NATIONAL ASSOCIATION OF PREVAILING WAGE CONTRACTORS, INC. has sponsored the creation of one or more 401k plans.
| Measure | Date | Value |
|---|
| 2017 : NAPWC HEALTH TRUST 2017 401k financial data |
|---|
| Expenses. Total of all expenses incurred | 2017-12-31 | $482,726 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $410,979 |
| Total plan assets at end of year | 2017-12-31 | $0 |
| Total plan assets at beginning of year | 2017-12-31 | $482,726 |
| Value of fidelity bond covering the plan | 2017-12-31 | $48,273 |
| Expenses. Other expenses not covered elsewhere | 2017-12-31 | $9,784 |
| Net income (gross income less expenses) | 2017-12-31 | $-482,726 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $482,726 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $61,963 |
| 2016 : NAPWC HEALTH TRUST 2016 401k financial data |
|---|
| Total plan liabilities at beginning of year | 2016-12-31 | $33,213 |
| Total income from all sources | 2016-12-31 | $481,600 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $9,673 |
| Total plan assets at end of year | 2016-12-31 | $482,726 |
| Total plan assets at beginning of year | 2016-12-31 | $44,012 |
| Value of fidelity bond covering the plan | 2016-12-31 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2016-12-31 | $9,673 |
| Other income received | 2016-12-31 | $481,600 |
| Net income (gross income less expenses) | 2016-12-31 | $471,927 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $482,726 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $10,799 |
| 2015 : NAPWC HEALTH TRUST 2015 401k financial data |
|---|
| Total plan liabilities at end of year | 2015-12-31 | $33,213 |
| Total plan liabilities at beginning of year | 2015-12-31 | $-27,110 |
| Total income from all sources | 2015-12-31 | $58,900 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $287,012 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $46,016 |
| Total plan assets at end of year | 2015-12-31 | $44,012 |
| Total plan assets at beginning of year | 2015-12-31 | $211,801 |
| Value of fidelity bond covering the plan | 2015-12-31 | $500,000 |
| Expenses. Other expenses not covered elsewhere | 2015-12-31 | $240,996 |
| Other income received | 2015-12-31 | $4,843 |
| Net income (gross income less expenses) | 2015-12-31 | $-228,112 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $10,799 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $238,911 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $54,057 |
| 2014 : NAPWC HEALTH TRUST 2014 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $-27,110 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $46,585 |
| Total income from all sources (including contributions) | 2014-12-31 | $1,295,020 |
| Total of all expenses incurred | 2014-12-31 | $1,366,022 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $1,074,268 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-12-31 | $1,290,588 |
| Value of total assets at end of year | 2014-12-31 | $211,801 |
| Value of total assets at beginning of year | 2014-12-31 | $356,498 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $291,754 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-12-31 | No |
| Administrative expenses professional fees incurred | 2014-12-31 | $128,698 |
| Was this plan covered by a fidelity bond | 2014-12-31 | Yes |
| Value of fidelity bond cover | 2014-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2014-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | Yes |
| Amount of non-exempt transactions with any party-in-interest | 2014-12-31 | $197,518 |
| Contributions received from participants | 2014-12-31 | $606 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2014-12-31 | $-103,831 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-12-31 | $199,945 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-12-31 | $270,945 |
| Other income not declared elsewhere | 2014-12-31 | $4,432 |
| Administrative expenses (other) incurred | 2014-12-31 | $110,087 |
| Liabilities. Value of operating payables at end of year | 2014-12-31 | $30,982 |
| Liabilities. Value of operating payables at beginning of year | 2014-12-31 | $847 |
| Total non interest bearing cash at end of year | 2014-12-31 | $11,856 |
| Total non interest bearing cash at beginning of year | 2014-12-31 | $71,321 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Value of net income/loss | 2014-12-31 | $-71,002 |
| Value of net assets at end of year (total assets less liabilities) | 2014-12-31 | $238,911 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-12-31 | $309,913 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-12-31 | $1,178,099 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2014-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
| Contributions received in cash from employer | 2014-12-31 | $1,289,982 |
| Employer contributions (assets) at beginning of year | 2014-12-31 | $14,232 |
| Contract administrator fees | 2014-12-31 | $52,969 |
| 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 | 2014-12-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2014-12-31 | $-58,092 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-12-31 | $45,738 |
| Did the plan have assets held for investment | 2014-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-12-31 | Unqualified |
| Accountancy firm name | 2014-12-31 | MOSS ADAMS LLP |
| Accountancy firm EIN | 2014-12-31 | 910189318 |
| 2013 : NAPWC HEALTH TRUST 2013 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $46,585 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $343,807 |
| Total income from all sources (including contributions) | 2013-12-31 | $3,390,246 |
| Total of all expenses incurred | 2013-12-31 | $3,398,477 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $2,881,004 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-12-31 | $3,390,246 |
| Value of total assets at end of year | 2013-12-31 | $356,498 |
