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CAWA ARIZONA HEALTH TRUST 401k Plan overview

Plan NameCAWA ARIZONA HEALTH TRUST
Plan identification number 501

CAWA ARIZONA HEALTH TRUST Benefits

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

401k Sponsoring company profile

CAWA ARIZONA HEALTH TRUST BOARD OF TRUSTEES has sponsored the creation of one or more 401k plans.

Company Name:CAWA ARIZONA HEALTH TRUST BOARD OF TRUSTEES
Employer identification number (EIN):834669944
NAIC Classification:811110
NAIC Description: Automotive Mechanical and Electrical Repair and Maintenance

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CAWA ARIZONA HEALTH TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01RODNEY K. PIERINI2024-08-20
5012022-01-01RODNEY K. PIERINI2023-10-10
5012021-01-01RODNEY K. PIERINI2022-10-14
5012020-01-01RODNEY K. PIERINI2021-07-26
5012019-04-18RODNEY K. PIERINI2020-07-07

Financial Data on CAWA ARIZONA HEALTH TRUST

Measure Date Value
2023 : CAWA ARIZONA HEALTH TRUST 2023 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$141,479
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$125,849
Total income from all sources (including contributions)2023-12-31$1,250,094
Total of all expenses incurred2023-12-31$1,252,823
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$1,092,709
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-12-31$1,250,094
Value of total assets at end of year2023-12-31$90,851
Value of total assets at beginning of year2023-12-31$77,950
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$160,114
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-12-31No
Was this plan covered by a fidelity bond2023-12-31Yes
Value of fidelity bond cover2023-12-31$500,000
If this is an individual account plan, was there a blackout period2023-12-31No
Were there any nonexempt tranactions with any party-in-interest2023-12-31No
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2023-12-31$39,150
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2023-12-31$52,529
Administrative expenses (other) incurred2023-12-31$95,914
Liabilities. Value of operating payables at end of year2023-12-31$87,939
Liabilities. Value of operating payables at beginning of year2023-12-31$67,536
Total non interest bearing cash at end of year2023-12-31$86,116
Total non interest bearing cash at beginning of year2023-12-31$77,950
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Value of net income/loss2023-12-31$-2,729
Value of net assets at end of year (total assets less liabilities)2023-12-31$-50,628
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$-47,899
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-12-31No
Were any leases to which the plan was party in default or uncollectible2023-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2023-12-31$1,092,709
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-12-31No
Was there a failure to transmit to the plan any participant contributions2023-12-31No
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Contributions received in cash from employer2023-12-31$1,250,094
Employer contributions (assets) at end of year2023-12-31$4,735
Contract administrator fees2023-12-31$47,850
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32023-12-31No
Liabilities. Value of benefit claims payable at end of year2023-12-31$14,390
Liabilities. Value of benefit claims payable at beginning of year2023-12-31$5,784
Did the plan have assets held for investment2023-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-12-31No
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31ANASTASI MOORE & MARTIN PLLC
Accountancy firm EIN2023-12-31208149014
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-01$141,479
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-01$125,849
Total income from all sources (including contributions)2023-01-01$1,250,094
Total of all expenses incurred2023-01-01$1,252,823
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-01-01$1,092,709
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-01-01$1,250,094
Value of total assets at end of year2023-01-01$90,851
Value of total assets at beginning of year2023-01-01$77,950
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-01-01$160,114
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-01-01No
Was this plan covered by a fidelity bond2023-01-01Yes
Value of fidelity bond cover2023-01-01$500,000
If this is an individual account plan, was there a blackout period2023-01-01No
Were there any nonexempt tranactions with any party-in-interest2023-01-01No
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2023-01-01$39,150
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2023-01-01$52,529
Administrative expenses (other) incurred2023-01-01$95,914
Liabilities. Value of operating payables at end of year2023-01-01$87,939
Liabilities. Value of operating payables at beginning of year2023-01-01$67,536
Total non interest bearing cash at end of year2023-01-01$86,116
Total non interest bearing cash at beginning of year2023-01-01$77,950
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-01No
Value of net income/loss2023-01-01$-2,729
Value of net assets at end of year (total assets less liabilities)2023-01-01$-50,628
Value of net assets at beginning of year (total assets less liabilities)2023-01-01$-47,899
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-01-01No
Were any loans by the plan or fixed income obligations due to the plan in default2023-01-01No
Were any leases to which the plan was party in default or uncollectible2023-01-01No
Expenses. Payments to insurance carriers foe the provision of benefits2023-01-01$1,092,709
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-01-01No
Was there a failure to transmit to the plan any participant contributions2023-01-01No
Has the plan failed to provide any benefit when due under the plan2023-01-01No
Contributions received in cash from employer2023-01-01$1,250,094
Employer contributions (assets) at end of year2023-01-01$4,735
Contract administrator fees2023-01-01$47,850
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32023-01-01No
Liabilities. Value of benefit claims payable at end of year2023-01-01$14,390
Liabilities. Value of benefit claims payable at beginning of year2023-01-01$5,784
Did the plan have assets held for investment2023-01-01No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-01-01No
Opinion of an independent qualified public accountant for this plan2023-01-011
Accountancy firm name2023-01-01ANASTASI MOORE & MARTIN PLLC
Accountancy firm EIN2023-01-01208149014
2022 : CAWA ARIZONA HEALTH TRUST 2022 401k financial data
Total plan liabilities at end of year2022-12-31$125,849
Total plan liabilities at beginning of year2022-12-31$63,060
Total income from all sources2022-12-31$874,210
Expenses. Total of all expenses incurred2022-12-31$885,576
Benefits paid (including direct rollovers)2022-12-31$767,074
Total plan assets at end of year2022-12-31$77,950
Total plan assets at beginning of year2022-12-31$26,527
Value of fidelity bond covering the plan2022-12-31$500,000
Total contributions received or receivable from participants2022-12-31$0
Expenses. Other expenses not covered elsewhere2022-12-31$70,459
Net income (gross income less expenses)2022-12-31$-11,366
Net plan assets at end of year (total assets less liabilities)2022-12-31$-47,899
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$-36,533
Total contributions received or receivable from employer(s)2022-12-31$874,210
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$48,043
2021 : CAWA ARIZONA HEALTH TRUST 2021 401k financial data
Total plan liabilities at end of year2021-12-31$63,060
Total plan liabilities at beginning of year2021-12-31$46,381
Total income from all sources2021-12-31$733,853
Expenses. Total of all expenses incurred2021-12-31$743,652
Benefits paid (including direct rollovers)2021-12-31$644,023
Total plan assets at end of year2021-12-31$26,527
Total plan assets at beginning of year2021-12-31$19,647
Value of fidelity bond covering the plan2021-12-31$500,000
Total contributions received or receivable from participants2021-12-31$9,419
Expenses. Other expenses not covered elsewhere2021-12-31$52,567
Net income (gross income less expenses)2021-12-31$-9,799
Net plan assets at end of year (total assets less liabilities)2021-12-31$-36,533
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$-26,734
Total contributions received or receivable from employer(s)2021-12-31$724,434
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$47,062
2020 : CAWA ARIZONA HEALTH TRUST 2020 401k financial data
Total plan liabilities at end of year2020-12-31$46,381
Total plan liabilities at beginning of year2020-12-31$51,485
Total income from all sources2020-12-31$709,406
Expenses. Total of all expenses incurred2020-12-31$734,381
Benefits paid (including direct rollovers)2020-12-31$631,227
Total plan assets at end of year2020-12-31$19,647
Total plan assets at beginning of year2020-12-31$49,726
Value of fidelity bond covering the plan2020-12-31$500,000
Expenses. Other expenses not covered elsewhere2020-12-31$49,336
Net income (gross income less expenses)2020-12-31$-24,975
Net plan assets at end of year (total assets less liabilities)2020-12-31$-26,734
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$-1,759
Total contributions received or receivable from employer(s)2020-12-31$709,406
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$53,818
2019 : CAWA ARIZONA HEALTH TRUST 2019 401k financial data
Total plan liabilities at end of year2019-12-31$51,485
Total income from all sources2019-12-31$59,161
Expenses. Total of all expenses incurred2019-12-31$60,920
Benefits paid (including direct rollovers)2019-12-31$52,591
Total plan assets at end of year2019-12-31$49,726
Value of fidelity bond covering the plan2019-12-31$500,000
Expenses. Other expenses not covered elsewhere2019-12-31$5,963
Net income (gross income less expenses)2019-12-31$-1,759
Net plan assets at end of year (total assets less liabilities)2019-12-31$-1,759
Total contributions received or receivable from employer(s)2019-12-31$59,161
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$2,366

