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PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 401k Plan overview

Plan NamePACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES
Plan identification number 541

PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES Benefits

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

401k Sponsoring company profile

PACIFIC GAS AND ELECTRIC COMPANY has sponsored the creation of one or more 401k plans.

Company Name:PACIFIC GAS AND ELECTRIC COMPANY
Employer identification number (EIN):940742640
NAIC Classification:221100

Additional information about PACIFIC GAS AND ELECTRIC COMPANY

Jurisdiction of Incorporation: California Department of State
Incorporation Date:
Company Identification Number: C0044131

More information about PACIFIC GAS AND ELECTRIC COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5412022-01-01ASHLEY MAWHORTER2023-10-03
5412021-01-01ASHLEY MAWHORTER2022-10-05
5412020-01-01
5412019-01-01
5412018-01-01
5412017-01-01JASON WELLS
5412016-01-01JASON WELLS
5412015-01-01JASON WELLS
5412014-01-01WILLIAM SHELLEY
5412013-01-01JOHN SIMON
5412012-01-01JOHN SIMON
5412011-01-01JOHN SIMON
5412009-01-01JOHN R. SIMON, SVP - HR JOHN R. SIMON, SVP - HR2010-10-11
5412009-01-01JOHN R. SIMON, SVP - HR JOHN R. SIMON, SVP - HR2010-10-11

Plan Statistics for PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES

401k plan membership statisitcs for PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES

Measure Date Value
2022: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2022 401k membership
Total participants, beginning-of-year2022-01-0125,425
Total number of active participants reported on line 7a of the Form 55002022-01-0125,253
Number of retired or separated participants receiving benefits2022-01-0198
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-0125,351
2021: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2021 401k membership
Total participants, beginning-of-year2021-01-0124,375
Total number of active participants reported on line 7a of the Form 55002021-01-0125,339
Number of retired or separated participants receiving benefits2021-01-0186
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-0125,425
2020: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2020 401k membership
Total participants, beginning-of-year2020-01-0123,009
Total number of active participants reported on line 7a of the Form 55002020-01-0124,303
Number of retired or separated participants receiving benefits2020-01-0172
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0124,375
2019: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2019 401k membership
Total participants, beginning-of-year2019-01-0123,096
Total number of active participants reported on line 7a of the Form 55002019-01-0122,965
Number of retired or separated participants receiving benefits2019-01-0144
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-0123,009
2018: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2018 401k membership
Total participants, beginning-of-year2018-01-0123,522
Total number of active participants reported on line 7a of the Form 55002018-01-0122,999
Number of retired or separated participants receiving benefits2018-01-0197
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-0123,096
2017: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2017 401k membership
Total participants, beginning-of-year2017-01-0124,176
Total number of active participants reported on line 7a of the Form 55002017-01-0123,393
Number of retired or separated participants receiving benefits2017-01-01129
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-0123,522
2016: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2016 401k membership
Total participants, beginning-of-year2016-01-0123,609
Total number of active participants reported on line 7a of the Form 55002016-01-0124,087
Number of retired or separated participants receiving benefits2016-01-0189
Total of all active and inactive participants2016-01-0124,176
2015: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2015 401k membership
Total participants, beginning-of-year2015-01-0123,101
Total number of active participants reported on line 7a of the Form 55002015-01-0123,489
Number of retired or separated participants receiving benefits2015-01-01120
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-0123,609
2014: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2014 401k membership
Total participants, beginning-of-year2014-01-0122,824
Total number of active participants reported on line 7a of the Form 55002014-01-0123,001
Number of retired or separated participants receiving benefits2014-01-01100
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0123,101
2013: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2013 401k membership
Total participants, beginning-of-year2013-01-0121,552
Total number of active participants reported on line 7a of the Form 55002013-01-0121,402
Number of retired or separated participants receiving benefits2013-01-01183
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-0121,585
2012: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2012 401k membership
Total participants, beginning-of-year2012-01-0120,650
Total number of active participants reported on line 7a of the Form 55002012-01-0121,250
Number of retired or separated participants receiving benefits2012-01-01302
Total of all active and inactive participants2012-01-0121,552
2011: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2011 401k membership
Total participants, beginning-of-year2011-01-0119,853
Total number of active participants reported on line 7a of the Form 55002011-01-0120,341
Number of retired or separated participants receiving benefits2011-01-01309
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-0120,650
2009: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2009 401k membership
Total participants, beginning-of-year2009-01-0120,121
Total number of active participants reported on line 7a of the Form 55002009-01-0119,771
Number of retired or separated participants receiving benefits2009-01-0175
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-0119,846

Form 5500 Responses for PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES

2022: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 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 planYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedYes
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 planYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 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 planYes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 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 planYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: PACIFIC GAS AND ELECTRIC COMPANY HEALTH CARE PLAN FOR ACTIVE EMPLOYEES 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 planYes
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberH11473
Policy instance 1
Insurance contract or identification numberH11473
Number of Individuals Covered7367
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 $67,366
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number68992S ET AL
Policy instance 2
Insurance contract or identification number68992S ET AL
Number of Individuals Covered2447
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 $8,666,175
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberH11473
Policy instance 1
Insurance contract or identification numberH11473
Number of Individuals Covered7367
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 $36,991,809
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number51312
Policy instance 2
Insurance contract or identification number51312
Number of Individuals Covered1860
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 $28,771,938
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number68988G
Policy instance 2
Insurance contract or identification number68988G
Number of Individuals Covered2324
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 $33,838,614
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number28
Policy instance 1
Insurance contract or identification number28
Number of Individuals Covered13408
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 $63,036,423
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberH11473
Policy instance 3
Insurance contract or identification numberH11473
Number of Individuals Covered6723
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 $35,794,480
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 47732 )
Policy contract numberH11473
Policy instance 3
Insurance contract or identification numberH11473
Number of Individuals Covered6119
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 $27,413,561
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number107932
Policy instance 4
Insurance contract or identification number107932
Number of Individuals Covered379
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 $1,683,046
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract number68988G
Policy instance 1
Insurance contract or identification number68988G
Number of Individuals Covered1987
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 $34,386,793
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number28
Policy instance 2
Insurance contract or identification number28
Number of Individuals Covered12459
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 $60,887,831
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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