| Value of total assets at beginning of year | 2013-12-31 | $661,951 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $517,473 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-12-31 | No |
| Administrative expenses professional fees incurred | 2013-12-31 | $100,432 |
| Was this plan covered by a fidelity bond | 2013-12-31 | Yes |
| Value of fidelity bond cover | 2013-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2013-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | Yes |
| Amount of non-exempt transactions with any party-in-interest | 2013-12-31 | $268,518 |
| Contributions received from participants | 2013-12-31 | $50,899 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2013-12-31 | $-283,348 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-12-31 | $270,945 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-12-31 | $270,526 |
| Administrative expenses (other) incurred | 2013-12-31 | $283,127 |
| Liabilities. Value of operating payables at end of year | 2013-12-31 | $847 |
| Liabilities. Value of operating payables at beginning of year | 2013-12-31 | $14,721 |
| Total non interest bearing cash at end of year | 2013-12-31 | $71,321 |
| Total non interest bearing cash at beginning of year | 2013-12-31 | $308,793 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Value of net income/loss | 2013-12-31 | $-8,231 |
| Value of net assets at end of year (total assets less liabilities) | 2013-12-31 | $309,913 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $318,144 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-12-31 | $3,164,352 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2013-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
| Contributions received in cash from employer | 2013-12-31 | $3,339,347 |
| Employer contributions (assets) at end of year | 2013-12-31 | $14,232 |
| Employer contributions (assets) at beginning of year | 2013-12-31 | $82,632 |
| Contract administrator fees | 2013-12-31 | $133,914 |
| 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 | 2013-12-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2013-12-31 | $45,738 |
| Liabilities. Value of benefit claims payable at beginning of year | 2013-12-31 | $329,086 |
| Did the plan have assets held for investment | 2013-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-12-31 | Unqualified |
| Accountancy firm name | 2013-12-31 | MOSS ADAMS LLP |
| Accountancy firm EIN | 2013-12-31 | 910189318 |
| 2012 : NAPWC HEALTH TRUST 2012 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $343,807 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $290,197 |
| Total income from all sources (including contributions) | 2012-12-31 | $7,212,370 |
| Total of all expenses incurred | 2012-12-31 | $7,126,781 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $6,701,641 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $7,212,370 |
| Value of total assets at end of year | 2012-12-31 | $661,951 |
| Value of total assets at beginning of year | 2012-12-31 | $522,752 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $425,140 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
| Administrative expenses professional fees incurred | 2012-12-31 | $119,014 |
| Was this plan covered by a fidelity bond | 2012-12-31 | Yes |
| Value of fidelity bond cover | 2012-12-31 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2012-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | Yes |
| Amount of non-exempt transactions with any party-in-interest | 2012-12-31 | $268,518 |
| Contributions received from participants | 2012-12-31 | $137,355 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-12-31 | $270,526 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-12-31 | $284,659 |
| Administrative expenses (other) incurred | 2012-12-31 | $12,303 |
| Liabilities. Value of operating payables at end of year | 2012-12-31 | $14,721 |
| Liabilities. Value of operating payables at beginning of year | 2012-12-31 | $14,492 |
| Total non interest bearing cash at end of year | 2012-12-31 | $308,793 |
| Total non interest bearing cash at beginning of year | 2012-12-31 | $134,180 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Value of net income/loss | 2012-12-31 | $85,589 |
| Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $318,144 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $232,555 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-12-31 | $6,701,641 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
| Contributions received in cash from employer | 2012-12-31 | $7,075,015 |
| Employer contributions (assets) at end of year | 2012-12-31 | $82,632 |
| Employer contributions (assets) at beginning of year | 2012-12-31 | $103,913 |
| Contract administrator fees | 2012-12-31 | $293,823 |
| 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 | 2012-12-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2012-12-31 | $329,086 |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-12-31 | $275,705 |
| Did the plan have assets held for investment | 2012-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Unqualified |
| Accountancy firm name | 2012-12-31 | MOSS ADAMS, LLP |
| Accountancy firm EIN | 2012-12-31 | 910189318 |
| 2011 : NAPWC HEALTH TRUST 2011 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $290,197 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $341,492 |
| Total income from all sources (including contributions) | 2011-12-31 | $8,185,441 |
| Total of all expenses incurred | 2011-12-31 | $7,946,214 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $7,519,323 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $8,185,441 |
| Value of total assets at end of year | 2011-12-31 | $522,752 |
| Value of total assets at beginning of year | 2011-12-31 | $334,820 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $426,891 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
