187,681
Value of total assets at end of year2015-12-31$25,472,568
Value of total assets at beginning of year2015-12-31$19,111,095
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$12,963,664
Total interest from all sources2015-12-31$1,159
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$15,000,000
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$92,287,409
Participant contributions at end of year2015-12-31$6,299,914
Participant contributions at beginning of year2015-12-31$1,704,293
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$220,719
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$64,852
Administrative expenses (other) incurred2015-12-31$12,963,664
Liabilities. Value of operating payables at end of year2015-12-31$9,566,098
Liabilities. Value of operating payables at beginning of year2015-12-31$942,726
Total non interest bearing cash at end of year2015-12-31$4,315,948
Total non interest bearing cash at beginning of year2015-12-31$2,662,653
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-3,249,766
Value of net assets at end of year (total assets less liabilities)2015-12-31$-9,751,249
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$-6,501,483
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Interest earned on other investments2015-12-31$1,159
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$12,471,002
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$177,900,272
Employer contributions (assets) at end of year2015-12-31$14,856,706
Employer contributions (assets) at beginning of year2015-12-31$14,744,149
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$248,003,940
Liabilities. Value of benefit claims payable at end of year2015-12-31$25,437,000
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$24,605,000
Did the plan have assets held for investment2015-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31CHAPMAN, HEXT & CO.
Accountancy firm EIN2015-12-31752053526
2014 : XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$25,612,578
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$19,679,952
Total income from all sources (including contributions)2014-12-31$266,068,994
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$266,190,436
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$258,339,940
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$266,068,302
Value of total assets at end of year2014-12-31$19,111,095
Value of total assets at beginning of year2014-12-31$13,299,911
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$7,850,496
Total interest from all sources2014-12-31$692
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$15,000,000
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$93,797,729
Participant contributions at end of year2014-12-31$1,704,293
Participant contributions at beginning of year2014-12-31$212,505
Assets. Other investments not covered elsewhere at end of year2014-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2014-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$64,852
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$64,852
Administrative expenses (other) incurred2014-12-31$7,850,496
Liabilities. Value of operating payables at end of year2014-12-31$942,726
Liabilities. Value of operating payables at beginning of year2014-12-31$2,493,100
Total non interest bearing cash at end of year2014-12-31$2,662,653
Total non interest bearing cash at beginning of year2014-12-31$3,348,663
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-121,442
Value of net assets at end of year (total assets less liabilities)2014-12-31$-6,501,483
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$-6,380,041
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Interest earned on other investments2014-12-31$692
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$12,388,794
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$172,270,573
Employer contributions (assets) at end of year2014-12-31$14,744,149
Employer contributions (assets) at beginning of year2014-12-31$9,738,743
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$245,951,146
Liabilities. Value of benefit claims payable at end of year2014-12-31$24,605,000
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$17,122,000
Did the plan have assets held for investment2014-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31CHAPMAN, HEXT & CO.
Accountancy firm EIN2014-12-31752053526
2013 : XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$19,679,952
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$16,681,068
Total income from all sources (including contributions)2013-12-31$241,353,032
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$250,370,999
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$243,070,527
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$241,352,520
Value of total assets at end of year2013-12-31$13,299,911
Value of total assets at beginning of year2013-12-31$19,318,994
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$7,300,472
Total interest from all sources2013-12-31$512
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$15,000,000
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$102,036,212
Participant contributions at end of year2013-12-31$212,505
Participant contributions at beginning of year2013-12-31$0
Assets. Other investments not covered elsewhere at end of year2013-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2013-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$64,852
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$208,271
Administrative expenses (other) incurred2013-12-31$7,300,472
Liabilities. Value of operating payables at end of year2013-12-31$2,493,100
Liabilities. Value of operating payables at beginning of year2013-12-31$2,861,797
Total non interest bearing cash at end of year2013-12-31$3,348,663
Total non interest bearing cash at beginning of year2013-12-31$918,282
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-9,017,967
Value of net assets at end of year (total assets less liabilities)2013-12-31$-6,380,041
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$2,637,926
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Interest earned on other investments2013-12-31$512
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$46,051,102
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$139,316,308
Employer contributions (assets) at end of year2013-12-31$9,738,743
Employer contributions (assets) at beginning of year2013-12-31$18,400,712
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$197,019,425
Liabilities. Value of benefit claims payable at end of year2013-12-31$17,122,000
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$13,611,000
Did the plan have assets held for investment2013-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31CHAPMAN, HEXT & CO.
Accountancy firm EIN2013-12-31752053526
2012 : XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$16,681,068
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$16,238,188
Total income from all sources (including contributions)2012-12-31$227,961,875
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$225,988,525
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$221,967,251
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$227,960,813
Value of total assets at end of year2012-12-31$19,318,994
Value of total assets at beginning of year2012-12-31$16,902,764
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$4,021,274
Total interest from all sources2012-12-31$1,062
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$15,000,000
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$94,852,912
Participant contributions at end of year2012-12-31$0
Participant contributions at beginning of year2012-12-31$173,985
Assets. Other investments not covered elsewhere at end of year2012-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$208,271
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$194,638
Administrative expenses (other) incurred2012-12-31$4,021,274
Liabilities. Value of operating payables at end of year2012-12-31$2,861,797
Liabilities. Value of operating payables at beginning of year2012-12-31$2,651,550
Total non interest bearing cash at end of year2012-12-31$918,282
Total non interest bearing cash at beginning of year2012-12-31$4,094,809
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$1,973,350
Value of net assets at end of year (total assets less liabilities)2012-12-31$2,637,926
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$664,576
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Interest earned on other investments2012-12-31$1,062
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$37,513,960
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$133,107,901
Employer contributions (assets) at end of year2012-12-31$18,400,712
Employer contributions (assets) at beginning of year2012-12-31$12,633,970
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$184,453,291
Liabilities. Value of benefit claims payable at end of year2012-12-31$13,611,000
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$13,392,000
Did the plan have assets held for investment2012-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31CHAPMAN, HEXT & CO.
Accountancy firm EIN2012-12-31752053526

