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MEDICAL EXPENSE COVERAGE PLAN 401k Plan overview

Plan NameMEDICAL EXPENSE COVERAGE PLAN
Plan identification number 505

MEDICAL EXPENSE COVERAGE PLAN Benefits

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

401k Sponsoring company profile

STANDARD INSURANCE COMPANY has sponsored the creation of one or more 401k plans.

Company Name:STANDARD INSURANCE COMPANY
Employer identification number (EIN):930242990
NAIC Classification:238210
NAIC Description:Electrical Contractors and Other Wiring Installation Contractors

Additional information about STANDARD INSURANCE COMPANY

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division
Incorporation Date: 1981-08-26
Company Identification Number: 15532211
Legal Registered Office Address: 500 SW SUBLIMITY BLVD

SUBLIMITY
United States of America (USA)
97385

More information about STANDARD INSURANCE COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDICAL EXPENSE COVERAGE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052015-01-01BENJAMIN C. FRASIER
5052014-01-01BENJAMIN C FRASIER
5052013-01-01JUNG RYU
5052012-01-01JUNG RYU
5052011-01-01JUNG RYU
5052009-01-01JAMES TAFF

Plan Statistics for MEDICAL EXPENSE COVERAGE PLAN

401k plan membership statisitcs for MEDICAL EXPENSE COVERAGE PLAN

Measure Date Value
2015: MEDICAL EXPENSE COVERAGE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-010
Total number of active participants reported on line 7a of the Form 55002015-01-010
Total of all active and inactive participants2015-01-010
2014: MEDICAL EXPENSE COVERAGE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-012,674
Total number of active participants reported on line 7a of the Form 55002014-01-012,503
Number of retired or separated participants receiving benefits2014-01-01278
Total of all active and inactive participants2014-01-012,781
2013: MEDICAL EXPENSE COVERAGE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-012,839
Total number of active participants reported on line 7a of the Form 55002013-01-012,377
Number of retired or separated participants receiving benefits2013-01-01297
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-012,674
Total participants2013-01-012,674
2012: MEDICAL EXPENSE COVERAGE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-012,893
Total number of active participants reported on line 7a of the Form 55002012-01-012,593
Number of retired or separated participants receiving benefits2012-01-01246
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-012,839
2011: MEDICAL EXPENSE COVERAGE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-012,962
Total number of active participants reported on line 7a of the Form 55002011-01-012,655
Number of retired or separated participants receiving benefits2011-01-01238
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-012,893
2009: MEDICAL EXPENSE COVERAGE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-013,179
Total number of active participants reported on line 7a of the Form 55002009-01-012,818
Number of retired or separated participants receiving benefits2009-01-01192
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-013,010

