SIERRA NATIONAL CONSTRUCTION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM
| Measure | Date | Value |
|---|
| 2023 : SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2023 401k financial data |
|---|
| Total plan liabilities at end of year | 2023-12-31 | $0 |
| Total plan liabilities at beginning of year | 2023-12-31 | $0 |
| Total income from all sources | 2023-12-31 | $569,177 |
| Expenses. Total of all expenses incurred | 2023-12-31 | $575,801 |
| Benefits paid (including direct rollovers) | 2023-12-31 | $572,842 |
| Total plan assets at end of year | 2023-12-31 | $24 |
| Total plan assets at beginning of year | 2023-12-31 | $6,648 |
| Total contributions received or receivable from participants | 2023-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2023-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2023-12-31 | $0 |
| Other income received | 2023-12-31 | $0 |
| Noncash contributions received | 2023-12-31 | $0 |
| Net income (gross income less expenses) | 2023-12-31 | $-6,624 |
| Net plan assets at end of year (total assets less liabilities) | 2023-12-31 | $24 |
| Net plan assets at beginning of year (total assets less liabilities) | 2023-12-31 | $6,648 |
| Total contributions received or receivable from employer(s) | 2023-12-31 | $569,177 |
| Value of certain deemed distributions of participant loans | 2023-12-31 | $0 |
| Value of corrective distributions | 2023-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2023-12-31 | $2,959 |
| 2022 : SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2022 401k financial data |
|---|
| Total income from all sources | 2022-12-31 | $639,964 |
| Expenses. Total of all expenses incurred | 2022-12-31 | $633,317 |
| Benefits paid (including direct rollovers) | 2022-12-31 | $629,785 |
| Total plan assets at end of year | 2022-12-31 | $6,648 |
| Total plan assets at beginning of year | 2022-12-31 | $1 |
| Net income (gross income less expenses) | 2022-12-31 | $6,647 |
| Net plan assets at end of year (total assets less liabilities) | 2022-12-31 | $6,648 |
| Net plan assets at beginning of year (total assets less liabilities) | 2022-12-31 | $1 |
| Total contributions received or receivable from employer(s) | 2022-12-31 | $639,964 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2022-12-31 | $3,532 |
| 2021 : SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2021 401k financial data |
|---|
| Total income from all sources | 2021-12-31 | $677,879 |
| Expenses. Total of all expenses incurred | 2021-12-31 | $677,879 |
| Benefits paid (including direct rollovers) | 2021-12-31 | $675,824 |
| Total plan assets at end of year | 2021-12-31 | $1 |
| Total plan assets at beginning of year | 2021-12-31 | $1 |
| Net income (gross income less expenses) | 2021-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-31 | $1 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-31 | $1 |
| Total contributions received or receivable from employer(s) | 2021-12-31 | $677,879 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2021-12-31 | $2,055 |
| 2020 : SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2020 401k financial data |
|---|
| Total income from all sources | 2020-12-31 | $605,103 |
| Expenses. Total of all expenses incurred | 2020-12-31 | $605,103 |
| Benefits paid (including direct rollovers) | 2020-12-31 | $603,681 |
| Total plan assets at end of year | 2020-12-31 | $1 |
| Total plan assets at beginning of year | 2020-12-31 | $1 |
| Net income (gross income less expenses) | 2020-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $1 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-31 | $1 |
| Total contributions received or receivable from employer(s) | 2020-12-31 | $605,103 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-12-31 | $1,422 |
| 2019 : SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2019 401k financial data |
|---|
| Total income from all sources | 2019-12-31 | $518,928 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $520,711 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $513,116 |
| Total plan assets at end of year | 2019-12-31 | $1 |
| Total plan assets at beginning of year | 2019-12-31 | $1,784 |
| Net income (gross income less expenses) | 2019-12-31 | $-1,783 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $1 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $1,784 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $518,928 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $7,595 |
| 2018 : SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2018 401k financial data |
|---|
| Total income from all sources | 2018-12-31 | $326,478 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $324,694 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $317,634 |
| Total plan assets at end of year | 2018-12-31 | $1,784 |
| Total plan assets at beginning of year | 2018-12-31 | $0 |
| Net income (gross income less expenses) | 2018-12-31 | $1,784 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $1,784 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $326,478 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $7,060 |
| 2017 : SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2017 401k financial data |
|---|
| Total income from all sources | 2017-12-31 | $245,845 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $245,845 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $238,531 |
| Total plan assets at end of year | 2017-12-31 | $0 |
| Total plan assets at beginning of year | 2017-12-31 | $0 |
| Net income (gross income less expenses) | 2017-12-31 | $0 |
| 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 | $0 |
| Total contributions received or receivable from employer(s) | 2017-12-31 | $245,845 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $7,314 |
| 2016 : SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2016 401k financial data |
|---|
