BOARD OF TRUSTEES, WESTERN HEALTHCARE INSURANCE TRUST has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan WESTERN HEALTHCARE INSURANCE TRUST
| Measure | Date | Value |
|---|
| 2023 : WESTERN HEALTHCARE INSURANCE TRUST 2023 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2023-12-31 | $792,610 |
| Total unrealized appreciation/depreciation of assets | 2023-12-31 | $792,610 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-12-31 | $1,080,945 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2023-12-31 | $2,077,285 |
| Total income from all sources (including contributions) | 2023-12-31 | $10,588,820 |
| Total loss/gain on sale of assets | 2023-12-31 | $-212,907 |
| Total of all expenses incurred | 2023-12-31 | $8,729,754 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2023-12-31 | $7,990,241 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2023-12-31 | $9,811,439 |
| Value of total assets at end of year | 2023-12-31 | $8,920,907 |
| Value of total assets at beginning of year | 2023-12-31 | $8,058,181 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2023-12-31 | $739,513 |
| Total interest from all sources | 2023-12-31 | $2,488 |
| Total dividends received (eg from common stock, registered investment company shares) | 2023-12-31 | $195,190 |
| Total dividends received from registered investment company shares (eg mutual funds) | 2023-12-31 | $195,190 |
| Were there any nonexempt tranactions with any party-in-interest | 2023-12-31 | No |
| Contributions received from participants | 2023-12-31 | $29,502 |
| Participant contributions at end of year | 2023-12-31 | $4,710 |
| Participant contributions at beginning of year | 2023-12-31 | $9,025 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2023-12-31 | $25,565 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2023-12-31 | $757,634 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2023-12-31 | $773,440 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2023-12-31 | $103,316 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2023-12-31 | $317,916 |
| Administrative expenses (other) incurred | 2023-12-31 | $483,397 |
| Liabilities. Value of operating payables at end of year | 2023-12-31 | $90,055 |
| Liabilities. Value of operating payables at beginning of year | 2023-12-31 | $53,934 |
| Total non interest bearing cash at end of year | 2023-12-31 | $0 |
| Total non interest bearing cash at beginning of year | 2023-12-31 | $315 |
| Value of net income/loss | 2023-12-31 | $1,859,066 |
| Value of net assets at end of year (total assets less liabilities) | 2023-12-31 | $7,839,962 |
| Value of net assets at beginning of year (total assets less liabilities) | 2023-12-31 | $5,980,896 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2023-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2023-12-31 | No |
| Investment advisory and management fees | 2023-12-31 | $12,722 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2023-12-31 | $6,999,794 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2023-12-31 | $6,360,789 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2023-12-31 | $970,544 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2023-12-31 | $715,558 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2023-12-31 | $715,558 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2023-12-31 | $2,488 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2023-12-31 | $7,964,676 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2023-12-31 | Yes |
| Has the plan failed to provide any benefit when due under the plan | 2023-12-31 | No |
| Contributions received in cash from employer | 2023-12-31 | $9,781,937 |
| Employer contributions (assets) at end of year | 2023-12-31 | $188,225 |
| Employer contributions (assets) at beginning of year | 2023-12-31 | $199,054 |
| Contract administrator fees | 2023-12-31 | $192,833 |
| Liabilities. Value of benefit claims payable at end of year | 2023-12-31 | $887,574 |
| Liabilities. Value of benefit claims payable at beginning of year | 2023-12-31 | $1,705,435 |
| Did the plan have assets held for investment | 2023-12-31 | Yes |
| Aggregate proceeds on sale of assets | 2023-12-31 | $4,028,535 |
| Aggregate carrying amount (costs) on sale of assets | 2023-12-31 | $4,241,442 |
| Opinion of an independent qualified public accountant for this plan | 2023-12-31 | Unqualified |
| Accountancy firm name | 2023-12-31 | SCHOEDEL & SCHOEDEL, CPAS PLLC |
| Accountancy firm EIN | 2023-12-31 | 910614823 |
| 2022 : WESTERN HEALTHCARE INSURANCE TRUST 2022 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2022-12-31 | $-1,214,469 |
| Total unrealized appreciation/depreciation of assets | 2022-12-31 | $-1,214,469 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $2,077,285 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $2,222,603 |
| Total income from all sources (including contributions) | 2022-12-31 | $8,429,120 |
| Total loss/gain on sale of assets | 2022-12-31 | $-30,716 |
| Total of all expenses incurred | 2022-12-31 | $9,138,213 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $8,416,697 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-12-31 | $9,478,762 |
| Value of total assets at end of year | 2022-12-31 | $8,058,181 |
| Value of total assets at beginning of year | 2022-12-31 | $8,912,592 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $721,516 |
| Total interest from all sources | 2022-12-31 | $669 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-12-31 | $194,874 |
| Total dividends received from registered investment company shares (eg mutual funds) | 2022-12-31 | $194,874 |
| Administrative expenses professional fees incurred | 2022-12-31 | $486,570 |
| Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
| Contributions received from participants | 2022-12-31 | $37,265 |
| Participant contributions at end of year | 2022-12-31 | $9,025 |
| Participant contributions at beginning of year | 2022-12-31 | $11,999 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2022-12-31 | $24,225 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-12-31 | $773,440 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-12-31 | $487,793 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2022-12-31 | $317,916 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2022-12-31 | $219,006 |
| Administrative expenses (other) incurred | 2022-12-31 | $44,282 |
| Liabilities. Value of operating payables at end of year | 2022-12-31 | $53,934 |
| Liabilities. Value of operating payables at beginning of year | 2022-12-31 | $18,326 |
| Total non interest bearing cash at end of year | 2022-12-31 | $315 |
| Total non interest bearing cash at beginning of year | 2022-12-31 | $725,063 |
| Value of net income/loss | 2022-12-31 | $-709,093 |
| Value of net assets at end of year (total assets less liabilities) | 2022-12-31 | $5,980,896 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-12-31 | $6,689,989 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
| Investment advisory and management fees | 2022-12-31 | $10,964 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-12-31 | $6,360,789 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-12-31 | $7,419,976 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-12-31 | $715,558 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-12-31 | $81,993 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-12-31 | $81,993 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2022-12-31 | $669 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-12-31 | $8,392,472 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | Yes |
| Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
| Contributions received in cash from employer | 2022-12-31 | $9,441,497 |
| Employer contributions (assets) at end of year | 2022-12-31 | $199,054 |
| Employer contributions (assets) at beginning of year | 2022-12-31 | $185,768 |
| Contract administrator fees | 2022-12-31 | $179,700 |
| Liabilities. Value of benefit claims payable at end of year | 2022-12-31 | $1,705,435 |
| Liabilities. Value of benefit claims payable at beginning of year | 2022-12-31 | $1,985,271 |