Form 5500 Responses for CAWA ARIZONA HEALTH TRUST

2023: CAWA ARIZONA HEALTH TRUST 2023 form 5500 responses
2023-01-01Type of plan entityMulitple employer plan
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: CAWA ARIZONA HEALTH TRUST 2022 form 5500 responses
2022-01-01Type of plan entityMulitple employer plan
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: CAWA ARIZONA HEALTH TRUST 2021 form 5500 responses
2021-01-01Type of plan entityMulitple employer plan
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: CAWA ARIZONA HEALTH TRUST 2020 form 5500 responses
2020-01-01Type of plan entityMulitple employer plan
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: CAWA ARIZONA HEALTH TRUST 2019 form 5500 responses
2019-04-18Type of plan entityMulitple employer plan
2019-04-18First time form 5500 has been submittedYes
2019-04-18This return/report is a short plan year return/report (less than 12 months)Yes
2019-04-18Plan funding arrangement – TrustYes
2019-04-18Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number011688
Policy instance 3
Insurance contract or identification number011688
Number of Individuals Covered128
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $230
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,257
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number53001 TO 53010
Policy instance 2
Insurance contract or identification number53001 TO 53010
Number of Individuals Covered235
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,071,102
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30044146
Policy instance 1
Insurance contract or identification number30044146
Number of Individuals Covered40
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number011688
Policy instance 3
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number53001 TO 53010
Policy instance 2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30044146
Policy instance 1
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number75776
Policy instance 3
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number53001 TO 53010
Policy instance 2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30044146
Policy instance 1
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number75776
Policy instance 3
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number53001 TO 53010
Policy instance 2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30044146
Policy instance 1
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30044146
Policy instance 1

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