COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN
401k plan membership statisitcs for COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN
| Measure | Date | Value |
|---|
| 2023: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-01-01 | 7,542 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 7,678 |
| Number of retired or separated participants receiving benefits | 2023-01-01 | 74 |
| Total of all active and inactive participants | 2023-01-01 | 7,752 |
| 2022: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 7,087 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 7,516 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 89 |
| Total of all active and inactive participants | 2022-01-01 | 7,605 |
| 2021: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 7,132 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 7,016 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 35 |
| Total of all active and inactive participants | 2021-01-01 | 7,051 |
| 2020: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 8,944 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 6,920 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 98 |
| Total of all active and inactive participants | 2020-01-01 | 7,018 |
| 2019: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 8,278 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 7,029 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 65 |
| Total of all active and inactive participants | 2019-01-01 | 7,094 |
| 2018: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 7,425 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 6,887 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 69 |
| Total of all active and inactive participants | 2018-01-01 | 6,956 |
| 2017: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 7,319 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 6,930 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 58 |
| Total of all active and inactive participants | 2017-01-01 | 6,988 |
| 2016: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 6,593 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 6,848 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 47 |
| Total of all active and inactive participants | 2016-01-01 | 6,895 |
| 2015: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 6,142 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 6,546 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 47 |
| Total of all active and inactive participants | 2015-01-01 | 6,593 |
| Total participants | 2015-01-01 | 0 |
| 2014: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 5,962 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 6,094 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 48 |
| Total of all active and inactive participants | 2014-01-01 | 6,142 |
| Total participants | 2014-01-01 | 0 |
| 2013: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 5,364 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 5,907 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 55 |
| Total of all active and inactive participants | 2013-01-01 | 5,962 |
| Total participants | 2013-01-01 | 0 |
| 2011: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 4,771 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 5,026 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 71 |
| Total of all active and inactive participants | 2011-01-01 | 5,097 |
| Total participants | 2011-01-01 | 5,097 |
| 2010: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 4,907 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 4,771 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 63 |
| Total of all active and inactive participants | 2010-01-01 | 4,834 |
| Total participants | 2010-01-01 | 4,834 |
| 2009: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 4,530 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 4,907 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 48 |
| Total of all active and inactive participants | 2009-01-01 | 4,955 |
| Total participants | 2009-01-01 | 4,955 |
| 2023: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2023 form 5500 responses |
|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2022: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HEALTH PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| COMMUNITY CARE HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | N/A |
| Policy instance | 3 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 8569 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $49,673,946 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 30028152 |
| Policy instance | 2 |
| Insurance contract or identification number | 30028152 | | Number of Individuals Covered | 7715 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 76489 |
| Policy instance | 1 |
| Insurance contract or identification number | 76489 | | Number of Individuals Covered | 1719 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $269,511 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COMMUNITY CARE HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | N/A |
| Policy instance | 3 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 8604 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $48,253,469 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 30028152 |
| Policy instance | 2 |
| Insurance contract or identification number | 30028152 | | Number of Individuals Covered | 7384 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 76489 |
| Policy instance | 1 |
| Insurance contract or identification number | 76489 | | Number of Individuals Covered | 1584 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $232,396 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 76489 |
| Policy instance | 1 |
| Insurance contract or identification number | 76489 | | Number of Individuals Covered | 1440 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $206,307 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 30028152 |
| Policy instance | 2 |
| Insurance contract or identification number | 30028152 | | Number of Individuals Covered | 6899 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COMMUNITY CARE HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | N/A |
| Policy instance | 3 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 3752 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $46,975,604 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COMMUNITY CARE HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | N/A |
| Policy instance | 3 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 3752 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $45,344,599 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 30028152 |
| Policy instance | 2 |
| Insurance contract or identification number | 30028152 | | Number of Individuals Covered | 7008 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 76489 |
| Policy instance | 1 |
| Insurance contract or identification number | 76489 | | Number of Individuals Covered | 1238 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $177,038 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COMMUNITY CARE HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | N/A |
| Policy instance | 3 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 2431 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 30028152 |
| Policy instance | 2 |
| Insurance contract or identification number | 30028152 | | Number of Individuals Covered | 6911 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 76489 |
| Policy instance | 1 |