| Did the plan have assets held for investment | 2022-12-31 | Yes |
| Aggregate proceeds on sale of assets | 2022-12-31 | $3,641,812 |
| Aggregate carrying amount (costs) on sale of assets | 2022-12-31 | $3,672,528 |
| Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
| Accountancy firm name | 2022-12-31 | SCHOEDEL & SCHOEDEL, CPAS PLLC |
| Accountancy firm EIN | 2022-12-31 | 910614823 |
| 2021 : WESTERN HEALTHCARE INSURANCE TRUST 2021 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2021-12-31 | $-201,022 |
| Total unrealized appreciation/depreciation of assets | 2021-12-31 | $-201,022 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $2,222,603 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $2,022,215 |
| Total income from all sources (including contributions) | 2021-12-31 | $8,957,341 |
| Total loss/gain on sale of assets | 2021-12-31 | $633,690 |
| Total of all expenses incurred | 2021-12-31 | $9,074,645 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $8,403,326 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-12-31 | $8,285,457 |
| Value of total assets at end of year | 2021-12-31 | $8,430,592 |
| Value of total assets at beginning of year | 2021-12-31 | $8,347,508 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $671,319 |
| Total interest from all sources | 2021-12-31 | $91 |
| Total dividends received (eg from common stock, registered investment company shares) | 2021-12-31 | $239,125 |
| Total dividends received from registered investment company shares (eg mutual funds) | 2021-12-31 | $239,125 |
| Administrative expenses professional fees incurred | 2021-12-31 | $375,113 |
| Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
| Contributions received from participants | 2021-12-31 | $36,190 |
| Participant contributions at end of year | 2021-12-31 | $11,999 |
| Participant contributions at beginning of year | 2021-12-31 | $3,191 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2021-12-31 | $7,164 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-12-31 | $5,793 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-12-31 | $574,525 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2021-12-31 | $219,006 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2021-12-31 | $152,668 |
| Administrative expenses (other) incurred | 2021-12-31 | $119,996 |
| Liabilities. Value of operating payables at end of year | 2021-12-31 | $18,326 |
| Liabilities. Value of operating payables at beginning of year | 2021-12-31 | $2,564 |
| Total non interest bearing cash at end of year | 2021-12-31 | $725,063 |
| Total non interest bearing cash at beginning of year | 2021-12-31 | $280,542 |
| Value of net income/loss | 2021-12-31 | $-117,304 |
| Value of net assets at end of year (total assets less liabilities) | 2021-12-31 | $6,207,989 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-12-31 | $6,325,293 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
| Investment advisory and management fees | 2021-12-31 | $8,585 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-12-31 | $7,419,976 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-12-31 | $7,043,222 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-12-31 | $81,993 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-12-31 | $85,448 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-12-31 | $85,448 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2021-12-31 | $91 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-12-31 | $8,396,162 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-12-31 | Yes |
| Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
| Contributions received in cash from employer | 2021-12-31 | $8,249,267 |
| Employer contributions (assets) at end of year | 2021-12-31 | $185,768 |
| Employer contributions (assets) at beginning of year | 2021-12-31 | $360,580 |
| Contract administrator fees | 2021-12-31 | $167,625 |
| Liabilities. Value of benefit claims payable at end of year | 2021-12-31 | $1,985,271 |
| Liabilities. Value of benefit claims payable at beginning of year | 2021-12-31 | $1,866,983 |
| Did the plan have assets held for investment | 2021-12-31 | Yes |
| Aggregate proceeds on sale of assets | 2021-12-31 | $6,412,004 |
| Aggregate carrying amount (costs) on sale of assets | 2021-12-31 | $5,778,314 |
| Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
| Accountancy firm name | 2021-12-31 | SCHOEDEL & SCHOEDEL, CPAS PLLC |
| Accountancy firm EIN | 2021-12-31 | 910614823 |
| 2020 : WESTERN HEALTHCARE INSURANCE TRUST 2020 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2020-12-31 | $372,363 |
| Total unrealized appreciation/depreciation of assets | 2020-12-31 | $372,363 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $2,022,215 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $1,362,579 |
| Total income from all sources (including contributions) | 2020-12-31 | $8,118,217 |
| Total loss/gain on sale of assets | 2020-12-31 | $51,835 |
| Total of all expenses incurred | 2020-12-31 | $7,965,541 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $7,614,007 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-12-31 | $7,499,395 |
| Value of total assets at end of year | 2020-12-31 | $8,347,508 |
| Value of total assets at beginning of year | 2020-12-31 | $7,535,196 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $351,534 |
| Total interest from all sources | 2020-12-31 | $420 |
| Total dividends received (eg from common stock, registered investment company shares) | 2020-12-31 | $194,204 |
| Total dividends received from registered investment company shares (eg mutual funds) | 2020-12-31 | $194,204 |
| Administrative expenses professional fees incurred | 2020-12-31 | $162,120 |
| Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
| Contributions received from participants | 2020-12-31 | $18,044 |
| Participant contributions at end of year | 2020-12-31 | $3,191 |
| Participant contributions at beginning of year | 2020-12-31 | $564 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-12-31 | $574,525 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-12-31 | $281,574 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2020-12-31 | $152,668 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2020-12-31 | $10,325 |
| Administrative expenses (other) incurred | 2020-12-31 | $22,582 |
| Liabilities. Value of operating payables at end of year | 2020-12-31 | $2,564 |
| Liabilities. Value of operating payables at beginning of year | 2020-12-31 | $4,442 |
| Total non interest bearing cash at end of year | 2020-12-31 | $280,542 |
| Total non interest bearing cash at beginning of year | 2020-12-31 | $355,225 |
| Value of net income/loss | 2020-12-31 | $152,676 |
| Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $6,325,293 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $6,172,617 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
| Investment advisory and management fees | 2020-12-31 | $4,832 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-12-31 | $7,043,222 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-12-31 | $6,507,912 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-12-31 | $85,448 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-12-31 | $225,860 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-12-31 | $225,860 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2020-12-31 | $420 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-12-31 | $7,614,007 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | Yes |
| Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
| Contributions received in cash from employer | 2020-12-31 | $7,481,351 |
| Employer contributions (assets) at end of year | 2020-12-31 | $360,580 |
| Employer contributions (assets) at beginning of year | 2020-12-31 | $164,061 |
| Contract administrator fees | 2020-12-31 | $162,000 |
| Liabilities. Value of benefit claims payable at end of year | 2020-12-31 | $1,866,983 |
| Liabilities. Value of benefit claims payable at beginning of year | 2020-12-31 | $1,347,812 |
| Did the plan have assets held for investment | 2020-12-31 | Yes |