| Administrative expenses professional fees incurred | 2011-12-31 | $101,147 |
| Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
| Value of fidelity bond cover | 2011-12-31 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2011-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | Yes |
| Amount of non-exempt transactions with any party-in-interest | 2011-12-31 | $282,651 |
| Contributions received from participants | 2011-12-31 | $248,665 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2011-12-31 | $284,659 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2011-12-31 | $75,251 |
| Administrative expenses (other) incurred | 2011-12-31 | $13,936 |
| Liabilities. Value of operating payables at end of year | 2011-12-31 | $14,492 |
| Liabilities. Value of operating payables at beginning of year | 2011-12-31 | $106,610 |
| Total non interest bearing cash at end of year | 2011-12-31 | $134,180 |
| Total non interest bearing cash at beginning of year | 2011-12-31 | $195,106 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Value of net income/loss | 2011-12-31 | $239,227 |
| Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $232,555 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $-6,672 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2011-12-31 | $7,519,323 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
| Contributions received in cash from employer | 2011-12-31 | $7,936,776 |
| Employer contributions (assets) at end of year | 2011-12-31 | $103,913 |
| Employer contributions (assets) at beginning of year | 2011-12-31 | $64,463 |
| Contract administrator fees | 2011-12-31 | $311,808 |
| 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 | 2011-12-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2011-12-31 | $275,705 |
| Liabilities. Value of benefit claims payable at beginning of year | 2011-12-31 | $234,882 |
| Did the plan have assets held for investment | 2011-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Unqualified |
| Accountancy firm name | 2011-12-31 | MOSS ADAMS, LLP |
| Accountancy firm EIN | 2011-12-31 | 910189318 |
| 2010 : NAPWC HEALTH TRUST 2010 401k financial data |
|---|
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $341,492 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $204,478 |
| Total income from all sources (including contributions) | 2010-12-31 | $6,289,767 |
| Total of all expenses incurred | 2010-12-31 | $6,308,478 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $5,293,976 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $6,289,767 |
| Value of total assets at end of year | 2010-12-31 | $334,820 |
| Value of total assets at beginning of year | 2010-12-31 | $216,517 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $1,014,502 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
| Administrative expenses professional fees incurred | 2010-12-31 | $182,408 |
| Was this plan covered by a fidelity bond | 2010-12-31 | Yes |
| Value of fidelity bond cover | 2010-12-31 | $500,000 |
| If this is an individual account plan, was there a blackout period | 2010-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2010-12-31 | $75,251 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2010-12-31 | $27,986 |
| Administrative expenses (other) incurred | 2010-12-31 | $563,671 |
| Liabilities. Value of operating payables at end of year | 2010-12-31 | $106,610 |
| Liabilities. Value of operating payables at beginning of year | 2010-12-31 | $13,174 |
| Total non interest bearing cash at end of year | 2010-12-31 | $195,106 |
| Total non interest bearing cash at beginning of year | 2010-12-31 | $132,092 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Value of net income/loss | 2010-12-31 | $-18,711 |
| Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $-6,672 |
| Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $12,039 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2010-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2010-12-31 | $5,293,976 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
| Contributions received in cash from employer | 2010-12-31 | $6,289,767 |
| Employer contributions (assets) at end of year | 2010-12-31 | $64,463 |
| Employer contributions (assets) at beginning of year | 2010-12-31 | $56,439 |
| Contract administrator fees | 2010-12-31 | $268,423 |
| 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 | 2010-12-31 | No |
| Liabilities. Value of benefit claims payable at end of year | 2010-12-31 | $234,882 |
| Liabilities. Value of benefit claims payable at beginning of year | 2010-12-31 | $191,304 |
| Did the plan have assets held for investment | 2010-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Unqualified |
| Accountancy firm name | 2010-12-31 | MOSS ADAMS, LLP |
| Accountancy firm EIN | 2010-12-31 | 910189318 |
| UNITED HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 70785 ) |
| Policy contract number | 240931-243746 |
| Policy instance | 1 |
| Insurance contract or identification number | 240931-243746 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-07-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $46,016 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
| Policy contract number | 25049 |
| Policy instance | 4 |
| Insurance contract or identification number | 25049 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $18 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $214 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18 | | Insurance broker organization code? | 3 | | Insurance broker name | CONTRACTOR MARKETING SERVICE |
|
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 638 |
| Policy instance | 1 |
| Insurance contract or identification number | 638 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $4,801 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $58,583 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,801 | | Insurance broker organization code? | 3 | | Insurance broker name | CONTRACTOR MARKETING SERVICE |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 892895-001 |
