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COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 401k Plan overview

Plan NameCOOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM
Plan identification number 501

COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Other welfare benefit cover

401k Sponsoring company profile

COOK GENERAL ENGINEERING, INC HEALTH & WELFARE has sponsored the creation of one or more 401k plans.

Company Name:COOK GENERAL ENGINEERING, INC HEALTH & WELFARE
Employer identification number (EIN):710895247
NAIC Classification:237990
NAIC Description:Other Heavy and Civil Engineering Construction

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01SEAN COOK2024-06-29 SEAN COOK2024-06-29
5012022-01-01SEAN COOK2023-07-09 SEAN COOK2023-07-09
5012021-01-01SEAN COOK2022-10-02 SEAN COOK2022-10-02
5012020-01-01SEAN COOK2021-05-09 SEAN COOK2021-05-09
5012019-01-01SEAN COOK2020-04-14
5012018-01-01
5012017-01-01
5012016-01-01SEAN COOK
5012015-01-01JENNIFER HESSION
5012014-01-01SEAN COOK
5012013-01-01SEAN COOK
5012012-09-01SEAN COOK

Plan Statistics for COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM

401k plan membership statisitcs for COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM

Measure Date Value
2023: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2023 401k membership
Total participants, beginning-of-year2023-01-015
Total number of active participants reported on line 7a of the Form 55002023-01-015
Total of all active and inactive participants2023-01-015
2022: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2022 401k membership
Total participants, beginning-of-year2022-01-015
Total number of active participants reported on line 7a of the Form 55002022-01-015
Total of all active and inactive participants2022-01-015
2021: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2021 401k membership
Total participants, beginning-of-year2021-01-015
Total number of active participants reported on line 7a of the Form 55002021-01-015
Total of all active and inactive participants2021-01-015
2020: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2020 401k membership
Total participants, beginning-of-year2020-01-016
Total number of active participants reported on line 7a of the Form 55002020-01-015
Total of all active and inactive participants2020-01-015
2019: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2019 401k membership
Total participants, beginning-of-year2019-01-0113
Total number of active participants reported on line 7a of the Form 55002019-01-016
Total of all active and inactive participants2019-01-016
2018: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2018 401k membership
Total participants, beginning-of-year2018-01-0113
Total number of active participants reported on line 7a of the Form 55002018-01-018
Total of all active and inactive participants2018-01-018
2017: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2017 401k membership
Total participants, beginning-of-year2017-01-0115
Total number of active participants reported on line 7a of the Form 55002017-01-0113
Total of all active and inactive participants2017-01-0113
2016: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2016 401k membership
Total participants, beginning-of-year2016-01-0116
Total number of active participants reported on line 7a of the Form 55002016-01-0115
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-0115
2015: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2015 401k membership
Total participants, beginning-of-year2015-01-0138
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-010
Total of all active and inactive participants2015-01-010
2014: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2014 401k membership
Total participants, beginning-of-year2014-01-0145
Total number of active participants reported on line 7a of the Form 55002014-01-0138
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0138
2013: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2013 401k membership
Total participants, beginning-of-year2013-01-0145
Total number of active participants reported on line 7a of the Form 55002013-01-0145
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-0145
2012: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2012 401k membership
Total participants, beginning-of-year2012-09-0120
Total number of active participants reported on line 7a of the Form 55002012-09-0129
Number of retired or separated participants receiving benefits2012-09-010
Number of other retired or separated participants entitled to future benefits2012-09-010
Total of all active and inactive participants2012-09-0129