| Insurance contract or identification number | 76489 | | Number of Individuals Covered | 970 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $148,059 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 76489 |
| Policy instance | 1 |
| Insurance contract or identification number | 76489 | | Number of Individuals Covered | 1109 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $160,810 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 30028152 |
| Policy instance | 2 |
| Insurance contract or identification number | 30028152 | | Number of Individuals Covered | 6814 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GF3860066717-01 |
| Policy instance | 3 |
| Insurance contract or identification number | GF3860066717-01 | | Number of Individuals Covered | 7436 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $64,498 | | Total amount of fees paid to insurance company | USD $29,640 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,262,943 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $41,984 | | Amount paid for insurance broker fees | 10392 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 402270G |
| Policy instance | 4 |
| Insurance contract or identification number | 402270G | | Number of Individuals Covered | 7396 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $90,741 | | Total amount of fees paid to insurance company | USD $53,476 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $2,011,581 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $67,503 | | Amount paid for insurance broker fees | 17410 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 402270G |
| Policy instance | 4 |
| Insurance contract or identification number | 402270G | | Number of Individuals Covered | 7323 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $100,004 | | Total amount of fees paid to insurance company | USD $33,215 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $1,803,322 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $100,004 | | Amount paid for insurance broker fees | 33215 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 | | Insurance broker name | TOWERS WATSON DELAWARE INC |
|
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 76489 |
| Policy instance | 1 |
| Insurance contract or identification number | 76489 | | Number of Individuals Covered | 1011 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $148,769 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 30028152 |
| Policy instance | 2 |
| Insurance contract or identification number | 30028152 | | Number of Individuals Covered | 6687 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GF3860066717-01 |
| Policy instance | 3 |
| Insurance contract or identification number | GF3860066717-01 | | Number of Individuals Covered | 8457 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $14,589 | | Total amount of fees paid to insurance company | USD $5,145 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $321,385 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,589 | | Amount paid for insurance broker fees | 3546 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | AON RISK SERVICES CENTRAL INC |
|
| COMMUNITY CARE HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | N/A |
| Policy instance | 1 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 1782 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 170202 |
| Policy instance | 2 |
| Insurance contract or identification number | 170202 | | Number of Individuals Covered | 6546 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of fees paid to insurance company | USD $1,140,847 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1140847 | | Additional information about fees paid to insurance broker | THE SERVICES, AND FEES, AS SET FORTH IN THE ADMINISTRATIVE AGREEMENT. | | Insurance broker name | ANTHEM BLUE CROSS LIFE AND HEALTH |
|
| COMMUNITY CARE HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | N/A |
| Policy instance | 1 |
| Insurance contract or identification number | N/A | | Number of Individuals Covered | 1819 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 170202 |
| Policy instance | 2 |
| Insurance contract or identification number | 170202 | | Number of Individuals Covered | 6094 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of fees paid to insurance company | USD $1,172,514 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1172514 | | Additional information about fees paid to insurance broker | THE SERVICES, AND FEES, AS SET FORTH IN THE ADMINISTRATIVE AGREEMENT. | | Insurance broker name | ANTHEM BLUE CROSS LIFE AND HEALTH |
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| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 170202 |
| Policy instance | 2 |
| Insurance contract or identification number | 170202 | | Number of Individuals Covered | 5907 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of fees paid to insurance company | USD $786,109 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 786109 | | Additional information about fees paid to insurance broker | THE SERVICES, AND FEES, AS SET FORTH IN THE ADMINISTRATIVE AGREEMENT. | | Insurance broker name | ANTHEM BLUE CROSS LIFE AND HEALTH |
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| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 275275 |
| Policy instance | 1 |
| Insurance contract or identification number | 275275 | | Number of Individuals Covered | 1363 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $310,083 | | Total amount of fees paid to insurance company | USD $33,433 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,410,329 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $310,083 | | Amount paid for insurance broker fees | 33433 | | Insurance broker organization code? | 3 | | Insurance broker name | VILLANE WARD INSURANCE SERV INC. |
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| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 275275 |
| Policy instance | 2 |
| Insurance contract or identification number | 275275 | | Number of Individuals Covered | 1220 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $142,966 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,334,588 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 170202 |
| Policy instance | 1 |
| Insurance contract or identification number | 170202 | | Number of Individuals Covered | 3807 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of fees paid to insurance company | USD $648,056 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) |
| Policy contract number | 170202 |
| Policy instance | 1 |
| Insurance contract or identification number | 170202 | | Number of Individuals Covered | 3138 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of fees paid to insurance company | USD $557,763 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 557763 | | Additional information about fees paid to insurance broker | THE SERVICES, AND FEES, AS SET FORTH IN THE ADMINISTRATIVE AGREEMENT. | | Insurance broker name | ANTHEM BLUE CORSS LIFE AND HEALTH |
|
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 275275 |
| Policy instance | 2 |
| Insurance contract or identification number | 275275 | | Number of Individuals Covered | 1633 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $170,098 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,300,986 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $170,098 | | Insurance broker organization code? | 3 | | Insurance broker name | AHART BENEFIT INSURANCE SERVICES |
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