| Total income from all sources | 2016-12-31 | $221,404 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $224,817 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $218,593 |
| Total plan assets at end of year | 2016-12-31 | $0 |
| Total plan assets at beginning of year | 2016-12-31 | $3,413 |
| Net income (gross income less expenses) | 2016-12-31 | $-3,413 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $3,413 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $221,404 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $6,224 |
| 2015 : SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2015 401k financial data |
|---|
| Total income from all sources | 2015-12-31 | $157,962 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $154,787 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $156,468 |
| Total plan assets at end of year | 2015-12-31 | $3,413 |
| Total plan assets at beginning of year | 2015-12-31 | $238 |
| Net income (gross income less expenses) | 2015-12-31 | $3,175 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $3,413 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $238 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $157,962 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $-1,681 |
| 2014 : SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2014 401k financial data |
|---|
| Total income from all sources | 2014-12-31 | $107,373 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $107,247 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $106,012 |
| Total plan assets at end of year | 2014-12-31 | $238 |
| Total plan assets at beginning of year | 2014-12-31 | $112 |
| Value of fidelity bond covering the plan | 2014-12-31 | $10,000 |
| Net income (gross income less expenses) | 2014-12-31 | $126 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $238 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $112 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $107,373 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-12-31 | $1,235 |
| 2013 : SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2013 401k financial data |
|---|
| Total income from all sources | 2013-12-31 | $58,769 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $59,578 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $57,293 |
| Total plan assets at end of year | 2013-12-31 | $112 |
| Total plan assets at beginning of year | 2013-12-31 | $921 |
| Net income (gross income less expenses) | 2013-12-31 | $-809 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $112 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $921 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $58,769 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-12-31 | $2,285 |
| 2012 : SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2012 401k financial data |
|---|
| Total income from all sources | 2012-12-31 | $119,673 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $123,881 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $115,835 |
| Total plan assets at end of year | 2012-12-31 | $921 |
| Total plan assets at beginning of year | 2012-12-31 | $5,129 |
| Net income (gross income less expenses) | 2012-12-31 | $-4,208 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $921 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $5,129 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $119,673 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2012-12-31 | $8,046 |
| 2011 : SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2011 401k financial data |
|---|
| Total income from all sources | 2011-12-31 | $155,632 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $151,879 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $144,749 |
| Total plan assets at end of year | 2011-12-31 | $5,129 |
| Total plan assets at beginning of year | 2011-12-31 | $1,376 |
| Net income (gross income less expenses) | 2011-12-31 | $3,753 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $5,129 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $1,376 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $155,632 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-12-31 | $7,130 |
| 2010 : SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2010 401k financial data |
|---|
| Total income from all sources | 2010-12-31 | $217,760 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $246,573 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $235,370 |
| Total plan assets at end of year | 2010-12-31 | $1,376 |
| Total plan assets at beginning of year | 2010-12-31 | $30,189 |
| Net income (gross income less expenses) | 2010-12-31 | $-28,813 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $1,376 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $30,189 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $217,760 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2010-12-31 | $11,203 |
| 2023: SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2023 form 5500 responses |
|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Submission has been amended | No |
| 2023-01-01 | This submission is the final filing | No |
| 2023-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2023-01-01 | Plan is a collectively bargained plan | No |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan funding arrangement – Trust | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement - Trust | Yes |
| 2022: SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – Trust | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement - Trust | Yes |
| 2021: SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – Trust | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement - Trust | Yes |
| 2020: SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – Trust | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement - Trust | Yes |
