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VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 401k Plan overview

Plan NameVERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM
Plan identification number 501

VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

VERNON EDWARDS CONSTRUCTORS, INC has sponsored the creation of one or more 401k plans.

Company Name:VERNON EDWARDS CONSTRUCTORS, INC
Employer identification number (EIN):770079395
NAIC Classification:236200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-01-01JAMES EDWARDS2021-09-29 JAMES EDWARDS2021-09-29
5012019-01-01JAMES EDWARDS2020-07-14 JAMES EDWARDS2020-07-14
5012018-01-01
5012017-01-01
5012016-01-01
5012015-01-01LIZBETH GARCIA
5012014-01-01JAMES EDWARDS
5012013-01-01JAMES EDWARDS
5012012-01-01JAMES EDWARDS
5012011-01-01JAMES EDWARDS
5012010-01-01JAMES EDWARDS
5012009-12-01JAMES EDWARDS JAMES EDWARDS2010-10-14

Plan Statistics for VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM

401k plan membership statisitcs for VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM

Measure Date Value
2020: VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2020 401k membership
Total participants, beginning-of-year2020-01-0117
Total number of active participants reported on line 7a of the Form 55002020-01-0111
Total of all active and inactive participants2020-01-0111
2019: VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2019 401k membership
Total participants, beginning-of-year2019-01-0121
Total number of active participants reported on line 7a of the Form 55002019-01-0117
Total of all active and inactive participants2019-01-0117
2018: VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2018 401k membership
Total participants, beginning-of-year2018-01-0119
Total number of active participants reported on line 7a of the Form 55002018-01-0121
Total of all active and inactive participants2018-01-0121
2017: VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2017 401k membership
Total participants, beginning-of-year2017-01-0120
Total number of active participants reported on line 7a of the Form 55002017-01-0119
Total of all active and inactive participants2017-01-0119
2016: VERNON EDWARDS CONSTRUCTION, 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 55002016-01-0120
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 participants2016-01-0120
2015: VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2015 401k membership
Total participants, beginning-of-year2015-01-0112
Total number of active participants reported on line 7a of the Form 55002015-01-0116
Total of all active and inactive participants2015-01-0116
2014: VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2014 401k membership
Total participants, beginning-of-year2014-01-0112
Total number of active participants reported on line 7a of the Form 55002014-01-0112
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 participants2014-01-0112
2013: VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2013 401k membership
Total participants, beginning-of-year2013-01-0116
Total number of active participants reported on line 7a of the Form 55002013-01-0112
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 participants2013-01-0112
2012: VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2012 401k membership
Total participants, beginning-of-year2012-01-019
Total number of active participants reported on line 7a of the Form 55002012-01-0111
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-0111
2011: VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2011 401k membership
Total participants, beginning-of-year2011-01-0112
Total number of active participants reported on line 7a of the Form 55002011-01-019
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-019
2010: VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2010 401k membership
Total participants, beginning-of-year2010-01-018
Total number of active participants reported on line 7a of the Form 55002010-01-0112
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-0112
2009: VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2009 401k membership
Total participants, beginning-of-year2009-12-018
Total number of active participants reported on line 7a of the Form 55002009-12-018
Number of retired or separated participants receiving benefits2009-12-010
Number of other retired or separated participants entitled to future benefits2009-12-010
Total of all active and inactive participants2009-12-018