| Aggregate proceeds on sale of assets | 2020-12-31 | $3,703,060 |
| Aggregate carrying amount (costs) on sale of assets | 2020-12-31 | $3,651,225 |
| Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Unqualified |
| Accountancy firm name | 2020-12-31 | SCHOEDEL & SCHOEDEL, CPAS PLLC |
| Accountancy firm EIN | 2020-12-31 | 910614823 |
| 2019 : WESTERN HEALTHCARE INSURANCE TRUST 2019 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-12-31 | $627,698 |
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-12-31 | $627,698 |
| Total unrealized appreciation/depreciation of assets | 2019-12-31 | $627,698 |
| Total unrealized appreciation/depreciation of assets | 2019-12-31 | $627,698 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $1,362,579 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $1,362,579 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $1,792,462 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $1,792,462 |
| Total income from all sources (including contributions) | 2019-12-31 | $8,548,211 |
| Total income from all sources (including contributions) | 2019-12-31 | $8,548,211 |
| Total loss/gain on sale of assets | 2019-12-31 | $16,177 |
| Total loss/gain on sale of assets | 2019-12-31 | $16,177 |
| Total of all expenses incurred | 2019-12-31 | $8,959,456 |
| Total of all expenses incurred | 2019-12-31 | $8,959,456 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $8,587,219 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $8,587,219 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $7,703,142 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $7,703,142 |
| Value of total assets at end of year | 2019-12-31 | $7,535,196 |
| Value of total assets at end of year | 2019-12-31 | $7,535,196 |
| Value of total assets at beginning of year | 2019-12-31 | $8,376,324 |
| Value of total assets at beginning of year | 2019-12-31 | $8,376,324 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $372,237 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $372,237 |
| Total interest from all sources | 2019-12-31 | $5,903 |
| Total interest from all sources | 2019-12-31 | $5,903 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-12-31 | $195,291 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-12-31 | $195,291 |
| Total dividends received from registered investment company shares (eg mutual funds) | 2019-12-31 | $195,291 |
| Total dividends received from registered investment company shares (eg mutual funds) | 2019-12-31 | $195,291 |
| Administrative expenses professional fees incurred | 2019-12-31 | $161,707 |
| Administrative expenses professional fees incurred | 2019-12-31 | $161,707 |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Contributions received from participants | 2019-12-31 | $6,373 |
| Contributions received from participants | 2019-12-31 | $6,373 |
| Participant contributions at end of year | 2019-12-31 | $564 |
| Participant contributions at end of year | 2019-12-31 | $564 |
| Participant contributions at beginning of year | 2019-12-31 | $289 |
| Participant contributions at beginning of year | 2019-12-31 | $289 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-12-31 | $281,574 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-12-31 | $281,574 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $1,289,496 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $1,289,496 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2019-12-31 | $10,325 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2019-12-31 | $10,325 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2019-12-31 | $6,822 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2019-12-31 | $6,822 |
| Administrative expenses (other) incurred | 2019-12-31 | $44,655 |
| Administrative expenses (other) incurred | 2019-12-31 | $44,655 |
| Liabilities. Value of operating payables at end of year | 2019-12-31 | $4,442 |
| Liabilities. Value of operating payables at end of year | 2019-12-31 | $4,442 |
| Liabilities. Value of operating payables at beginning of year | 2019-12-31 | $26,178 |
| Liabilities. Value of operating payables at beginning of year | 2019-12-31 | $26,178 |
| Total non interest bearing cash at end of year | 2019-12-31 | $355,225 |
| Total non interest bearing cash at end of year | 2019-12-31 | $355,225 |
| Total non interest bearing cash at beginning of year | 2019-12-31 | $195,925 |
| Total non interest bearing cash at beginning of year | 2019-12-31 | $195,925 |
| Value of net income/loss | 2019-12-31 | $-411,245 |
| Value of net income/loss | 2019-12-31 | $-411,245 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $6,172,617 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $6,172,617 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $6,583,862 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $6,583,862 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Investment advisory and management fees | 2019-12-31 | $3,875 |
| Investment advisory and management fees | 2019-12-31 | $3,875 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-12-31 | $6,507,912 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-12-31 | $6,507,912 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-12-31 | $5,593,431 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-12-31 | $5,593,431 |
| Interest earned on other investments | 2019-12-31 | $5,159 |
| Interest earned on other investments | 2019-12-31 | $5,159 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-12-31 | $225,860 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-12-31 | $225,860 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-12-31 | $1,059,611 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-12-31 | $1,059,611 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-12-31 | $1,059,611 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-12-31 | $1,059,611 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-12-31 | $744 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-12-31 | $744 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $8,587,219 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $8,587,219 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | Yes |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | Yes |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Contributions received in cash from employer | 2019-12-31 | $7,696,769 |
| Contributions received in cash from employer | 2019-12-31 | $7,696,769 |
| Employer contributions (assets) at end of year | 2019-12-31 | $164,061 |
| Employer contributions (assets) at end of year | 2019-12-31 | $164,061 |
| Employer contributions (assets) at beginning of year | 2019-12-31 | $237,572 |
| Employer contributions (assets) at beginning of year | 2019-12-31 | $237,572 |
| Contract administrator fees | 2019-12-31 | $162,000 |
| Contract administrator fees | 2019-12-31 | $162,000 |
| Liabilities. Value of benefit claims payable at end of year | 2019-12-31 | $1,347,812 |
| Liabilities. Value of benefit claims payable at end of year | 2019-12-31 | $1,347,812 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-12-31 | $1,759,462 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-12-31 | $1,759,462 |
| Did the plan have assets held for investment | 2019-12-31 | Yes |
| Did the plan have assets held for investment | 2019-12-31 | Yes |
| Aggregate proceeds on sale of assets | 2019-12-31 | $1,894,886 |
| Aggregate proceeds on sale of assets | 2019-12-31 | $1,894,886 |
| Aggregate carrying amount (costs) on sale of assets | 2019-12-31 | $1,878,709 |
| Aggregate carrying amount (costs) on sale of assets | 2019-12-31 | $1,878,709 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | No |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Unqualified |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Unqualified |
| Accountancy firm name | 2019-12-31 | SCHOEDEL & SCHOEDEL CPAS, PLLC |
| Accountancy firm name | 2019-12-31 | SCHOEDEL & SCHOEDEL CPAS, PLLC |
| Accountancy firm EIN | 2019-12-31 | 910614823 |
| Accountancy firm EIN | 2019-12-31 | 910614823 |
| 2018 : WESTERN HEALTHCARE INSURANCE TRUST 2018 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2018-12-31 | $-359,234 |