Financial Data on COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM

Measure Date Value
2023 : COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2023 401k financial data
Total plan liabilities at end of year2023-12-31$0
Total plan liabilities at beginning of year2023-12-31$0
Total income from all sources2023-12-31$0
Expenses. Total of all expenses incurred2023-12-31$64
Benefits paid (including direct rollovers)2023-12-31$0
Total plan assets at end of year2023-12-31$152
Total plan assets at beginning of year2023-12-31$216
Total contributions received or receivable from participants2023-12-31$0
Expenses. Other expenses not covered elsewhere2023-12-31$0
Contributions received from other sources (not participants or employers)2023-12-31$0
Other income received2023-12-31$0
Noncash contributions received2023-12-31$0
Net income (gross income less expenses)2023-12-31$-64
Net plan assets at end of year (total assets less liabilities)2023-12-31$152
Net plan assets at beginning of year (total assets less liabilities)2023-12-31$216
Total contributions received or receivable from employer(s)2023-12-31$0
Value of certain deemed distributions of participant loans2023-12-31$0
Value of corrective distributions2023-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2023-12-31$64
2022 : COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2022 401k financial data
Total income from all sources2022-12-31$0
Expenses. Total of all expenses incurred2022-12-31$-71
Benefits paid (including direct rollovers)2022-12-31$0
Total plan assets at end of year2022-12-31$216
Total plan assets at beginning of year2022-12-31$145
Net income (gross income less expenses)2022-12-31$71
Net plan assets at end of year (total assets less liabilities)2022-12-31$216
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$145
Total contributions received or receivable from employer(s)2022-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$-71
2021 : COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2021 401k financial data
Total income from all sources2021-12-31$0
Expenses. Total of all expenses incurred2021-12-31$510
Benefits paid (including direct rollovers)2021-12-31$255
Total plan assets at end of year2021-12-31$145
Total plan assets at beginning of year2021-12-31$655
Net income (gross income less expenses)2021-12-31$-510
Net plan assets at end of year (total assets less liabilities)2021-12-31$145
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$655
Total contributions received or receivable from employer(s)2021-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$255
2020 : COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2020 401k financial data
Total income from all sources2020-12-31$0
Expenses. Total of all expenses incurred2020-12-31$614
Benefits paid (including direct rollovers)2020-12-31$0
Total plan assets at end of year2020-12-31$655
Total plan assets at beginning of year2020-12-31$1,269
Net income (gross income less expenses)2020-12-31$-614
Net plan assets at end of year (total assets less liabilities)2020-12-31$655
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$1,269
Total contributions received or receivable from employer(s)2020-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$614
2019 : COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2019 401k financial data
Total income from all sources2019-12-31$0
Expenses. Total of all expenses incurred2019-12-31$412
Benefits paid (including direct rollovers)2019-12-31$0
Total plan assets at end of year2019-12-31$1,269
Total plan assets at beginning of year2019-12-31$1,681
Net income (gross income less expenses)2019-12-31$-412
Net plan assets at end of year (total assets less liabilities)2019-12-31$1,269
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$1,681
Total contributions received or receivable from employer(s)2019-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$412
2018 : COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2018 401k financial data
Total income from all sources2018-12-31$0
Expenses. Total of all expenses incurred2018-12-31$1,100
Benefits paid (including direct rollovers)2018-12-31$485
Total plan assets at end of year2018-12-31$1,681
Total plan assets at beginning of year2018-12-31$2,781
Net income (gross income less expenses)2018-12-31$-1,100
Net plan assets at end of year (total assets less liabilities)2018-12-31$1,681
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$2,781
Total contributions received or receivable from employer(s)2018-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$615
2017 : COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2017 401k financial data
Total income from all sources2017-12-31$0
Expenses. Total of all expenses incurred2017-12-31$1,345
Benefits paid (including direct rollovers)2017-12-31$629
Total plan assets at end of year2017-12-31$2,781
Total plan assets at beginning of year2017-12-31$4,126
Net income (gross income less expenses)2017-12-31$-1,345
Net plan assets at end of year (total assets less liabilities)2017-12-31$2,781
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$4,126
Total contributions received or receivable from employer(s)2017-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$716
2016 : COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2016 401k financial data
Total income from all sources2016-12-31$0
Expenses. Total of all expenses incurred2016-12-31$865
Benefits paid (including direct rollovers)2016-12-31$19
Total plan assets at end of year2016-12-31$4,126
Total plan assets at beginning of year2016-12-31$4,991
Net income (gross income less expenses)2016-12-31$-865
Net plan assets at end of year (total assets less liabilities)2016-12-31$4,126
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$4,991
Total contributions received or receivable from employer(s)2016-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$846
2015 : COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2015 401k financial data
Total income from all sources2015-12-31$74,245
Expenses. Total of all expenses incurred2015-12-31$73,484
Benefits paid (including direct rollovers)2015-12-31$74,321
Total plan assets at end of year2015-12-31$4,991
Total plan assets at beginning of year2015-12-31$4,230
Net income (gross income less expenses)2015-12-31$761
Net plan assets at end of year (total assets less liabilities)2015-12-31$4,991
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$4,230
Total contributions received or receivable from employer(s)2015-12-31$74,245
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$-837
2014 : COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2014 401k financial data
Total income from all sources2014-12-31$151,994
Expenses. Total of all expenses incurred2014-12-31$174,246
Benefits paid (including direct rollovers)2014-12-31$158,300
Total plan assets at end of year2014-12-31$4,230
Total plan assets at beginning of year2014-12-31$26,482
Value of fidelity bond covering the plan2014-12-31$50,000
Net income (gross income less expenses)2014-12-31$-22,252
Net plan assets at end of year (total assets less liabilities)2014-12-31$4,230
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$26,482
Total contributions received or receivable from employer(s)2014-12-31$151,994
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$15,946
2013 : COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2013 401k financial data
Total income from all sources2013-12-31$109,078
Expenses. Total of all expenses incurred2013-12-31$113,020
Benefits paid (including direct rollovers)2013-12-31$103,633
Total plan assets at end of year2013-12-31$26,482
Total plan assets at beginning of year2013-12-31$30,424
Net income (gross income less expenses)2013-12-31$-3,942
Net plan assets at end of year (total assets less liabilities)2013-12-31$26,482
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$30,424
Total contributions received or receivable from employer(s)2013-12-31$109,078
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$9,387
2012 : COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2012 401k financial data
Total income from all sources2012-12-31$59,043
Expenses. Total of all expenses incurred2012-12-31$28,619
Benefits paid (including direct rollovers)2012-12-31$28,063
Total plan assets at end of year2012-12-31$30,424
Total plan assets at beginning of year2012-12-31$0
Net income (gross income less expenses)2012-12-31$30,424
Net plan assets at end of year (total assets less liabilities)2012-12-31$30,424
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$0
Total contributions received or receivable from employer(s)2012-12-31$59,043
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$556

