SANSEI GARDENS, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan NEW IMAGE LANDSCAPE & SENSEI GARDENS HEALTH AND WELFARE PLAN
401k plan membership statisitcs for NEW IMAGE LANDSCAPE & SENSEI GARDENS HEALTH AND WELFARE PLAN
Measure | Date | Value |
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2022: NEW IMAGE LANDSCAPE & SENSEI GARDENS HEALTH AND WELFARE PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-11-01 | 121 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-11-01 | 121 |
Number of retired or separated participants receiving benefits | 2022-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2022-11-01 | 0 |
Total of all active and inactive participants | 2022-11-01 | 121 |
Number of employers contributing to the scheme | 2022-11-01 | 0 |
2021: NEW IMAGE LANDSCAPE & SENSEI GARDENS HEALTH AND WELFARE PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-11-01 | 121 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-11-01 | 121 |
Number of retired or separated participants receiving benefits | 2021-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-11-01 | 0 |
Total of all active and inactive participants | 2021-11-01 | 121 |
Number of employers contributing to the scheme | 2021-11-01 | 0 |
2020: NEW IMAGE LANDSCAPE & SENSEI GARDENS HEALTH AND WELFARE PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-11-01 | 146 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-11-01 | 121 |
Total of all active and inactive participants | 2020-11-01 | 121 |
Total participants | 2020-11-01 | 121 |
2019: NEW IMAGE LANDSCAPE & SENSEI GARDENS HEALTH AND WELFARE PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-11-01 | 164 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-11-01 | 166 |
Total of all active and inactive participants | 2019-11-01 | 166 |
Total participants | 2019-11-01 | 166 |
2018: NEW IMAGE LANDSCAPE & SENSEI GARDENS HEALTH AND WELFARE PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-11-01 | 145 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-11-01 | 164 |
Total of all active and inactive participants | 2018-11-01 | 164 |
Total participants | 2018-11-01 | 164 |
2017: NEW IMAGE LANDSCAPE & SENSEI GARDENS HEALTH AND WELFARE PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-11-01 | 133 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-11-01 | 145 |
Total of all active and inactive participants | 2017-11-01 | 145 |
Total participants | 2017-11-01 | 145 |
2016: NEW IMAGE LANDSCAPE & SENSEI GARDENS HEALTH AND WELFARE PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-11-01 | 136 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-11-01 | 133 |
Total of all active and inactive participants | 2016-11-01 | 133 |
Total participants | 2016-11-01 | 133 |
2015: NEW IMAGE LANDSCAPE & SENSEI GARDENS HEALTH AND WELFARE PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-11-01 | 111 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-11-01 | 136 |
Total of all active and inactive participants | 2015-11-01 | 136 |
Total participants | 2015-11-01 | 136 |
2014: NEW IMAGE LANDSCAPE & SENSEI GARDENS HEALTH AND WELFARE PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-11-01 | 113 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-11-01 | 111 |
Number of retired or separated participants receiving benefits | 2014-11-01 | 0 |
Total of all active and inactive participants | 2014-11-01 | 111 |
2022: NEW IMAGE LANDSCAPE & SENSEI GARDENS HEALTH AND WELFARE PLAN 2022 form 5500 responses |
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2022-11-01 | Type of plan entity | Single employer plan |
2022-11-01 | Plan funding arrangement – Insurance | Yes |
2022-11-01 | Plan benefit arrangement – Insurance | Yes |
2021: NEW IMAGE LANDSCAPE & SENSEI GARDENS HEALTH AND WELFARE PLAN 2021 form 5500 responses |
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2021-11-01 | Type of plan entity | Single employer plan |
2021-11-01 | Plan funding arrangement – Insurance | Yes |
2021-11-01 | Plan benefit arrangement – Insurance | Yes |
2020: NEW IMAGE LANDSCAPE & SENSEI GARDENS HEALTH AND WELFARE PLAN 2020 form 5500 responses |
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2020-11-01 | Type of plan entity | Single employer plan |
2020-11-01 | Submission has been amended | No |
2020-11-01 | This submission is the final filing | No |
2020-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-11-01 | Plan is a collectively bargained plan | No |
2020-11-01 | Plan funding arrangement – Insurance | Yes |
2020-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-11-01 | Plan benefit arrangement – Insurance | Yes |
2020-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2019: NEW IMAGE LANDSCAPE & SENSEI GARDENS HEALTH AND WELFARE PLAN 2019 form 5500 responses |
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2019-11-01 | Type of plan entity | Single employer plan |
2019-11-01 | Submission has been amended | No |
2019-11-01 | This submission is the final filing | No |
2019-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2019-11-01 | Plan is a collectively bargained plan | No |
2019-11-01 | Plan funding arrangement – Insurance | Yes |
2019-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-11-01 | Plan benefit arrangement – Insurance | Yes |
2019-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2018: NEW IMAGE LANDSCAPE & SENSEI GARDENS HEALTH AND WELFARE PLAN 2018 form 5500 responses |