| Total unrealized appreciation/depreciation of assets | 2018-12-31 | $-359,234 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $1,792,462 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $697,253 |
| Total income from all sources (including contributions) | 2018-12-31 | $12,810,765 |
| Total loss/gain on sale of assets | 2018-12-31 | $29,854 |
| Total of all expenses incurred | 2018-12-31 | $14,000,733 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $13,638,087 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $12,937,666 |
| Value of total assets at end of year | 2018-12-31 | $8,376,324 |
| Value of total assets at beginning of year | 2018-12-31 | $8,471,083 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $362,646 |
| Total interest from all sources | 2018-12-31 | $37,522 |
| Total dividends received (eg from common stock, registered investment company shares) | 2018-12-31 | $164,957 |
| Total dividends received from registered investment company shares (eg mutual funds) | 2018-12-31 | $164,957 |
| Administrative expenses professional fees incurred | 2018-12-31 | $149,626 |
| Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
| Contributions received from participants | 2018-12-31 | $3,843 |
| Participant contributions at end of year | 2018-12-31 | $289 |
| Participant contributions at beginning of year | 2018-12-31 | $769 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-12-31 | $1,289,496 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-12-31 | $2,017,163 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2018-12-31 | $6,822 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2018-12-31 | $4,300 |
| Administrative expenses (other) incurred | 2018-12-31 | $48,464 |
| Liabilities. Value of operating payables at end of year | 2018-12-31 | $26,178 |
| Liabilities. Value of operating payables at beginning of year | 2018-12-31 | $5,470 |
| Total non interest bearing cash at end of year | 2018-12-31 | $195,925 |
| Total non interest bearing cash at beginning of year | 2018-12-31 | $149,666 |
| Value of net income/loss | 2018-12-31 | $-1,189,968 |
| Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $6,583,862 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $7,773,830 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
| Investment advisory and management fees | 2018-12-31 | $2,556 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2018-12-31 | $5,593,431 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2018-12-31 | $5,237,411 |
| Interest earned on other investments | 2018-12-31 | $36,168 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-12-31 | $1,059,611 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-12-31 | $623,740 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-12-31 | $623,740 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-12-31 | $1,354 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $13,638,087 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | Yes |
| Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
| Contributions received in cash from employer | 2018-12-31 | $12,933,823 |
| Employer contributions (assets) at end of year | 2018-12-31 | $237,572 |
| Employer contributions (assets) at beginning of year | 2018-12-31 | $442,334 |
| Contract administrator fees | 2018-12-31 | $162,000 |
| Liabilities. Value of benefit claims payable at end of year | 2018-12-31 | $1,759,462 |
| Liabilities. Value of benefit claims payable at beginning of year | 2018-12-31 | $687,483 |
| Did the plan have assets held for investment | 2018-12-31 | Yes |
| Aggregate proceeds on sale of assets | 2018-12-31 | $4,413,282 |
| Aggregate carrying amount (costs) on sale of assets | 2018-12-31 | $4,383,428 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Unqualified |
| Accountancy firm name | 2018-12-31 | SCHOEDEL & SCHOEDEL CPAS, PLLC |
| Accountancy firm EIN | 2018-12-31 | 910614823 |
| 2017 : WESTERN HEALTHCARE INSURANCE TRUST 2017 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2017-12-31 | $118,211 |
| Total unrealized appreciation/depreciation of assets | 2017-12-31 | $118,211 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $697,253 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $573,376 |
| Total income from all sources (including contributions) | 2017-12-31 | $13,447,032 |
| Total loss/gain on sale of assets | 2017-12-31 | $121,463 |
| Total of all expenses incurred | 2017-12-31 | $12,581,299 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $12,209,611 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $13,021,259 |
| Value of total assets at end of year | 2017-12-31 | $8,471,083 |
| Value of total assets at beginning of year | 2017-12-31 | $7,481,473 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $371,688 |
| Total interest from all sources | 2017-12-31 | $22,783 |
| Total dividends received (eg from common stock, registered investment company shares) | 2017-12-31 | $163,316 |
| Total dividends received from registered investment company shares (eg mutual funds) | 2017-12-31 | $163,316 |
| Administrative expenses professional fees incurred | 2017-12-31 | $162,520 |
| Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
| Contributions received from participants | 2017-12-31 | $6,454 |
| Participant contributions at end of year | 2017-12-31 | $769 |
| Participant contributions at beginning of year | 2017-12-31 | $43 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-12-31 | $2,017,163 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-12-31 | $1,593,658 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2017-12-31 | $4,300 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2017-12-31 | $7,765 |
| Administrative expenses (other) incurred | 2017-12-31 | $44,437 |
| Liabilities. Value of operating payables at end of year | 2017-12-31 | $5,470 |
| Liabilities. Value of operating payables at beginning of year | 2017-12-31 | $6,553 |
| Total non interest bearing cash at end of year | 2017-12-31 | $149,666 |
| Total non interest bearing cash at beginning of year | 2017-12-31 | $377,193 |
| Value of net income/loss | 2017-12-31 | $865,733 |
| Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $7,773,830 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $6,908,097 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
| Investment advisory and management fees | 2017-12-31 | $2,731 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2017-12-31 | $5,237,411 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2017-12-31 | $4,836,873 |
| Interest earned on other investments | 2017-12-31 | $21,715 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-12-31 | $623,740 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-12-31 | $480,471 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-12-31 | $480,471 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-12-31 | $1,068 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $12,209,611 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | Yes |
| Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
| Contributions received in cash from employer | 2017-12-31 | $13,014,805 |
| Employer contributions (assets) at end of year | 2017-12-31 | $442,334 |
| Employer contributions (assets) at beginning of year | 2017-12-31 | $193,235 |
| Contract administrator fees | 2017-12-31 | $162,000 |
| Liabilities. Value of benefit claims payable at end of year | 2017-12-31 | $687,483 |
| Liabilities. Value of benefit claims payable at beginning of year | 2017-12-31 | $559,058 |
| Did the plan have assets held for investment | 2017-12-31 | Yes |
| Aggregate proceeds on sale of assets | 2017-12-31 | $1,473,989 |
| Aggregate carrying amount (costs) on sale of assets | 2017-12-31 | $1,352,526 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Unqualified |
| Accountancy firm name | 2017-12-31 | SCHOEDEL & SCHOEDEL CPAS, PLLC |
| Accountancy firm EIN | 2017-12-31 | 910614823 |
| 2016 : WESTERN HEALTHCARE INSURANCE TRUST 2016 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2016-12-31 | $-4,000 |