Financial Data on VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM

Measure Date Value
2020 : VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2020 401k financial data
Total income from all sources2020-12-31$210,780
Expenses. Total of all expenses incurred2020-12-31$219,888
Benefits paid (including direct rollovers)2020-12-31$217,176
Total plan assets at end of year2020-12-31$0
Total plan assets at beginning of year2020-12-31$9,108
Net income (gross income less expenses)2020-12-31$-9,108
Net plan assets at end of year (total assets less liabilities)2020-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$9,108
Total contributions received or receivable from employer(s)2020-12-31$210,780
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$2,712
2019 : VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2019 401k financial data
Total income from all sources2019-12-31$247,053
Expenses. Total of all expenses incurred2019-12-31$243,579
Benefits paid (including direct rollovers)2019-12-31$240,691
Total plan assets at end of year2019-12-31$9,108
Total plan assets at beginning of year2019-12-31$5,634
Net income (gross income less expenses)2019-12-31$3,474
Net plan assets at end of year (total assets less liabilities)2019-12-31$9,108
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$5,634
Total contributions received or receivable from employer(s)2019-12-31$247,053
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$2,888
2018 : VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2018 401k financial data
Total income from all sources2018-12-31$226,287
Expenses. Total of all expenses incurred2018-12-31$223,447
Benefits paid (including direct rollovers)2018-12-31$238,199
Total plan assets at end of year2018-12-31$5,634
Total plan assets at beginning of year2018-12-31$2,794
Net income (gross income less expenses)2018-12-31$2,840
Net plan assets at end of year (total assets less liabilities)2018-12-31$5,634
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$2,794
Total contributions received or receivable from employer(s)2018-12-31$226,287
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$-14,752
2017 : VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2017 401k financial data
Total income from all sources2017-12-31$267,590
Expenses. Total of all expenses incurred2017-12-31$266,468
Benefits paid (including direct rollovers)2017-12-31$244,814
Total plan assets at end of year2017-12-31$2,794
Total plan assets at beginning of year2017-12-31$1,672
Net income (gross income less expenses)2017-12-31$1,122
Net plan assets at end of year (total assets less liabilities)2017-12-31$2,794
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$1,672
Total contributions received or receivable from employer(s)2017-12-31$267,590
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$21,654
2016 : VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2016 401k financial data
Total income from all sources2016-12-31$137,791
Expenses. Total of all expenses incurred2016-12-31$148,735
Benefits paid (including direct rollovers)2016-12-31$147,320
Total plan assets at end of year2016-12-31$1,672
Total plan assets at beginning of year2016-12-31$12,616
Net income (gross income less expenses)2016-12-31$-10,944
Net plan assets at end of year (total assets less liabilities)2016-12-31$1,672
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$12,616
Total contributions received or receivable from employer(s)2016-12-31$137,791
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$1,415
2015 : VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2015 401k financial data
Total income from all sources2015-12-31$144,162
Expenses. Total of all expenses incurred2015-12-31$131,546
Benefits paid (including direct rollovers)2015-12-31$137,081
Total plan assets at end of year2015-12-31$12,616
Total plan assets at beginning of year2015-12-31$0
Expenses. Other expenses not covered elsewhere2015-12-31$-5,535
Net income (gross income less expenses)2015-12-31$12,616
Net plan assets at end of year (total assets less liabilities)2015-12-31$12,616
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$0
Total contributions received or receivable from employer(s)2015-12-31$144,162
2014 : VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2014 401k financial data
Total income from all sources2014-12-31$97,484
Expenses. Total of all expenses incurred2014-12-31$97,757
Benefits paid (including direct rollovers)2014-12-31$87,709
Total plan assets at end of year2014-12-31$0
Total plan assets at beginning of year2014-12-31$273
Value of fidelity bond covering the plan2014-12-31$125,000
Net income (gross income less expenses)2014-12-31$-273
Net plan assets at end of year (total assets less liabilities)2014-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$273
Total contributions received or receivable from employer(s)2014-12-31$97,484
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$10,048
2013 : VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2013 401k financial data
Total income from all sources2013-12-31$86,343
Expenses. Total of all expenses incurred2013-12-31$86,420
Benefits paid (including direct rollovers)2013-12-31$76,261
Total plan assets at end of year2013-12-31$273
Total plan assets at beginning of year2013-12-31$350
Value of fidelity bond covering the plan2013-12-31$125,000
Net income (gross income less expenses)2013-12-31$-77
Net plan assets at end of year (total assets less liabilities)2013-12-31$273
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$350
Total contributions received or receivable from employer(s)2013-12-31$86,343
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$10,159
2012 : VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2012 401k financial data
Total income from all sources2012-12-31$64,784
Expenses. Total of all expenses incurred2012-12-31$67,393
Benefits paid (including direct rollovers)2012-12-31$66,244
Total plan assets at end of year2012-12-31$350
Total plan assets at beginning of year2012-12-31$2,959
Value of fidelity bond covering the plan2012-12-31$80,000
Net income (gross income less expenses)2012-12-31$-2,609
Net plan assets at end of year (total assets less liabilities)2012-12-31$350
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$2,959
Total contributions received or receivable from employer(s)2012-12-31$64,784
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$1,149
2011 : VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2011 401k financial data
Total income from all sources2011-12-31$52,168
Expenses. Total of all expenses incurred2011-12-31$49,209
Benefits paid (including direct rollovers)2011-12-31$44,438
Total plan assets at end of year2011-12-31$2,959
Total plan assets at beginning of year2011-12-31$0
Value of fidelity bond covering the plan2011-12-31$80,000
Net income (gross income less expenses)2011-12-31$2,959
Net plan assets at end of year (total assets less liabilities)2011-12-31$2,959
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$0
Total contributions received or receivable from employer(s)2011-12-31$52,168
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$4,771
2010 : VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2010 401k financial data
Total income from all sources2010-12-31$41,688
Expenses. Total of all expenses incurred2010-12-31$41,688
Benefits paid (including direct rollovers)2010-12-31$39,150
Total plan assets at end of year2010-12-31$0
Total plan assets at beginning of year2010-12-31$0
Net income (gross income less expenses)2010-12-31$0
Net plan assets at end of year (total assets less liabilities)2010-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$0
Total contributions received or receivable from employer(s)2010-12-31$41,688
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$2,538