| Policy instance | 2 |
| Insurance contract or identification number | 892895-001 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $448 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,465 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $448 | | Insurance broker organization code? | 3 | | Insurance broker name | CONTRACTOR MARKETING SERVICE |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
| Policy contract number | G000AH5M |
| Policy instance | 3 |
| Insurance contract or identification number | G000AH5M | | Number of Individuals Covered | 0 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $27 | | 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 $326 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27 | | Insurance broker organization code? | 3 | | Insurance broker name | CONTRACTOR MARKETING SERVICE |
|
| UNITED HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 70785 ) |
| Policy contract number | 240931-243746 |
| Policy instance | 5 |
| Insurance contract or identification number | 240931-243746 | | Number of Individuals Covered | 42 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $90,555 | | 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 $1,104,991 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $90,555 | | Insurance broker organization code? | 3 | | Insurance broker name | CONTRACTOR MARKETING SERVICE |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 892895-001 |
| Policy instance | 2 |
| Insurance contract or identification number | 892895-001 | | Number of Individuals Covered | 42 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $4,511 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $50,615 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,511 | | Insurance broker organization code? | 3 | | Insurance broker name | CONTRACTOR MARKETING SERVICE |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
| Policy contract number | G000AH5M |
| Policy instance | 3 |
| Insurance contract or identification number | G000AH5M | | Number of Individuals Covered | 44 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $230 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,577 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $230 | | Insurance broker organization code? | 3 | | Insurance broker name | CONTRACTOR MARKETING SERVICE |
|
| CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
| Policy contract number | 25049 |
| Policy instance | 4 |
| Insurance contract or identification number | 25049 | | Number of Individuals Covered | 37 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $1,145 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,844 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,145 | | Insurance broker organization code? | 3 | | Insurance broker name | CONTRACTOR MARKETING SERVICE |
|
| UNITED HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 70785 ) |
| Policy contract number | 240931-243746 |
| Policy instance | 5 |
| Insurance contract or identification number | 240931-243746 | | Number of Individuals Covered | 181 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $268,484 | | 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 $3,012,780 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $268,484 | | Insurance broker organization code? | 3 | | Insurance broker name | CONTRACTOR MARKETING SERVICE |
|
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 638 |
| Policy instance | 1 |
| Insurance contract or identification number | 638 | | Number of Individuals Covered | 16 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $5,121 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $57,467 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,121 | | Insurance broker organization code? | 3 | | Insurance broker name | CONTRACTOR MARKETING SERVICE |
|
| AMERICAN SPECIALTY HEALTH (National Association of Insurance Commissioners NAIC id number: 84697 ) |
| Policy contract number | 14344-00 |
| Policy instance | 1 |
| Insurance contract or identification number | 14344-00 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $3,903 | | 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 | CHIROPRACTIC | | Welfare Benefit Premiums Paid to Carrier | USD $3,903 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $376 | | Insurance broker organization code? | 3 | | Insurance broker name | CONTRACTOR MARKETING SERVICE |
|
| UNITED HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 70785 ) |
| Policy contract number | 240931-243746 |
| Policy instance | 6 |
| Insurance contract or identification number | 240931-243746 | | Number of Individuals Covered | 477 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $5,832,500 | | 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 $5,832,500 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $562,431 | | Insurance broker organization code? | 3 | | Insurance broker name | CONTRACTOR MARKETING SERVICE |
|
| CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
| Policy contract number | 25049 |
| Policy instance | 5 |
| Insurance contract or identification number | 25049 | | Number of Individuals Covered | 124 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $22,487 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,487 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,168 | | Insurance broker organization code? | 3 | | Insurance broker name | CONTRACTOR MARKETING SERVICE |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
| Policy contract number | G000AH5M |
| Policy instance | 4 |