| 2019: SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – Trust | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement - Trust | Yes |
| 2018: SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – Trust | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement - Trust | Yes |
| 2017: SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – Trust | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement - Trust | Yes |
| 2016: SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015: SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – Trust | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
| 2014: SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – Trust | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement - Trust | Yes |
| 2013: SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – Trust | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement - Trust | Yes |
| 2012: SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement - Trust | Yes |
| 2011: SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – Trust | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement - Trust | Yes |
| 2009: SIERRA NATIONAL CONSTRUCTION, INC INSURANCE PROGRAM 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement - Trust | Yes |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
| Policy contract number | 1177833-10001 |
| Policy instance | 5 |
| Insurance contract or identification number | 1177833-10001 | | Number of Individuals Covered | 43 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $12,756 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 ) |
| Policy contract number | 25416 |
| Policy instance | 4 |
| Insurance contract or identification number | 25416 | | Number of Individuals Covered | 18 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $29,463 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 625928 |
| Policy instance | 3 |
| Insurance contract or identification number | 625928 | | Number of Individuals Covered | 47 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $368,004 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 ) |
| Policy contract number | W00270871000 |
| Policy instance | 2 |
| Insurance contract or identification number | W00270871000 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $148,110 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | H6S70 |
| Policy instance | 1 |
| Insurance contract or identification number | H6S70 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $14,508 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | H6S70 |
| Policy instance | 1 |
| Insurance contract or identification number | H6S70 | | Number of Individuals Covered | 15 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $18,047 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 ) |
| Policy contract number | W00270871000 |
| Policy instance | 2 |
| Insurance contract or identification number | W00270871000 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $157,369 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| HEALTHNOW MD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | HY2800 |
| Policy instance | 3 |
| Insurance contract or identification number | HY2800 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $473 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 625928 |
| Policy instance | 4 |
| Insurance contract or identification number | 625928 | | Number of Individuals Covered | 49 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $408,326 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 ) |
| Policy contract number | 25416 |
| Policy instance | 5 |
| Insurance contract or identification number | 25416 | | Number of Individuals Covered | 49 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $45,570 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 ) |
| Policy contract number | 25416 |
| Policy instance | 5 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 625928 |
| Policy instance | 4 |
| HEALTHNOW MD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | HY2800 |
| Policy instance | 3 |
| CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 ) |
| Policy contract number | W00270871000 |
| Policy instance | 2 |
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | H6S70 |
| Policy instance | 1 |
| KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 ) |
| Policy contract number | 25416 |
| Policy instance | 6 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 625928 |
| Policy instance | 5 |
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 632117-001 |
| Policy instance | 4 |
| HEALTHNOW MD (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | HY2800 |
| Policy instance | 3 |
| CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 ) |
| Policy contract number | W00270871000 |
| Policy instance | 2 |
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | H6S70 |
| Policy instance | 1 |
| CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 ) |
| Policy contract number | W00270871000 |
| Policy instance | 1 |
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 632117-001 |
| Policy instance | 2 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 625928 |
| Policy instance | 3 |
| KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 ) |
| Policy contract number | 25416 |
| Policy instance | 4 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 625928 |
| Policy instance | 3 |
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 632117-001 |
| Policy instance | 2 |
| CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 ) |
| Policy contract number | W00270871000 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 625928 |
| Policy instance | 3 |
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
| Policy contract number | 632117-001 |
| Policy instance | 2 |
| CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 ) |
| Policy contract number | W00270871000 |
| Policy instance | 1 |