Form 5500 Responses for VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM

2020: VERNON EDWARDS CONSTRUCTION, 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 filingYes
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: VERNON EDWARDS CONSTRUCTION, 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 – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: VERNON EDWARDS CONSTRUCTION, 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 – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: VERNON EDWARDS CONSTRUCTION, 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 – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: VERNON EDWARDS CONSTRUCTION, 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 – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: VERNON EDWARDS CONSTRUCTION, 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 filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: VERNON EDWARDS CONSTRUCTION, 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: VERNON EDWARDS CONSTRUCTION, 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: VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: VERNON EDWARDS CONSTRUCTION, INC. INSURANCE PROGRAM 2009 form 5500 responses
2009-12-01Type of plan entitySingle employer plan
2009-12-01First time form 5500 has been submittedYes
2009-12-01Submission has been amendedNo
2009-12-01This submission is the final filingNo
2009-12-01This return/report is a short plan year return/report (less than 12 months)Yes
2009-12-01Plan is a collectively bargained planNo
2009-12-01Plan funding arrangement – InsuranceYes
2009-12-01Plan funding arrangement – TrustYes
2009-12-01Plan benefit arrangement – InsuranceYes
2009-12-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract number4417600
Policy instance 1
Insurance contract or identification number4417600
Number of Individuals Covered11
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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 $217,176
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract number4417600
Policy instance 1
Insurance contract or identification number4417600
Number of Individuals Covered17
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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 $240,691
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract number4417600
Policy instance 1
Insurance contract or identification number4417600
Number of Individuals Covered21
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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 $238,199
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract number4417600
Policy instance 1
Insurance contract or identification number4417600
Number of Individuals Covered19
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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 $244,814
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
Insurance broker nameTHE EYCK FINANCIAL
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract number4417600
Policy instance 1
Insurance contract or identification number4417600
Number of Individuals Covered16
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 $137,081
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
Insurance broker nameTEN EYCK FINANCIAL
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract number4417600
Policy instance 1
Insurance contract or identification number4417600
Number of Individuals Covered12
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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 $87,709
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Insurance broker organization code?3
Insurance broker nameTEN EYCK FINANCIAL
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract number4417600
Policy instance 1
Insurance contract or identification number4417600
Number of Individuals Covered12
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 $76,261
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
Insurance broker nameTEN EYCK FINANCIAL
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number875A/877A/878A
Policy instance 1
Insurance contract or identification number875A/877A/878A
Number of Individuals Covered11
Insurance policy start date2012-01-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $0
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 $66,244
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
Insurance broker nameBENECO
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number875A/877A/878A
Policy instance 1
Insurance contract or identification number875A/877A/878A
Number of Individuals Covered9
Insurance policy start date2011-01-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $0
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 $44,438
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number875A/877A/878A
Policy instance 1
Insurance contract or identification number875A/877A/878A
Number of Individuals Covered0
Insurance policy start date2010-01-01
Insurance policy end date2010-06-30
Total amount of commissions paid to insurance brokerUSD $0
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 $25,966
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
Insurance broker nameTEN EYCK FINANCIAL
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberW99557/WP3629
Policy instance 2
Insurance contract or identification numberW99557/WP3629
Number of Individuals Covered12
Insurance policy start date2010-10-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 $13,184
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Insurance broker organization code?3
Insurance broker nameTEN EYCK FINANCIAL

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