| Insurance contract or identification number | G000AH5M | | Number of Individuals Covered | 85 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $3,401 | | 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 $3,401 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $328 | | Insurance broker organization code? | 3 | | Insurance broker name | CONTRACTOR MARKETING SERVICE |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 892895-001 |
| Policy instance | 3 |
| Insurance contract or identification number | 892895-001 | | Number of Individuals Covered | 141 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $68,730 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $68,730 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,628 | | Insurance broker organization code? | 3 | | Insurance broker name | CONTRACTOR MARKETING SERVICE |
|
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 638 |
| Policy instance | 2 |
| Insurance contract or identification number | 638 | | Number of Individuals Covered | 24 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $81,632 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $81,632 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,872 | | Insurance broker organization code? | 3 | | Insurance broker name | CONTRACTOR MARKETING SERVICE |
|
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 638 |
| Policy instance | 2 |
| Insurance contract or identification number | 638 | | Number of Individuals Covered | 32 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $7,103 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $80,264 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) |
| Policy contract number | 892895-001 |
| Policy instance | 3 |
| Insurance contract or identification number | 892895-001 | | Number of Individuals Covered | 221 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $6,817 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $77,032 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
| Policy contract number | G000AH5M |
| Policy instance | 4 |
| Insurance contract or identification number | G000AH5M | | Number of Individuals Covered | 137 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $310 | | 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 $3,505 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 ) |
| Policy contract number | 25049 |
| Policy instance | 5 |
| Insurance contract or identification number | 25049 | | Number of Individuals Covered | 190 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $2,432 | | 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 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $27,485 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN SPECIALTY HEALTH (National Association of Insurance Commissioners NAIC id number: 84697 ) |
| Policy contract number | 14344-00 |
| Policy instance | 1 |
| Insurance contract or identification number | 14344-00 | | Number of Individuals Covered | 153 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $440 | | 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 | CHIROPRACTIC | | Welfare Benefit Premiums Paid to Carrier | USD $4,970 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED HEALTHCARE (National Association of Insurance Commissioners NAIC id number: 70785 ) |
| Policy contract number | 240931-243746 |
| Policy instance | 6 |
| Insurance contract or identification number | 240931-243746 | | Number of Individuals Covered | 337 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $584,624 | | 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 $6,605,806 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ON-SITE HEALTH & SAFETY (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 000-000-000 |
| Policy instance | 6 |
| Insurance contract or identification number | 000-000-000 | | Number of Individuals Covered | 1076 | | Insurance policy start date | 2010-09-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $1,239 | | 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 $12,276 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SIMNSA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 619-407-4082 |
| Policy instance | 5 |
| Insurance contract or identification number | 619-407-4082 | | Number of Individuals Covered | 21 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $3,100 | | 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 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $30,594 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 949-930-1570 |
| Policy instance | 3 |
| Insurance contract or identification number | 949-930-1570 | | Number of Individuals Covered | 131 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $9,194 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $90,730 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SAFEGUARD (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 949-425-4388 |
| Policy instance | 2 |
| Insurance contract or identification number | 949-425-4388 | | Number of Individuals Covered | 463 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $3,475 | | 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 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $34,299 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITED HEALTHCARE OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 800-624-9326 |
| Policy instance | 1 |
| Insurance contract or identification number | 800-624-9326 | | Number of Individuals Covered | 1076 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $515,743 | | 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 $5,089,770 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AMERICAN SPECIALTY HEALTH (National Association of Insurance Commissioners NAIC id number: 84697 ) |
| Policy contract number | 800-260-5533 |
| Policy instance | 4 |
| Insurance contract or identification number | 800-260-5533 | | Number of Individuals Covered | 81 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $167 | | 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 $1,644 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