| Total unrealized appreciation/depreciation of assets | 2016-12-31 | $-4,000 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $573,376 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $1,239,092 |
| Total income from all sources (including contributions) | 2016-12-31 | $12,766,208 |
| Total loss/gain on sale of assets | 2016-12-31 | $31,106 |
| Total of all expenses incurred | 2016-12-31 | $12,448,834 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $12,135,541 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $12,597,556 |
| Value of total assets at end of year | 2016-12-31 | $7,481,473 |
| Value of total assets at beginning of year | 2016-12-31 | $7,829,815 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $313,293 |
| Total interest from all sources | 2016-12-31 | $17,083 |
| Total dividends received (eg from common stock, registered investment company shares) | 2016-12-31 | $124,463 |
| Total dividends received from registered investment company shares (eg mutual funds) | 2016-12-31 | $124,463 |
| Administrative expenses professional fees incurred | 2016-12-31 | $133,376 |
| Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
| Contributions received from participants | 2016-12-31 | $1,745 |
| Participant contributions at end of year | 2016-12-31 | $43 |
| Participant contributions at beginning of year | 2016-12-31 | $491 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2016-12-31 | $836 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-12-31 | $1,593,658 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-12-31 | $1,514,650 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2016-12-31 | $7,765 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2016-12-31 | $8,656 |
| Administrative expenses (other) incurred | 2016-12-31 | $33,888 |
| Liabilities. Value of operating payables at end of year | 2016-12-31 | $6,553 |
| Liabilities. Value of operating payables at beginning of year | 2016-12-31 | $9,095 |
| Total non interest bearing cash at end of year | 2016-12-31 | $377,193 |
| Total non interest bearing cash at beginning of year | 2016-12-31 | $755,352 |
| Value of net income/loss | 2016-12-31 | $317,374 |
| Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $6,908,097 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $6,590,723 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
| Investment advisory and management fees | 2016-12-31 | $2,029 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2016-12-31 | $4,836,873 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2016-12-31 | $2,928,042 |
| Interest earned on other investments | 2016-12-31 | $14,773 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-12-31 | $480,471 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-12-31 | $2,179,316 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-12-31 | $2,179,316 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-12-31 | $2,310 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $12,135,541 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | Yes |
| Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
| Contributions received in cash from employer | 2016-12-31 | $12,594,975 |
| Employer contributions (assets) at end of year | 2016-12-31 | $193,235 |
| Employer contributions (assets) at beginning of year | 2016-12-31 | $451,964 |
| Contract administrator fees | 2016-12-31 | $144,000 |
| Liabilities. Value of benefit claims payable at end of year | 2016-12-31 | $559,058 |
| Liabilities. Value of benefit claims payable at beginning of year | 2016-12-31 | $1,221,341 |
| Did the plan have assets held for investment | 2016-12-31 | Yes |
| Aggregate proceeds on sale of assets | 2016-12-31 | $1,154,454 |
| Aggregate carrying amount (costs) on sale of assets | 2016-12-31 | $1,123,348 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Unqualified |
| Accountancy firm name | 2016-12-31 | SCHOEDEL & SCHOEDEL CPAS, PLLC |
| Accountancy firm EIN | 2016-12-31 | 910614823 |
| 2015 : WESTERN HEALTHCARE INSURANCE TRUST 2015 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2015-12-31 | $-63,576 |
| Total unrealized appreciation/depreciation of assets | 2015-12-31 | $-63,576 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $1,239,092 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $1,619,591 |
| Total income from all sources (including contributions) | 2015-12-31 | $14,078,286 |
| Total loss/gain on sale of assets | 2015-12-31 | $16,536 |
| Total of all expenses incurred | 2015-12-31 | $14,388,320 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $14,067,505 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-12-31 | $14,036,667 |
| Value of total assets at end of year | 2015-12-31 | $7,829,815 |
| Value of total assets at beginning of year | 2015-12-31 | $8,520,348 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $320,815 |
| Total interest from all sources | 2015-12-31 | $11,690 |
| Total dividends received (eg from common stock, registered investment company shares) | 2015-12-31 | $76,969 |
| Total dividends received from registered investment company shares (eg mutual funds) | 2015-12-31 | $76,969 |
| Administrative expenses professional fees incurred | 2015-12-31 | $137,771 |
| Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
| Contributions received from participants | 2015-12-31 | $9,178 |
| Participant contributions at end of year | 2015-12-31 | $491 |
| Participant contributions at beginning of year | 2015-12-31 | $307 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-12-31 | $1,514,650 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-12-31 | $1,806,887 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2015-12-31 | $8,656 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2015-12-31 | $908 |
| Administrative expenses (other) incurred | 2015-12-31 | $36,823 |
| Liabilities. Value of operating payables at end of year | 2015-12-31 | $9,095 |
| Liabilities. Value of operating payables at beginning of year | 2015-12-31 | $2,715 |
| Total non interest bearing cash at end of year | 2015-12-31 | $755,352 |
| Total non interest bearing cash at beginning of year | 2015-12-31 | $2,428,619 |
| Value of net income/loss | 2015-12-31 | $-310,034 |
| Value of net assets at end of year (total assets less liabilities) | 2015-12-31 | $6,590,723 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-12-31 | $6,900,757 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
| Investment advisory and management fees | 2015-12-31 | $2,221 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2015-12-31 | $2,928,042 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2015-12-31 | $2,874,480 |
| Interest earned on other investments | 2015-12-31 | $10,665 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-12-31 | $2,179,316 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-12-31 | $577,999 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-12-31 | $577,999 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-12-31 | $1,025 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-12-31 | $14,067,505 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
| Contributions received in cash from employer | 2015-12-31 | $14,027,489 |
| Employer contributions (assets) at end of year | 2015-12-31 | $451,964 |
| Employer contributions (assets) at beginning of year | 2015-12-31 | $832,056 |
| Contract administrator fees | 2015-12-31 | $144,000 |
| Liabilities. Value of benefit claims payable at end of year | 2015-12-31 | $1,221,341 |
| Liabilities. Value of benefit claims payable at beginning of year | 2015-12-31 | $1,615,968 |
| Did the plan have assets held for investment | 2015-12-31 | Yes |
| Aggregate proceeds on sale of assets | 2015-12-31 | $946,955 |
| Aggregate carrying amount (costs) on sale of assets | 2015-12-31 | $930,419 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-12-31 | Unqualified |
| Accountancy firm name | 2015-12-31 | SCHOEDEL & SCHOEDEL CPAS, PLLC |
| Accountancy firm EIN | 2015-12-31 | 910614823 |
| 2014 : WESTERN HEALTHCARE INSURANCE TRUST 2014 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2014-12-31 | $11,972 |