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2018-11-01 | Type of plan entity | Single employer plan |
2018-11-01 | Submission has been amended | No |
2018-11-01 | This submission is the final filing | No |
2018-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-11-01 | Plan is a collectively bargained plan | No |
2018-11-01 | Plan funding arrangement – Insurance | Yes |
2018-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-11-01 | Plan benefit arrangement – Insurance | Yes |
2018-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: NEW IMAGE LANDSCAPE & SENSEI GARDENS HEALTH AND WELFARE PLAN 2017 form 5500 responses |
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2017-11-01 | Type of plan entity | Single employer plan |
2017-11-01 | Submission has been amended | No |
2017-11-01 | This submission is the final filing | No |
2017-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-11-01 | Plan is a collectively bargained plan | No |
2017-11-01 | Plan funding arrangement – Insurance | Yes |
2017-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-11-01 | Plan benefit arrangement – Insurance | Yes |
2017-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: NEW IMAGE LANDSCAPE & SENSEI GARDENS HEALTH AND WELFARE PLAN 2016 form 5500 responses |
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2016-11-01 | Type of plan entity | Single employer plan |
2016-11-01 | Submission has been amended | No |
2016-11-01 | This submission is the final filing | No |
2016-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-11-01 | Plan is a collectively bargained plan | No |
2016-11-01 | Plan funding arrangement – Insurance | Yes |
2016-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-11-01 | Plan benefit arrangement – Insurance | Yes |
2016-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: NEW IMAGE LANDSCAPE & SENSEI GARDENS HEALTH AND WELFARE PLAN 2015 form 5500 responses |
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2015-11-01 | Type of plan entity | Single employer plan |
2015-11-01 | Submission has been amended | No |
2015-11-01 | This submission is the final filing | No |
2015-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-11-01 | Plan is a collectively bargained plan | No |
2015-11-01 | Plan funding arrangement – Insurance | Yes |
2015-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-11-01 | Plan benefit arrangement – Insurance | Yes |
2015-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2014: NEW IMAGE LANDSCAPE & SENSEI GARDENS HEALTH AND WELFARE PLAN 2014 form 5500 responses |
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2014-11-01 | Type of plan entity | Single employer plan |
2014-11-01 | First time form 5500 has been submitted | Yes |
2014-11-01 | Submission has been amended | No |
2014-11-01 | This submission is the final filing | No |
2014-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-11-01 | Plan is a collectively bargained plan | No |
2014-11-01 | Plan funding arrangement – Insurance | Yes |
2014-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-11-01 | Plan benefit arrangement – Insurance | Yes |
2014-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
NATIONAL GUARDIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: ) |
Policy contract number | F22001, F22002 |
Policy instance | 2 |
Insurance contract or identification number | F22001, F22002 | Number of Individuals Covered | 98 | Insurance policy start date | 2022-11-01 | Insurance policy end date | 2023-10-31 | Total amount of commissions paid to insurance broker | USD $5,292 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $76,502 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,292 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 604516 |
Policy instance | 1 |
Insurance contract or identification number | 604516 | Number of Individuals Covered | 136 | Insurance policy start date | 2022-11-01 | Insurance policy end date | 2023-10-31 | Total amount of commissions paid to insurance broker | USD $44,992 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $931,636 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $23,947 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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NATIONAL GUARDIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: ) |
Policy contract number | F22001. F22002 |
Policy instance | 2 |
Insurance contract or identification number | F22001. F22002 | Number of Individuals Covered | 112 | Insurance policy start date | 2021-11-01 | Insurance policy end date | 2022-10-31 | Total amount of commissions paid to insurance broker | USD $5,058 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $79,125 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,058 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 604516 |
Policy instance | 1 |
Insurance contract or identification number | 604516 | Number of Individuals Covered | 163 | Insurance policy start date | 2021-11-01 | Insurance policy end date | 2022-10-31 | Total amount of commissions paid to insurance broker | USD $46,212 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $918,910 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $39,022 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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NATIONAL GUARDIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: ) |
Policy contract number | F22-001 ET AL |
Policy instance | 2 |
