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KAISER PERMANENTE TAX SHELTERED ANNUITY PLAN III 401k Plan overview

Plan NameKAISER PERMANENTE TAX SHELTERED ANNUITY PLAN III
Plan identification number 002

KAISER PERMANENTE TAX SHELTERED ANNUITY PLAN III Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

KAISER FOUNDATION HEALTH PLAN, INC. has sponsored the creation of one or more 401k plans.

Company Name:KAISER FOUNDATION HEALTH PLAN, INC.
Employer identification number (EIN):941340523
NAIC Classification:621491
NAIC Description:HMO Medical Centers

Additional information about KAISER FOUNDATION HEALTH PLAN, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2002-12-27
Company Identification Number: 0800157095
Legal Registered Office Address: 1 KAISER PLZ STE 445

OAKLAND
United States of America (USA)
94612

More information about KAISER FOUNDATION HEALTH PLAN, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KAISER PERMANENTE TAX SHELTERED ANNUITY PLAN III

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022017-01-04BILL G. REID

Plan Statistics for KAISER PERMANENTE TAX SHELTERED ANNUITY PLAN III

401k plan membership statisitcs for KAISER PERMANENTE TAX SHELTERED ANNUITY PLAN III

Measure Date Value
2017: KAISER PERMANENTE TAX SHELTERED ANNUITY PLAN III 2017 401k membership
Total participants, beginning-of-year2017-01-040
Total number of active participants reported on line 7a of the Form 55002017-01-0429,651
Number of retired or separated participants receiving benefits2017-01-0422
Number of other retired or separated participants entitled to future benefits2017-01-041,506
Total of all active and inactive participants2017-01-0431,179
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-0413
Total participants2017-01-0431,192
Number of participants with account balances2017-01-0430,799
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-04481

Financial Data on KAISER PERMANENTE TAX SHELTERED ANNUITY PLAN III

Measure Date Value
2017 : KAISER PERMANENTE TAX SHELTERED ANNUITY PLAN III 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total transfer of assets to this plan2017-12-31$1,436,987,999
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$424,541,643
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$66,258,719
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$65,502,631
Value of total corrective distributions2017-12-31$10,761
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$183,742,812
Value of total assets at end of year2017-12-31$1,795,270,923
Value of total assets at beginning of year2017-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$745,327
Total interest from all sources2017-12-31$4,020,216
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$55,849,196
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$55,849,196
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$72,500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$147,269,160
Participant contributions at end of year2017-12-31$41,318,421
Participant contributions at beginning of year2017-12-31$0
Participant contributions at end of year2017-12-31$1,088,857
Participant contributions at beginning of year2017-12-31$0
Assets. Other investments not covered elsewhere at end of year2017-12-31$6,551,878
Assets. Other investments not covered elsewhere at beginning of year2017-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$13,632,499
Other income not declared elsewhere2017-12-31$559,552
Administrative expenses (other) incurred2017-12-31$745,327
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$358,282,924
Value of net assets at end of year (total assets less liabilities)2017-12-31$1,795,270,923
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$1,601,476,053
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$0
Interest on participant loans2017-12-31$1,578,048
Interest earned on other investments2017-12-31$2,442,168
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$140,344,608
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$180,369,867
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$22,841,153
Employer contributions (assets) at end of year2017-12-31$4,491,106
Employer contributions (assets) at beginning of year2017-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$65,502,631
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31MORRIS DAVIS CHAN & TAN LLP
Accountancy firm EIN2017-12-31942214860

Form 5500 Responses for KAISER PERMANENTE TAX SHELTERED ANNUITY PLAN III

2017: KAISER PERMANENTE TAX SHELTERED ANNUITY PLAN III 2017 form 5500 responses
2017-01-04Type of plan entitySingle employer plan
2017-01-04First time form 5500 has been submittedYes
2017-01-04Submission has been amendedNo
2017-01-04This submission is the final filingNo
2017-01-04This return/report is a short plan year return/report (less than 12 months)Yes
2017-01-04Plan is a collectively bargained planNo
2017-01-04Plan funding arrangement – InsuranceYes
2017-01-04Plan funding arrangement – TrustYes
2017-01-04Plan benefit arrangement – InsuranceYes
2017-01-04Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberGAC32782A
Policy instance 1
Insurance contract or identification numberGAC32782A
Number of Individuals Covered2757
Insurance policy start date2017-01-04
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
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

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