| Total unrealized appreciation/depreciation of assets | 2014-12-31 | $11,972 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $1,619,591 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $700,847 |
| Total income from all sources (including contributions) | 2014-12-31 | $17,168,602 |
| Total loss/gain on sale of assets | 2014-12-31 | $62,443 |
| Total of all expenses incurred | 2014-12-31 | $16,108,466 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $15,780,297 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-12-31 | $16,980,368 |
| Value of total assets at end of year | 2014-12-31 | $8,520,348 |
| Value of total assets at beginning of year | 2014-12-31 | $6,541,468 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $328,169 |
| Total interest from all sources | 2014-12-31 | $13,728 |
| Total dividends received (eg from common stock, registered investment company shares) | 2014-12-31 | $100,091 |
| Total dividends received from registered investment company shares (eg mutual funds) | 2014-12-31 | $100,091 |
| Administrative expenses professional fees incurred | 2014-12-31 | $155,439 |
| Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
| Contributions received from participants | 2014-12-31 | $8,055 |
| Participant contributions at end of year | 2014-12-31 | $307 |
| Participant contributions at beginning of year | 2014-12-31 | $435 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-12-31 | $1,806,887 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-12-31 | $2,646,845 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year | 2014-12-31 | $908 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2014-12-31 | $6,171 |
| Administrative expenses (other) incurred | 2014-12-31 | $29,500 |
| Liabilities. Value of operating payables at end of year | 2014-12-31 | $2,715 |
| Liabilities. Value of operating payables at beginning of year | 2014-12-31 | $1,782 |
| Total non interest bearing cash at end of year | 2014-12-31 | $2,428,619 |
| Total non interest bearing cash at beginning of year | 2014-12-31 | $216,430 |
| Value of net income/loss | 2014-12-31 | $1,060,136 |
| Value of net assets at end of year (total assets less liabilities) | 2014-12-31 | $6,900,757 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-12-31 | $5,840,621 |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
| Investment advisory and management fees | 2014-12-31 | $2,230 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2014-12-31 | $2,874,480 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2014-12-31 | $2,593,521 |
| Interest earned on other investments | 2014-12-31 | $12,590 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-12-31 | $577,999 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-12-31 | $577,543 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-12-31 | $577,543 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2014-12-31 | $1,138 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-12-31 | $15,780,297 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | Yes |
| Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
| Contributions received in cash from employer | 2014-12-31 | $16,972,313 |
| Employer contributions (assets) at end of year | 2014-12-31 | $832,056 |
| Employer contributions (assets) at beginning of year | 2014-12-31 | $506,694 |
| Contract administrator fees | 2014-12-31 | $141,000 |
| Liabilities. Value of benefit claims payable at end of year | 2014-12-31 | $1,615,968 |
| Liabilities. Value of benefit claims payable at beginning of year | 2014-12-31 | $692,894 |
| Did the plan have assets held for investment | 2014-12-31 | Yes |
| Aggregate proceeds on sale of assets | 2014-12-31 | $1,572,180 |
| Aggregate carrying amount (costs) on sale of assets | 2014-12-31 | $1,509,737 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-12-31 | Unqualified |
| Accountancy firm name | 2014-12-31 | SCHOEDEL & SCHOEDEL CPAS, PLLC |
| Accountancy firm EIN | 2014-12-31 | 910614823 |
| WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 ) |
| Policy contract number | WHIT2/WHITV |
| Policy instance | 5 |
| Insurance contract or identification number | WHIT2/WHITV | | Number of Individuals Covered | 1180 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $3,665 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $775,549 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 ) |
| Policy contract number | 416 ET AL |
| Policy instance | 4 |
| Insurance contract or identification number | 416 ET AL | | Number of Individuals Covered | 6061 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,953,877 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 145336 ET AL |
| Policy instance | 3 |
| Insurance contract or identification number | 145336 ET AL | | Number of Individuals Covered | 4193 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $159,055 | | Total amount of fees paid to insurance company | USD $30,475 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $27,104 | | 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 number | 07103793 |
| Policy instance | 2 |
| Insurance contract or identification number | 07103793 | | Number of Individuals Covered | 951 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $2,783 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $137,919 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 ) |
| Policy contract number | 00653 ET AL |
| Policy instance | 1 |
| Insurance contract or identification number | 00653 ET AL | | Number of Individuals Covered | 5955 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid in cash? | Yes | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 ) |
| Policy contract number | 00653 ET AL |
| Policy instance | 1 |
| Insurance contract or identification number | 00653 ET AL | | Number of Individuals Covered | 5593 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $88,253 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid in cash? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $29,523 | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 07103793 |
| Policy instance | 2 |
| Insurance contract or identification number | 07103793 | | Number of Individuals Covered | 833 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $3,577 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $132,266 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,003 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 145336 ET AL |
| Policy instance | 3 |
| Insurance contract or identification number | 145336 ET AL | | Number of Individuals Covered | 4938 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $217,235 | | Total amount of fees paid to insurance company | USD $28,826 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $112,747 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $97,000 | | Amount paid for insurance broker fees | 6494 | | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 ) |
| Policy contract number | 416 ET AL |
| Policy instance | 4 |
| Insurance contract or identification number | 416 ET AL | | Number of Individuals Covered | 5941 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,922,793 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 ) |
| Policy contract number | WHIT2/WHITV |
| Policy instance | 5 |
| Insurance contract or identification number | WHIT2/WHITV | | Number of Individuals Covered | 1154 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $4,176 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $725,342 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,176 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 ) |
| Policy contract number | 416 ET AL |
| Policy instance | 1 |
| Insurance contract or identification number | 416 ET AL | | Number of Individuals Covered | 11973 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | 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 number | 07103793 |
| Policy instance | 2 |
| Insurance contract or identification number | 07103793 | | Number of Individuals Covered | 850 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $2,842 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $117,179 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,186 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 145336 ET AL |