Financial Data on MEDICAL EXPENSE COVERAGE PLAN

Measure Date Value
2015 : MEDICAL EXPENSE COVERAGE PLAN 2015 401k financial data
Transfers to/from the plan2015-01-01$-20,884,364
Total plan liabilities at beginning of year2015-01-01$1,835,000
Total plan assets at end of year2015-01-01$0
Total plan assets at beginning of year2015-01-01$22,719,364
Net plan assets at end of year (total assets less liabilities)2015-01-01$0
Net plan assets at beginning of year (total assets less liabilities)2015-01-01$20,884,364
2014 : MEDICAL EXPENSE COVERAGE PLAN 2014 401k financial data
Unrealized appreciation/depreciation of real estate assets2014-12-31$1,495,505
Total unrealized appreciation/depreciation of assets2014-12-31$1,495,505
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$1,835,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$1,587,000
Total income from all sources (including contributions)2014-12-31$28,414,135
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$26,512,186
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$26,437,353
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$26,089,619
Value of total assets at end of year2014-12-31$22,719,364
Value of total assets at beginning of year2014-12-31$20,569,415
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$74,833
Total interest from all sources2014-12-31$829,011
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Administrative expenses professional fees incurred2014-12-31$11,313
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$20,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$7,796,606
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$177,377
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$182,032
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$1,835,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$1,587,000
Administrative expenses (other) incurred2014-12-31$63,520
Total non interest bearing cash at end of year2014-12-31$1,011
Total non interest bearing cash at beginning of year2014-12-31$1,001
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$1,901,949
Value of net assets at end of year (total assets less liabilities)2014-12-31$20,884,364
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$18,982,415
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Income. Interest from US Government securities2014-12-31$829,011
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$516,226
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$556,265
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$556,265
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$10,315,837
Asset value of US Government securities at end of year2014-12-31$17,921,836
Asset value of US Government securities at beginning of year2014-12-31$16,793,624
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$18,293,013
Employer contributions (assets) at end of year2014-12-31$1,492,719
Employer contributions (assets) at beginning of year2014-12-31$1,288,873
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$16,121,516
Asset. Corporate debt instrument debt (other) at end of year2014-12-31$2,610,195
Asset. Corporate debt instrument debt (other) at beginning of year2014-12-31$1,747,620
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31MOSS ADAMS LLP
Accountancy firm EIN2014-12-31910189318
2013 : MEDICAL EXPENSE COVERAGE PLAN 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets2013-12-31$-1,799,707
Total unrealized appreciation/depreciation of assets2013-12-31$-1,799,707
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$1,587,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$1,569,000
Total income from all sources (including contributions)2013-12-31$23,897,691
Total loss/gain on sale of assets2013-12-31$8,496
Total of all expenses incurred2013-12-31$26,201,377
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$26,201,377
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$24,864,406
Value of total assets at end of year2013-12-31$20,569,415
Value of total assets at beginning of year2013-12-31$22,855,101
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$0
Total interest from all sources2013-12-31$824,496
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$20,000,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$7,456,826
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$684,000
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$182,032
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$173,004
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$1,587,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$1,569,000
Total non interest bearing cash at end of year2013-12-31$1,001
Total non interest bearing cash at beginning of year2013-12-31$1,009
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-2,303,686
Value of net assets at end of year (total assets less liabilities)2013-12-31$18,982,415
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$21,286,101
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Income. Interest from US Government securities2013-12-31$823,938
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$556,265
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$1,382,610
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$1,382,610
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$558
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$9,673,980
Asset value of US Government securities at end of year2013-12-31$16,793,624
Asset value of US Government securities at beginning of year2013-12-31$19,029,326
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$17,407,580
Employer contributions (assets) at end of year2013-12-31$1,288,873
Employer contributions (assets) at beginning of year2013-12-31$1,264,762
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$15,843,397
Asset. Corporate debt instrument debt (other) at end of year2013-12-31$1,747,620
Asset. Corporate debt instrument debt (other) at beginning of year2013-12-31$1,004,390
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Aggregate proceeds on sale of assets2013-12-31$693,496
Aggregate carrying amount (costs) on sale of assets2013-12-31$685,000
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31DELOITTE & TOUCHE, LLP
Accountancy firm EIN2013-12-31133891517
2012 : MEDICAL EXPENSE COVERAGE PLAN 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets2012-12-31$341,570
Total unrealized appreciation/depreciation of assets2012-12-31$341,570
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$1,569,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$1,835,000
Total income from all sources (including contributions)2012-12-31$25,628,805
Total loss/gain on sale of assets2012-12-31$14,807
Total of all expenses incurred2012-12-31$24,808,274
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$24,808,274
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$24,431,896
Value of total assets at end of year2012-12-31$22,855,101
Value of total assets at beginning of year2012-12-31$22,300,570
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$0
Total interest from all sources2012-12-31$840,532
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$20,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$7,475,173
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$173,004
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$182,919
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$1,569,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$1,835,000
Total non interest bearing cash at end of year2012-12-31$1,009
Total non interest bearing cash at beginning of year2012-12-31$236,702
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$820,531
Value of net assets at end of year (total assets less liabilities)2012-12-31$21,286,101
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$20,465,570
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Income. Interest from US Government securities2012-12-31$839,992
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$1,382,610
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$540
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$9,327,143
Asset value of US Government securities at end of year2012-12-31$19,029,326
Asset value of US Government securities at beginning of year2012-12-31$20,277,150
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$16,956,723
Employer contributions (assets) at end of year2012-12-31$1,264,762
Employer contributions (assets) at beginning of year2012-12-31$1,603,799
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$15,481,131
Asset. Corporate debt instrument debt (other) at end of year2012-12-31$1,004,390
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Aggregate proceeds on sale of assets2012-12-31$824,000
Aggregate carrying amount (costs) on sale of assets2012-12-31$809,193
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31DELOITTE & TOUCHE, LLP
Accountancy firm EIN2012-12-31133891517
2011 : MEDICAL EXPENSE COVERAGE PLAN 2011 401k financial data
Unrealized appreciation/depreciation of real estate assets2011-12-31$1,867,405
Total unrealized appreciation/depreciation of assets2011-12-31$1,867,405
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$1,835,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$1,885,000
Total income from all sources (including contributions)2011-12-31$28,347,356
Total loss/gain on sale of assets2011-12-31$604
Total of all expenses incurred2011-12-31$25,938,946
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$25,938,946
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$25,657,245
Value of total assets at end of year2011-12-31$22,300,570
Value of total assets at beginning of year2011-12-31$19,942,160
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$0
Total interest from all sources2011-12-31$822,102
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$20,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$7,629,822
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$182,919
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$161,423
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$1,835,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$1,885,000
Total non interest bearing cash at end of year2011-12-31$236,702
Total non interest bearing cash at beginning of year2011-12-31$961,267
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$2,408,410
Value of net assets at end of year (total assets less liabilities)2011-12-31$20,465,570
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$18,057,160
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Income. Interest from US Government securities2011-12-31$821,345
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$757
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$9,336,665
Asset value of US Government securities at end of year2011-12-31$20,277,150
Asset value of US Government securities at beginning of year2011-12-31$17,067,042
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$18,027,423
Employer contributions (assets) at end of year2011-12-31$1,603,799
Employer contributions (assets) at beginning of year2011-12-31$1,752,428
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$16,602,281
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Aggregate proceeds on sale of assets2011-12-31$1,085,000
Aggregate carrying amount (costs) on sale of assets2011-12-31$1,084,396
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31DELOITTE & TOUCHE, LLP
Accountancy firm EIN2011-12-31133891517
2010 : MEDICAL EXPENSE COVERAGE PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$-595,316
Total unrealized appreciation/depreciation of assets2010-12-31$-595,316
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$1,885,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$1,912,000
Total income from all sources (including contributions)2010-12-31$24,996,440
Total loss/gain on sale of assets2010-12-31$634
Total of all expenses incurred2010-12-31$24,952,947
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$24,952,947
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$24,779,532
Value of total assets at end of year2010-12-31$19,942,160
Value of total assets at beginning of year2010-12-31$19,898,667
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$0
Total interest from all sources2010-12-31$811,590
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$20,000,000
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$7,473,872
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$-53,030
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$161,423
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$186,530
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$1,885,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$1,912,000
Total non interest bearing cash at end of year2010-12-31$961,267
Total non interest bearing cash at beginning of year2010-12-31$347,113
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$43,493
Value of net assets at end of year (total assets less liabilities)2010-12-31$18,057,160
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$17,986,667
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Income. Interest from US Government securities2010-12-31$809,691
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$1,899
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$9,699,837
Asset value of US Government securities at end of year2010-12-31$17,067,042
Asset value of US Government securities at beginning of year2010-12-31$17,607,579
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$17,305,660
Employer contributions (assets) at end of year2010-12-31$1,752,428
Employer contributions (assets) at beginning of year2010-12-31$1,757,445
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$15,306,140
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$4,400,000
Aggregate carrying amount (costs) on sale of assets2010-12-31$4,399,366
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31DELOITTE & TOUCHE, LLP
Accountancy firm EIN2010-12-31133891517