Form 5500 Responses for COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM

2023: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement - TrustYes
2022: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2021: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingYes
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: COOK GENERAL ENGINEERING, INC. INSURANCE PROGRAM 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01First time form 5500 has been submittedYes
2012-09-01Submission has been amendedNo
2012-09-01This submission is the final filingNo
2012-09-01This return/report is a short plan year return/report (less than 12 months)Yes
2012-09-01Plan is a collectively bargained planNo
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan funding arrangement – TrustYes
2012-09-01Plan benefit arrangement – InsuranceYes
2012-09-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PREMIER ACCESS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60237 )
Policy contract number3385
Policy instance 1
Insurance contract or identification number3385
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $850
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $8,821
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $850
Insurance broker organization code?3
Insurance broker nameBENECO
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number641330-0000
Policy instance 2
Insurance contract or identification number641330-0000
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,494
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $64,598
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $3,494
Insurance broker organization code?3
Insurance broker nameBENECO
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number641330-0000
Policy instance 1
Insurance contract or identification number641330-0000
Number of Individuals Covered38
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $5,746
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $134,646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $5,746
Insurance broker organization code?3
Insurance broker nameBENECO
PREMIER ACCESS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60237 )
Policy contract number3385
Policy instance 2
Insurance contract or identification number3385
Number of Individuals Covered38
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,440
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $18,702
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $1,440
Insurance broker organization code?3
Insurance broker nameBENECO
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number641330-0000
Policy instance 1
Insurance contract or identification number641330-0000
Number of Individuals Covered45
Insurance policy start date2013-09-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,703
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $84,587
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $3,703
Insurance broker organization code?3
Insurance broker nameBENECO
PREMIER ACCESS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60237 )
Policy contract number3385
Policy instance 2
Insurance contract or identification number3385
Number of Individuals Covered45
Insurance policy start date2013-09-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,513
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $14,095
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $1,513
Insurance broker organization code?3
Insurance broker nameBENECO
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number641330-0000
Policy instance 1
Insurance contract or identification number641330-0000
Number of Individuals Covered22
Insurance policy start date2012-09-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $940
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $22,822
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $940
Insurance broker organization code?3
Insurance broker nameBENECO
PREMIER ACCESS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60237 )
Policy contract number3385
Policy instance 2
Insurance contract or identification number3385
Number of Individuals Covered22
Insurance policy start date2012-09-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $115
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $5,043
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $115
Insurance broker organization code?3
Insurance broker nameBENECO

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