| Policy instance | 3 |
| Insurance contract or identification number | 145336 ET AL | | Number of Individuals Covered | 5049 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $176,392 | | Total amount of fees paid to insurance company | USD $22,411 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $100,768 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $59,679 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 5088 | | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION |
|
| DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 ) |
| Policy contract number | 416 ET AL |
| Policy instance | 4 |
| Insurance contract or identification number | 416 ET AL | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,984,300 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 ) |
| Policy contract number | WA212 |
| Policy instance | 5 |
| Insurance contract or identification number | WA212 | | Number of Individuals Covered | 1067 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $635,837 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 ) |
| Policy contract number | 416 ET AL |
| Policy instance | 1 |
| Insurance contract or identification number | 416 ET AL | | Number of Individuals Covered | 11876 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid in cash? | Yes | | 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 number | 07103793 |
| Policy instance | 2 |
| Insurance contract or identification number | 07103793 | | Number of Individuals Covered | 1255 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $2,011 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $143,245 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,527 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 145336 ET AL |
| Policy instance | 3 |
| Insurance contract or identification number | 145336 ET AL | | Number of Individuals Covered | 4793 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $166,061 | | Total amount of fees paid to insurance company | USD $26,215 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $63,444 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $69,302 | | Amount paid for insurance broker fees | 5504 | | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 ) |
| Policy contract number | 416 ET AL |
| Policy instance | 4 |
| Insurance contract or identification number | 416 ET AL | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,112,010 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 ) |
| Policy contract number | WA212 |
| Policy instance | 5 |
| Insurance contract or identification number | WA212 | | Number of Individuals Covered | 904 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $596,556 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 ) |
| Policy contract number | WA212 |
| Policy instance | 5 |
| Insurance contract or identification number | WA212 | | Number of Individuals Covered | 990 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $3,518 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $528,864 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,518 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 ) |
| Policy contract number | 416 ET AL |
| Policy instance | 4 |
| Insurance contract or identification number | 416 ET AL | | Number of Individuals Covered | 6326 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,858,153 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 145336 ET AL |
| Policy instance | 3 |
| Insurance contract or identification number | 145336 ET AL | | Number of Individuals Covered | 4805 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $145,540 | | Total amount of fees paid to insurance company | USD $41,224 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $134,581 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $51,389 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 27149 | | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 07103793 |
| Policy instance | 2 |
| Insurance contract or identification number | 07103793 | | Number of Individuals Covered | 409 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $2,218 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $94,832 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,908 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 ) |
| Policy contract number | 653, 659 |
| Policy instance | 1 |
| Insurance contract or identification number | 653, 659 | | Number of Individuals Covered | 3745 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 ) |
| Policy contract number | WA212/Z149 |
| Policy instance | 5 |
| Insurance contract or identification number | WA212/Z149 | | Number of Individuals Covered | 1288 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $3,215 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $720,735 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,215 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 ) |
| Policy contract number | 416 ET AL |
| Policy instance | 4 |
| Insurance contract or identification number | 416 ET AL | | Number of Individuals Covered | 6818 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,217,483 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 145336 ET AL |
| Policy instance | 3 |
| Insurance contract or identification number | 145336 ET AL | | Number of Individuals Covered | 4928 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $164,230 | | Total amount of fees paid to insurance company | USD $38,989 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $181,207 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $46,565 | | Amount paid for insurance broker fees | 3168 | | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 07103793 |
| Policy instance | 2 |
| Insurance contract or identification number | 07103793 | | Number of Individuals Covered | 522 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $2,036 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $83,649 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,783 | | Insurance broker organization code? | 3 |
|
| DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 ) |
| Policy contract number | 418 ET AL |
| Policy instance | 1 |
| Insurance contract or identification number | 418 ET AL | | Number of Individuals Covered | 12351 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid in cash? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 ) |
| Policy contract number | 418 ET AL |
| Policy instance | 1 |
| Insurance contract or identification number | 418 ET AL | | Number of Individuals Covered | 12498 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid in cash? | Yes | | 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 number | 07103793 |
| Policy instance | 2 |
| Insurance contract or identification number | 07103793 | | Number of Individuals Covered | 601 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $2,657 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $92,911 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,095 | | Insurance broker organization code? | 3 | | Insurance broker name | BURNLEY WILSON ASSOCIATES |
|
| DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 ) |
| Policy contract number | 416 ET AL |
| Policy instance | 4 |
| Insurance contract or identification number | 416 ET AL | | Number of Individuals Covered | 6592 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,118,916 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 ) |
| Policy contract number | WA212/Z149 |
| Policy instance | 5 |
| Insurance contract or identification number | WA212/Z149 | | Number of Individuals Covered | 1367 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $3,232 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $742,443 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,232 | | Insurance broker organization code? | 3 | | Insurance broker name | KIBBLE & PRENTICE HOLDING COMPANY |
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| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 145336 ET AL |
| Policy instance | 3 |