Form 5500 Responses for XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN

2020: XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingYes
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: XEROX BUSINESS SERVICES, LLC FUNDED WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number26193
Policy instance 2
UNITED BEHAVIORAL HEALTH DBA OPTUM (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number15457
Policy instance 14
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number94014
Policy instance 1
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number227021
Policy instance 3
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number14354
Policy instance 4
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number801998
Policy instance 5
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0724834
Policy instance 6
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number19477
Policy instance 7
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number35579
Policy instance 8
GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 )
Policy contract number2050100
Policy instance 13
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberQ0023
Policy instance 12
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberQ0109
Policy instance 11
HUMANA HEALTH PLANS OF PUERTO RICO INC (National Association of Insurance Commissioners NAIC id number: 95721 )
Policy contract number113015
Policy instance 10
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
Policy contract number10118
Policy instance 9
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberQ0109
Policy instance 11
HUMANA HEALTH PLANS OF PUERTO RICO INC (National Association of Insurance Commissioners NAIC id number: 95721 )
Policy contract number113015
Policy instance 10
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
Policy contract number10118
Policy instance 9
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number35579
Policy instance 8
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number19477
Policy instance 7
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0724834
Policy instance 6
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number801998
Policy instance 5
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number14354
Policy instance 4
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number227021
Policy instance 3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number26193
Policy instance 2
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number94014
Policy instance 1
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberQ0023
Policy instance 12
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number19477
Policy instance 7
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number94014
Policy instance 1
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number26193
Policy instance 2
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberQ0023
Policy instance 12
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberQ0109
Policy instance 11
HUMANA HEALTH PLANS OF PUERTO RICO INC (National Association of Insurance Commissioners NAIC id number: 95721 )
Policy contract number113015
Policy instance 10
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
Policy contract number10118
Policy instance 9
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number35579
Policy instance 8
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0724834
Policy instance 6
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number801998
Policy instance 5
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number14354
Policy instance 4
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number227021
Policy instance 3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number801998
Policy instance 5
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number14354
Policy instance 4
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number227021
Policy instance 3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number26193
Policy instance 2
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number94014
Policy instance 1
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0724834
Policy instance 6
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number19477
Policy instance 7
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number35579
Policy instance 8
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
Policy contract number10118
Policy instance 9
HUMANA HEALTH PLANS OF PUERTO RICO INC (National Association of Insurance Commissioners NAIC id number: 95721 )
Policy contract number113015
Policy instance 10
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberQ0109
Policy instance 11
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberQ0023
Policy instance 12
HUMANA HEALTH PLANS OF PUERTO RICO INC (National Association of Insurance Commissioners NAIC id number: 95721 )
Policy contract number113015
Policy instance 12
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
Policy contract number10118
Policy instance 11
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number35579
Policy instance 10
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number94014
Policy instance 1
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number26193
Policy instance 2
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number227021
Policy instance 3
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number14354
Policy instance 4
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberQ0023
Policy instance 5
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberQ0109
Policy instance 6
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number801998
Policy instance 7
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0724834
Policy instance 8
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number19477
Policy instance 9
HUMANA HEALTH PLANS OF PUERTO RICO INC (National Association of Insurance Commissioners NAIC id number: 95721 )
Policy contract number113015
Policy instance 5
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number14354
Policy instance 4
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number227021
Policy instance 3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number26193
Policy instance 2
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number94014
Policy instance 1
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberQ0023
Policy instance 6
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberQ0109
Policy instance 7
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number801998
Policy instance 8
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0724834
Policy instance 9
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number19477
Policy instance 10
KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )
Policy contract number35579
Policy instance 11
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC. (National Association of Insurance Commissioners NAIC id number: 96237 )
Policy contract number10118
Policy instance 12
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number227021
Policy instance 5
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number26193
Policy instance 4
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number94014
Policy instance 3
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract numberST-0942-3212
Policy instance 2
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number800468
Policy instance 1
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract numberST-0100-4676
Policy instance 9
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number14354
Policy instance 6
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number11543000
Policy instance 7
GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 )
Policy contract number1DB8
Policy instance 8
HUMANA HEALTH PLANS OF PUERTO RICO INC (National Association of Insurance Commissioners NAIC id number: 95721 )
Policy contract number113015/113319
Policy instance 10
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberQ0023
Policy instance 11
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberQ0109
Policy instance 12
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number801998
Policy instance 13
HIGHMARK HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number08356527
Policy instance 7
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0743025
Policy instance 6
TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 )
Policy contract numberSP0000926
Policy instance 5
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number89445
Policy instance 4
KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 )
Policy contract number14354
Policy instance 3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number227021
Policy instance 2
GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 )
Policy contract numberQP08
Policy instance 8
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract numberST-0100-4676
Policy instance 9
HUMANA HEALTH PLANS OF PUERTO RICO INC (National Association of Insurance Commissioners NAIC id number: 95721 )
Policy contract number113015
Policy instance 10
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )
Policy contract number00010943
Policy instance 11
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number174035
Policy instance 12
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract numberST-0942-3212
Policy instance 14
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number94014
Policy instance 15
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number26193
Policy instance 16
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number800468
Policy instance 1
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )
Policy contract numberQP08
Policy instance 13

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