Insurance contract or identification number | F22-001 ET AL | Number of Individuals Covered | 49 | Insurance policy start date | 2020-11-01 | Insurance policy end date | 2021-10-31 | Total amount of commissions paid to insurance broker | USD $5,887 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $79,400 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,887 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 604516 |
Policy instance | 1 |
Insurance contract or identification number | 604516 | Number of Individuals Covered | 121 | Insurance policy start date | 2020-11-01 | Insurance policy end date | 2021-10-31 | Total amount of commissions paid to insurance broker | USD $39,318 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $1,141,452 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $39,318 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | F22-001 ET AL |
Policy instance | 2 |
Insurance contract or identification number | F22-001 ET AL | Number of Individuals Covered | 126 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-10-31 | Total amount of commissions paid to insurance broker | USD $13,219 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $96,714 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,219 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 604516 |
Policy instance | 1 |
Insurance contract or identification number | 604516 | Number of Individuals Covered | 166 | Insurance policy start date | 2019-11-01 | Insurance policy end date | 2020-10-31 | Total amount of commissions paid to insurance broker | USD $47,708 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $881,653 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $47,708 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | F22-001 F22-002 |
Policy instance | 2 |
Insurance contract or identification number | F22-001 F22-002 | Number of Individuals Covered | 116 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-10-31 | Total amount of commissions paid to insurance broker | USD $5,784 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $94,704 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,784 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 604516 |
Policy instance | 1 |
Insurance contract or identification number | 604516 | Number of Individuals Covered | 164 | Insurance policy start date | 2018-11-01 | Insurance policy end date | 2019-10-31 | Total amount of commissions paid to insurance broker | USD $38,697 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $864,928 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $38,697 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | F22-001 & 002 |
Policy instance | 2 |
Insurance contract or identification number | F22-001 & 002 | Number of Individuals Covered | 121 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2018-10-31 | Total amount of commissions paid to insurance broker | USD $4,070 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $65,646 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 604516 |
Policy instance | 1 |
Insurance contract or identification number | 604516 | Number of Individuals Covered | 145 | Insurance policy start date | 2017-11-01 | Insurance policy end date | 2018-10-31 | Total amount of commissions paid to insurance broker | USD $32,402 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $625,378 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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NATIONAL GUARDIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: ) |
Policy contract number | F22-36269 |
Policy instance | 2 |
Insurance contract or identification number | F22-36269 | Number of Individuals Covered | 62 | Insurance policy start date | 2015-11-01 | Insurance policy end date | 2016-10-31 | Total amount of commissions paid to insurance broker | USD $4,578 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $45,784 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,578 | Insurance broker organization code? | 3 | Insurance broker name | AMES-GRENZ INSURANCE SERVICES, INC. |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 604516 |
Policy instance | 1 |
Insurance contract or identification number | 604516 | Number of Individuals Covered | 136 | Insurance policy start date | 2015-11-01 | Insurance policy end date | 2016-10-31 | Total amount of commissions paid to insurance broker | USD $27,974 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $551,009 | Commission paid to Insurance Broker | USD $27,974 | Insurance broker organization code? | 3 | Insurance broker name | AMES-GRENZ INSURANCE SERVICES, INC. |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 604516 |
Policy instance | 1 |
Insurance contract or identification number | 604516 | Number of Individuals Covered | 111 | Insurance policy start date | 2014-11-01 | Insurance policy end date | 2015-10-31 | Total amount of commissions paid to insurance broker | USD $24,873 | Total amount of fees paid to insurance company | USD $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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | 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 Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | 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 Carrier | USD $505,918 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,873 | Insurance broker organization code? | 3 | Insurance broker name | AMES-GRENZ INSURANCE SERVICES, INC. |
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