Form 5500 Responses for MEDICAL EXPENSE COVERAGE PLAN

2015: MEDICAL EXPENSE COVERAGE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01This submission is the final filingYes
2015-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: MEDICAL EXPENSE COVERAGE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: MEDICAL EXPENSE COVERAGE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: MEDICAL EXPENSE COVERAGE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: MEDICAL EXPENSE COVERAGE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: MEDICAL EXPENSE COVERAGE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number1876
Policy instance 1
Insurance contract or identification number1876
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 )
Policy contract number100573
Policy instance 2
Insurance contract or identification number100573
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number1876
Policy instance 2
Insurance contract or identification number1876
Number of Individuals Covered1984
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $5,870
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $10,380,017
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees5870
Additional information about fees paid to insurance brokerBROKER
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON DELAWARE INC.
PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95005 )
Policy contract number100573
Policy instance 1
Insurance contract or identification number100573
Number of Individuals Covered33
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $158,678
PROVIDENCE MEDICARE SUPPLEMENT (National Association of Insurance Commissioners NAIC id number: 95005 )
Policy contract number100573
Policy instance 1
Insurance contract or identification number100573
Number of Individuals Covered33
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $130,277
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number1876
Policy instance 2
Insurance contract or identification number1876
Number of Individuals Covered1978
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $10,529,174
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PROVIDENCE MEDICARE SUPPLEMENT (National Association of Insurance Commissioners NAIC id number: 95005 )
Policy contract number100573
Policy instance 2
Insurance contract or identification number100573
Number of Individuals Covered34
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $149,346
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number1876
Policy instance 1
Insurance contract or identification number1876
Number of Individuals Covered2079
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,566
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $9,327,502
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees2566
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameTOWERS WATSON PENNSYLVANIA INC
PROVIDENCE MEDICARE SUPPLEMENT (National Association of Insurance Commissioners NAIC id number: 95005 )
Policy contract number100573
Policy instance 1
Insurance contract or identification number100573
Number of Individuals Covered29
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $140,723
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number1876
Policy instance 2
Insurance contract or identification number1876
Number of Individuals Covered1009
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,589
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $9,330,983
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number1876
Policy instance 1
Insurance contract or identification number1876
Number of Individuals Covered1020
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,563
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $8,861,442
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PROVIDENCE MEDICARE SUPPLEMENT (National Association of Insurance Commissioners NAIC id number: 95005 )
Policy contract number100573
Policy instance 2
Insurance contract or identification number100573
Number of Individuals Covered26
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $125,582
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract number376413
Policy instance 3
Insurance contract or identification number376413
Number of Individuals Covered47
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $15,402
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $814,812
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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