| Insurance contract or identification number | 145336 ET AL | | Number of Individuals Covered | 4293 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $193,069 | | Total amount of fees paid to insurance company | USD $31,352 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $231,412 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $43,732 | | Amount paid for insurance broker fees | 2237 | | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN & BROWN OF NY INC |
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| DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 ) |
| Policy contract number | 418 ET AL |
| Policy instance | 1 |
| Insurance contract or identification number | 418 ET AL | | Number of Individuals Covered | 14884 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 ) |
| Policy contract number | Z149/WA212 KAD |
| Policy instance | 2 |
| Insurance contract or identification number | Z149/WA212 KAD | | Number of Individuals Covered | 327 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $366,700 | | 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: 47317 ) |
| Policy contract number | 237089668 |
| Policy instance | 3 |
| Insurance contract or identification number | 237089668 | | Number of Individuals Covered | 715 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $4,346 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $108,697 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,801 | | Insurance broker organization code? | 3 | | Insurance broker name | USI NW DBA KIBBLE & PRENTICE HOLDIN |
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| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 31246 |
| Policy instance | 4 |
| Insurance contract or identification number | 31246 | | Number of Individuals Covered | 267 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $593 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,136 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $593 | | Insurance broker organization code? | 3 | | Insurance broker name | PARKER SMITH AND FEEK INC |
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| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 145336 ET AL |
| Policy instance | 5 |
| Insurance contract or identification number | 145336 ET AL | | Number of Individuals Covered | 4958 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $157,600 | | Total amount of fees paid to insurance company | USD $8,098 | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $50,119 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 785 | | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION | | Insurance broker name | C2 CENTRIC LLC |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 648701 |
| Policy instance | 6 |
| Insurance contract or identification number | 648701 | | Number of Individuals Covered | 20 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $1,190 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,009 | | Insurance broker organization code? | 3 | | Insurance broker name | BROWN & BROWN OF WA INC |
|
| DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 ) |
| Policy contract number | 416 ET AL |
| Policy instance | 7 |
| Insurance contract or identification number | 416 ET AL | | Number of Individuals Covered | 7141 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,186,396 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 ) |
| Policy contract number | Z149/WA212 |
| Policy instance | 8 |
| Insurance contract or identification number | Z149/WA212 | | Number of Individuals Covered | 589 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $2,546 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $617,667 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,497 | | Insurance broker organization code? | 3 | | Insurance broker name | KIBBLE & PRENTICE HOLDING COMPANY |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 145336 ET AL |
| Policy instance | 9 |
| Insurance contract or identification number | 145336 ET AL | | Number of Individuals Covered | 3721 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $60,239 | | Total amount of fees paid to insurance company | USD $1,494 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $22,298 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 694 | | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION | | Insurance broker name | USI NORTHEAST INC |
|
| WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 ) |
| Policy contract number | Z149/WA212 KAD |
| Policy instance | 2 |
| Insurance contract or identification number | Z149/WA212 KAD | | Number of Individuals Covered | 301 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $313,891 | | 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: 47317 ) |
| Policy contract number | 07103793 |
| Policy instance | 3 |
| Insurance contract or identification number | 07103793 | | Number of Individuals Covered | 1212 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $6,957 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $174,169 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,937 | | Insurance broker organization code? | 3 | | Insurance broker name | ARGUS INSURANCE INC. |
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| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 145336 ET AL |
| Policy instance | 5 |
| Insurance contract or identification number | 145336 ET AL | | Number of Individuals Covered | 4378 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $153,567 | | Total amount of fees paid to insurance company | USD $12,560 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $74,763 | | Amount paid for insurance broker fees | 9174 | | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | C2 CENTRIC LLC |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 145336 ET AL |
| Policy instance | 4 |
| Insurance contract or identification number | 145336 ET AL | | Number of Individuals Covered | 4190 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $51,704 | | Total amount of fees paid to insurance company | USD $2,036 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,352 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1747 | | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION | | Insurance broker name | ALLIANT INSURANCE SERVICES INC. |
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| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 648701 |
| Policy instance | 6 |
| Insurance contract or identification number | 648701 | | Number of Individuals Covered | 19 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $1,196 | | Total amount of fees paid to insurance company | USD $13 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,019 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 13 | | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION | | Insurance broker name | BROWN AND BROWN OF WA INC |
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| DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 ) |
| Policy contract number | 416 ET AL |
| Policy instance | 7 |
| Insurance contract or identification number | 416 ET AL | | Number of Individuals Covered | 6845 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,396,974 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 ) |
| Policy contract number | Z149/WA212 |
| Policy instance | 8 |
| Insurance contract or identification number | Z149/WA212 | | Number of Individuals Covered | 569 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $2,636 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $617,196 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,636 | | Insurance broker organization code? | 3 | | Insurance broker name | PAYNEWEST INSURANCE INC |
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| DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 ) |
| Policy contract number | 418 ET AL |
| Policy instance | 1 |
| Insurance contract or identification number | 418 ET AL | | Number of Individuals Covered | 17972 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid in cash? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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